Outcomes and moderators of Early Start Denver Model intervention in young children with autism spectrum disorder delivered in a mixed individual and group setting

Autism ◽  
2019 ◽  
Vol 24 (3) ◽  
pp. 718-729 ◽  
Author(s):  
Annarita Contaldo ◽  
Costanza Colombi ◽  
Caterina Pierotti ◽  
Patrizia Masoni ◽  
Filippo Muratori
Keyword(s):  
Autism Spectrum Disorder ◽  
Symptom Severity ◽  
Adaptive Functioning ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Group Setting ◽  
Community Based ◽  
Early Start ◽  
Early Start Denver Model

Several studies have shown the efficacy and effectiveness of the Early Start Denver Model, both in university and in community-based settings. However, a limited number of studies have investigated predictors of outcomes. In this study, we examined outcomes in 32 children diagnosed with autism spectrum disorder after 1 year of community-based Early Start Denver Model intervention, with the aim to identify predictors of treatment objectives acquisition, as measured by the Early Start Denver Model Curriculum Checklist. At a group level, the participants demonstrated improvement in their communication as well as adaptive functioning skills, while they showed a decrease in symptom severity. The large heterogeneity in outcomes identified was related to the pre-treatment non-verbal abilities, symptom severity, action and gesture repertoire, and lexical comprehension. We discussed our results in terms of implications for developing “personalized” interventions for children with autism spectrum disorder.

scholarly journals Integrating the Early Start Denver Model into Israeli community autism spectrum disorder preschools: Effectiveness and treatment response predictors

Autism ◽  
2020 ◽  
Vol 24 (8) ◽  
pp. 2081-2093 ◽  
Author(s):  
Yana Sinai-Gavrilov ◽  
Tali Gev ◽  
Irit Mor-Snir ◽  
Giacomo Vivanti ◽  
Ofer Golan
Keyword(s):  
Autism Spectrum Disorder ◽  
Economic Status ◽  
Intervention Group ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Early Start ◽  
Early Start Denver Model ◽  
Intensive Intervention ◽  
Developmental Intervention

Early intensive intervention has been shown to significantly affect the development of children with autism spectrum disorder. However, the costly implementation of such interventions limits their wide dissemination in the community. This study examined an integration of the Early Start Denver Model into community preschool programs for children with autism spectrum disorder in Israel. Four community preschools implemented the preschool-based Early Start Denver Model and four implemented a multidisciplinary developmental intervention which is widely applied in Israeli community autism spectrum disorder preschools. Fifty-one children (aged 33–57 months) participated in the study. Twenty-six attended the preschool-based Early Start Denver Model preschools and twenty-five attended the multidisciplinary developmental intervention settings. Groups were comparable on age, developmental functioning, and socio-economic status. Compared to the multidisciplinary developmental intervention group, children in the preschool-based Early Start Denver Model treatment made greater gains on blinded measures of overall cognitive development, receptive and expressive language skills, as well as on parent- and teacher-reported adaptive communication and socialization abilities. In the preschool-based Early Start Denver Model group, children with lower symptom severity, higher adaptive functioning, and receptive language abilities at pre-treatment showed greater improvement. This study documents the successful integration of an Early Start Denver Model intervention into pre-existing community preschools, underlining the importance of disseminating evidence-based early intervention in community settings. Lay Abstract Early intensive intervention has been shown to significantly affect the development of children with Autism. However, the costly implementation of such interventions limits their wide dissemination in the community. This study examined an integration of a research-supported early intensive intervention model called the Early Start Denver Model into community preschool programs for children with Autism in Israel. Four community preschools implemented the preschool-based Early Start Denver Model and four implemented the existing multidisciplinary developmental intervention which is widely applied in Israeli community preschools for children with autism. Fifty-one children (aged 33–57 months) participated in the study. Twenty-six attended the preschool-based Early Start Denver Model preschools and twenty-five attended the multidisciplinary developmental intervention preschools. Before the intervention began, groups were comparable on children’s age and developmental functioning and on families’ socio-economic status. Results showed that, compared to the multidisciplinary developmental intervention group, children in the preschool-based Early Start Denver Model treatment group made greater gains on measures of overall cognitive development, language skills, as well as on parent- and teacher-reported adaptive communication and socialization abilities. Children who had lower autism symptom severity, higher adaptive functioning and better language understanding abilities before taking part in the preschool-based Early Start Denver Model program showed greater improvements following it. This study documents the successful implementation of an intensive early intervention program in pre-existing community preschools, underlining the importance of the integration of research-supported intervention programs into community settings.

