Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). The Cochrane Database of Systematic Reviews, 10, CD009260

Child Study Center, Yale University School of Medicine, 230 South Frontage Road, PO BOX 207900, New Haven, CT, USA, 06520-7900.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 10/2012; 10(10):CD009260. DOI: 10.1002/14651858.CD009260.pub2
Source: PubMed


Early intensive behavioral intervention (EIBI) is one of the most widely used treatments for children with autism spectrum disorder (ASD). The purpose of our review was to examine the research on EIBI. We found a total of five studies that compared EIBI to generic special education services for children with ASD in schools. Only one study randomly assigned children to a treatment or comparison group, which is considered the 'gold standard' for research. The other four studies used parent preference to assign children to groups. We examined and compared the results of all five studies. A total of 203 children (all were younger than six years old when they started treatment) were included in the five studies. We found that children receiving the EIBI treatment performed better than children in the comparison groups after about two years of treatment on tests of adaptive behavior (behaviors that increase independence and the ability to adapt to one's environment), intelligence, social skills, communication and language, autism symptoms, and quality of life. The evidence supports the use of EIBI for some children with ASD. However, the quality of this evidence is low as only a small number of children were involved in the studies and only one study randomly assigned children to groups.

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Available from: Brian Reichow, Aug 06, 2014
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    • "These complex public health and policy issues require scrutiny of the ASD intervention literature . Using diverse methodologies, systematic reviews have been conducted under the auspices of the Cochrane Collaboration (Reichow, Barton, Boyd, & Hume, 2012), RAND Corporation (Maglione et al., 2012), government agencies in the United States (Warren, Veenstra- VanderWeele et al., 2011; Weitlauf et al., 2014; What Works Clearinghouse, 2010) and United Kingdom (Kendall et al., 2013), and many other organizations and teams of investigators (Reichow, 2012). Given all the changes in the climate for research on ASD interventions , an update on the empirical status of such interventions , based on Journal of Clinical Child & Adolescent Psychology's (JCCAP's) methods criteria (developed specifically for evaluating studies of treatments for childhood behavior disorders), is timely. "
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    ABSTRACT: This evidence base update examines the level of empirical support for interventions for children with autism spectrum disorder (ASD) younger than 5 years old. It focuses on research published since a previous review in this journal (Rogers & Vismara, 2008119. Rogers, S. J. & Vismara, L. A. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child & Adolescent Psychology, 37, 8–38. doi:10.1080/15374410701817808[Taylor & Francis Online], [PubMed], [Web of Science ®]View all references). We identified psychological or behavioral interventions that had been manualized and evaluated in either (a) experimental or quasi-experimental group studies or (b) systematic reviews of single-subject studies. We extracted data from all studies that met these criteria and were published after the previous review. Interventions were categorized across two dimensions. First, primary theoretical principles included applied behavior analysis (ABA), developmental social-pragmatic (DSP), or both. Second, practice elements included scope (comprehensive or focused), modality (individual intervention with the child, parent training, or classrooms), and intervention targets (e.g., spoken language or alternative and augmentative communication). We classified two interventions as well-established (individual, comprehensive ABA and teacher-implemented, focused ABA + DSP), 3 as probably efficacious (individual, focused ABA for augmentative and alternative communication; individual, focused ABA + DSP; and focused DSP parent training), and 5 as possibly efficacious (individual, comprehensive ABA + DSP; comprehensive ABA classrooms; focused ABA for spoken communication; focused ABA parent training; and teacher-implemented, focused DSP). The evidence base for ASD interventions has grown substantially since 2008. An increasing number of interventions have some empirical support; others are emerging as potentially efficacious. Priorities for future research include improving outcome measures, developing interventions for understudied ASD symptoms (e.g., repetitive behaviors), pinpointing mechanisms of action in interventions, and adapting interventions for implementation with fidelity by community providers.
    Preview · Article · Nov 2015 · Journal of Clinical Child & Adolescent Psychology
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    • "From a theoretical point of view, differentiating between autism subtypes is not crucial because to a certain extent the same three core domains are involved (Allen, et al., 2001) (Buitelaar, Van der Gaag, Klin, & Volkmar, 1999) (Kim, et al., 2014) (Snow & Lecavalier, 2011) (Walker, et al., 2004) and the same type of intervention is applied (Reichow, et al., 2012) (Rutter, 2006). However, in practical terms, subtyping autism is essential for several reasons. "
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    ABSTRACT: The objective of this study was to identify differences between and determine predictors for Autistic Disorder (AD) and Pervasive developmental disorder not otherwise specified (PDD-NOS). The motivation behind this is that the criteria for PDD-NOS stated in the Diagnostic and Statistical Manual of Mental Disorders - fourth edition (DSM-4) are ambiguous and need clarification in order to formulate more precise and validated criteria. Differences and predictors were derived from the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), a questionnaire which is conducted as part of Routine Outcome Monitoring in mental health institutions. Participants originated from a pool of individuals who were assessed at the child- and adolescent psychiatric department of the University Medical Centre Utrecht (The Netherlands). Seventy-two children and adolescents with AD (mean age 9.5 years, SD= 4.2) and 75 with PDD-NOS (mean age 9.6 years, SD= 4.2) were included and analyzed with on 15 items of the HoNOSCA. Independent sample T-test showed that the AD subgroup displayed significantly more problems on the items ‘overactivity, attention or concentration’, ‘scholastic or language skills’ and ‘self-care and independence’ whereas the PDD-NOS subgroup displayed significantly more problems regarding ‘emotional and related symptoms’. Binary logistic regression revealed that more problems on ‘overactivity, attention or concentration’, ‘self-care and independence’ and ‘disruptive, antisocial or aggressive behavior’ are predictive for AD rather than PDD-NOS with respectively OR of 2.06 (95%C.I. 1.34-3.18), 1.75 (95%C.I. 1.30-2.36) and 1.32 (95%C.I. 1.00-1.75). More ‘emotional and related symptoms’ predicted PDD-NOS rather than AD with an OR 1.79 (95%C.I. 1.28-2.49). The HoNOSCA could serve as a rapid and cost-effective instrument to help identify cases of AD and PDD-NOS. Emotional and related symptoms may be useful to formulate new and more precise criteria for PDD-NOS.
    Full-text · Article · Apr 2015
    • "The VABS is well established as an outcomes measure and is arguably more clinically relevant than some other forms of assessment, given that parents or caregivers act as informants , and the assessment therefore focuses on how individuals are generally functioning within their day-to-day lives rather than under prescribed testing conditions. In fact, a recent Cochrane review (Reichow et al., 2012) recommends adaptive behaviour as a more suitable measure of outcome than IQ. The fact that older learners within the sample showed larger gains within the VABS assessment may be explained by a number of factors. "
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    ABSTRACT: Research evaluations of Applied Behaviour Analysis (ABA)-based interventions for children with autism demonstrate positive outcomes. However, little research has focused on the translation of these evidence-based interventions into service delivery models within existing education systems. In the present article, we provide a description of the comprehensive ABA-based educational model used within TreeHouse School, London, UK. In addition, we analyse progress data over 12 months for a group of learners attending the school. Fifty-three students with autism were tested and then re-tested with the Assessment of Basic Language and Learning Skills (ABLLS-R). For 23 of these students a repeated Vineland Adaptive Behavior Scales (VABS) assessment was also available. Repeated measures t-tests revealed statistically significant improvements over time on all ABLLS domains and for all VABS scores. These data provide preliminary evidence that an ABA-based educational model can be integrated into the UK system and produce positive outcomes for children.
    No preview · Article · Feb 2015 · British Journal of Special Education
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