Abstract
Different early intervention programs, developed predominantly in the US, for preschool aged children with autism spectrum disorders (ASD) have been published. Several systematic review articles including a German Health Technology Assessment on behavioural and skill-based early interventions in children with ASD reported insufficient evidence and a substantial problem of generalisability to the German context. In Germany, approx. 2–5 h early intervention is supported by social services. Here, we report the results of a 1 year pre–post pilot study on a developmentally based social pragmatic approach, the Frankfurt Early Intervention program FFIP. In FFIP, individual 2:1, behaviourally and developmentally based therapy with the child is combined with parent training and training of kindergarten teachers. Treatment frequency is 2 h/week. Outcome measures were the Vineland Adaptive Behaviour Scales II (VABS), mental age and the ADOS severity score. Improvements after 1 year were observed for the VABS socialisation scale and the mental age quotient/IQ (medium effect sizes). Results are comparable with several other studies with a similar or slightly higher therapeutic intensity implementing comparable or different early intervention methods or programs. Compared to most high-intensity programs (30–40 h/week), lower cognitive gains were observed. Results have to be replicated and assessed by a randomized-controlled study before any final conclusions can be drawn.
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References
Billstedt E, Gillberg IC, Gillberg C (2007) Autism in adults: symptom patterns and early childhood predictors. Use of the DISCO in a community sample followed from childhood. J Child Psychol Psychiatry 48:1102–1110
Bolte S, Poustka F (2004) Diagnostic observation scale for autistic disorders: initial results of reliability and validity. Z Kinder Jugendpsychiatr Psychother 32:45–50
Charman T (2003) Why is joint attention a pivotal skill in autism? Philos Trans R Soc Lond B Biol Sci 358:315–324
Cohen H, Amerine-Dickens M, Smith T (2006) Early intensive behavioral treatment: replication of the UCLA model in a community setting. J Dev Behav Pediatr 27:S145–S155
Dawson G, Rogers S, Munson J, Smith M, Winter J, Greenson J, Donaldson A, Varley J (2010) Randomized, controlled trial of an intervention for toddlers with autism: the early start Denver model. Pediatrics 125:e17–e23
Delprato DJ (2001) Comparisons of discrete-trial and normalized behavioral language intervention for young children with autism. J Autism Dev Disord 31:315–325
Eikeseth S, Smith T, Jahr E, Eldevik S (2002) Intensive behavioral treatment at school for 4- to 7-year-old children with autism. A 1-year comparison controlled study. Behav Modif 26:49–68
Eldevik S, Eikeseth S, Jahr E, Smith T (2006) Effects of low-intensity behavioral treatment for children with autism and mental retardation. J Autism Dev Disord 36:211–224
Eldevik S, Jahr E, Eikeseth S, Hastings RP, Hughes CJ (2010) Cognitive and adaptive behavior outcomes of behavioral intervention for young children with intellectual disability. Behav Modif 34:16–34
Fernell E, Hedvall A, Westerlund J, Hoglund CL, Eriksson M, Barnevik OM, Holm A, Norrelgen F, Kjellmer L, Gillberg C (2011) Early intervention in 208 Swedish preschoolers with autism spectrum disorder. A prospective naturalistic study. Res Dev Disabil 32:2092–2101
Freitag CM (2008) Autismus-Spektrum-Störungen. Reinhardt, Munich
Freitag CM (2010) Empirically based early intervention programs for children with autistic disorders—a selective literature review. Z Kinder Jugendpsychiatr Psychother 38:247–256
Gabriels RL, Hill DE, Pierce RA, Rogers SJ, Wehner B (2001) Predictors of treatment outcome in young children with autism: a retrospective study. Autism 5:407–429
Gotham K, Risi S, Pickles A, Lord C (2007) The autism diagnostic observation schedule: revised algorithms for improved diagnostic validity. J Autism Dev Disord 37:613–627
Gotham K, Pickles A, Lord C (2009) Standardizing ADOS scores for a measure of severity in autism spectrum disorders. J Autism Dev Disord 39:693–705
Green J, Charman T, McConachie H, Aldred C, Slonims V, Howlin P, Le CA, Leadbitter K, Hudry K, Byford S, Barrett B, Temple K, Macdonald W, Pickles A (2010) Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial. Lancet 375:2152–2160
Hayward D, Eikeseth S, Gale C, Morgan S (2009) Assessing progress during treatment for young children with autism receiving intensive behavioural interventions. Autism 13:613–633
Howard JS, Sparkman CR, Cohen HG, Green G, Stanislaw H (2005) A comparison of intensive behavior analytic and eclectic treatments for young children with autism. Res Dev Disabil 26:359–383