Preliminary clinical outcomes of a short-term low-intensity Early Start Denver Model implemented in the Taiwanese public health system

Autism ◽  
2020 ◽  
Vol 24 (5) ◽  
pp. 1300-1306
Author(s):  
Tzu-Ling Lin ◽  
Chung-Hsin Chiang ◽  
Suk Yin Ho ◽  
Hsin-Chi Wu ◽  
Ching-Ching Wong
Keyword(s):  
Autism Spectrum Disorder ◽  
Young Children ◽  
Public Health System ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Early Start ◽  
Early Start Denver Model ◽  
Young Children With Autism

The Early Start Denver Model is an evidence-based, comprehensive naturalistic developmental behavioral intervention. Randomized controlled studies indicate that long-term, high-intensity Early Start Denver Model in home-based settings can positively impact the clinical outcomes of young children with autism spectrum disorder. However, it is difficult to deliver high-intensity early intervention in an under-resourced country such as Taiwan. This study evaluated the effects of implementing the Early Start Denver Model with adaptations (including low intensity, shorter duration, and delivery in general hospitals by multidisciplinary professionals) within the Taiwanese public health system. A pre- and post-intervention study was conducted. Sixteen children with autism spectrum disorder (mean age of 33.5 months) received 6 months of one-on-one Early Start Denver Model intervention (approximately 8 h per week). The children showed significant post-intervention improvements in language and overall cognitive functioning and reduced symptom severity in communication and play. This study suggests that delivering the Early Start Denver Model in community-based hospitals may be an effective intervention, with a wider reach, for young children with autism spectrum disorder in Taiwan. The next steps in Taiwan are to incorporate a control group and assess the long-term effects of the adapted Taiwanese Early Start Denver Model program. Lay Abstract The Early Start Denver Model is a comprehensive naturalistic developmental behavioral intervention for young children with autism spectrum disorder. Rigorous studies indicate that long-term, high-intensity Early Start Denver Model in home-based settings can help young children with autism spectrum disorder have great progress in language, cognitive development, and adaptive skills and reduce overall symptom severity. In accordance with the current limitations in resourcing for early intervention in Taiwan, this study evaluated the effects of implementing the Early Start Denver Model in the Taiwanese public health system with some adaptations, including lower intensity, shorter duration, and delivery in general hospitals. A total of 16 children with autism spectrum disorder, aged between 25 and 46 months, received approximately 8 h per week one-on-one Early Start Denver Model intervention. After 6 months of intervention, the children showed great improvements in language and overall cognitive functioning and reduced symptom severity in communication and play. This study suggests that directly delivering the Early Start Denver Model in community-based hospitals may be an effective intervention, which can make more young children with autism spectrum disorder in Taiwan access the Early Start Denver Model service.

Temperament influences the relationship between symptom severity and adaptive functioning in children with autism spectrum disorder

Autism ◽  
2020 ◽  
Vol 24 (8) ◽  
pp. 2057-2070
Author(s):  
Vivian Lee ◽  
Eric Duku ◽  
Lonnie Zwaigenbaum ◽  
Teresa Bennett ◽  
Peter Szatmari ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Symptom Severity ◽  
Adaptive Functioning ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Autism Symptoms ◽  
Adaptive Functioning Skills ◽  
The Impact ◽  
The Relationship

Temperament is a construct that is relatively stable over time but varies between individuals. Research suggests that children with autism spectrum disorder have a ‘reactive’ temperament profile when compared to peers with or without disabilities. However, our understanding of how temperament varies within children with autism and how it relates to child symptoms and outcomes is limited. This study aimed to (a) explore the variation of individual temperament traits within a sample of school-aged children with autism to determine whether subgroups of children with similar trait profiles emerge and (b) examine whether temperament influences the relationship between autism symptoms and adaptive functioning outcomes. Results revealed that children with autism can be classified empirically into two distinct profiles – ‘Even’ and ‘Reactive’ temperaments. Correlational and hierarchical regression analyses indicated that both temperament profiles and baseline symptom severity predicted adaptive functioning outcomes 1 year later. There was a significant interaction between temperament and symptom severity, suggesting temperament can influence the impact of increasing symptom severity on adaptive functioning skills in children with autism. Study findings highlight the importance of considering temperament in understanding the individual differences that influence the development of daily functioning and developmental outcomes in children with autism. Lay Abstract Temperament is often thought of as behavioural traits that are relatively stable over time but can vary between individuals. Children diagnosed with autism spectrum disorder are often characterized as having ‘reactive’ and ‘negative’ temperaments when compared to same-aged peers with or without disabilities, which can negatively impact the development of adaptive functioning skills but little is known about variations of temperament between individual children diagnosed with autism spectrum disorder. This study aimed to (a) explore the variation of individual temperament traits within a sample of school-aged children with autism spectrum disorder to determine whether subgroups with similar trait profiles emerge and (b) examine whether temperament influences the relationship between autism symptoms and adaptive functioning outcomes. Results from our dataset suggest that children diagnosed with autism spectrum disorder fit under two profiles: ‘even’ and ‘reactive’. Furthermore, our analysis shows that temperament can influence the impact of increasing symptom severity on adaptive functioning skills in children with autism spectrum disorder. Study findings highlight the importance of considering temperament when trying to understand the individual differences that influence the development of functioning and developmental outcomes in children with autism spectrum disorder.

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