Howlin P, Goode S, Hutton J, Rutter M (2004) Adult outcome for children with autism. J Child Psychol Psychiatry 45:212–229
Howlin P, Magiati I, Charman T (2009) Systematic review of early intensive behavioral interventions for children with autism. Am J Intellect Dev Disabil 114:23–41
Ingersoll B (2010) Pilot randomized controlled trial of reciprocal imitation training for teaching elicited and spontaneous imitation to children with autism. J Autism Dev Disord 40:1154–1160
Kasari C, Paparella T, Freeman S, Jahromi LB (2008) Language outcome in autism: randomized comparison of joint attention and play interventions. J Consult Clin Psychol 76:125–137
Lord C, Rutter M, Le Couteur A (1994) Autism diagnostic interview-revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord 24:659–685
Lord C, Risi S, Lambrecht L, Cook EH Jr, Leventhal BL, DiLavore PC, Pickles A, Rutter M (2000) The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord 30:205–223
Magiati I, Howlin P (2001) Monitoring the progress of preschool children with autism enrolled in early intervention programmes: problems in cognitive assessment. Autism 5:399–406
Magiati I, Charman T, Howlin P (2007) A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist nursery provision for children with autism spectrum disorders. J Child Psychol Psychiatry 48:803–812
Matson JL, Benavidez DA, Compton LS, Paclawskyj T, Baglio C (1996) Behavioral treatment of autistic persons: a review of research from 1980 to the present. Res Dev Disabil 17:433–465
Oosterling I, Visser J, Swinkels S, Rommelse N, Donders R, Woudenberg T, Roos S, van der Gaag RJ, Buitelaar J (2010) Randomized controlled trial of the focus parent training for toddlers with autism: 1-year outcome. J Autism Dev Disord 40:1447–1458
Ospina MB, Krebs SJ, Clark B, Karkhaneh M, Hartling L, Tjosvold L, Vandermeer B, Smith V (2008) Behavioural and developmental interventions for autism spectrum disorder: a clinical systematic review. PLoS ONE 3:e3755
Peters-Scheffer N, Didden R, Mulders M, Korzilius H (2010) Low intensity behavioral treatment supplementing preschool services for young children with autism spectrum disorders and severe to mild intellectual disability. Res Dev Disabil 31:1678–1684
Poustka F, Lisch S, Ruhl D, Sacher A, Schmotzer G, Werner K (1996) The standardized diagnosis of autism, autism diagnostic interview-revised: interrater reliability of the German form of the interview. Psychopathology 29:145–153
Reuner G, Rosenkranz J, Pietz J, Horn R (2008) Bayley II, 2nd edn. Pearson, Frankfurt (Deutsche Version)
Rogers SJ, Hepburn SL, Stackhouse T, Wehner E (2003) Imitation performance in toddlers with autism and those with other developmental disorders. J Child Psychol Psychiatry 44:763–781
Salt J, Shemilt J, Sellars V, Boyd S, Coulson T, McCool S (2002) The Scottish Centre for autism preschool treatment programme. II The results of a controlled treatment outcome study. Autism 6:33–46
Siller M, Sigman M (2008) Modeling longitudinal change in the language abilities of children with autism: parent behaviors and child characteristics as predictors of change. Dev Psychol 44:1691–1704
Smith T, Eikeseth S, Klevstrand M, Lovaas OI (1997) Intensive behavioral treatment for preschoolers with severe mental retardation and pervasive developmental disorder. Am J Ment Retard 102:238–249
Smith T, Groen AD, Wynn JW (2000) Randomized trial of intensive early intervention for children with pervasive developmental disorder. Am J Ment Retard 105:269–285
Tellegen PJ, Laros JA, Petermann F (2007) Snijders-Oomen nonverbaler intelligenztest von 2½ bis 7 Jahren (SON-R 2½–7). Hogrefe, Göttingen
Sparrow SS, Chicchetti DV, Balla DA (2005) Vineland adaptive behavior scales (Vineland-II), 2nd edn. Pearson, Minneapolis
Tsang SK, Shek DT, Lam LL, Tang FL, Cheung PM (2007) Brief report: application of the TEACCH program on Chinese pre-school children with autism–does culture make a difference? J Autism Dev Disord 37:390–396
Valenti M, Cerbo R, Masedu F, De CM, Sorge G (2010) Intensive intervention for children and adolescents with autism in a community setting in Italy: a single-group longitudinal study. Child Adolesc Psychiatry Ment Health 4:23–32
Weinmann S, Schwarzbach C, Begemann M, Roll S, Vauth C, Willich SN, Greiner W (2009) Behavioural and skill-based early interventions in children with autism spectrum disorders. GMS Health Technol Assess 5:Doc10
Acknowledgments
We thank the parents and their children for taking part in the study. Heiko Zerlaut, Frankfurt, excellently established the data base and supported data entry.
Conflict of interest
The authors report no conflicts of interest with regard to the study. CMF has been on the speaker’s corner of Eli Lilly during the last 12 months.
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Freitag, C.M., Feineis-Matthews, S., Valerian, J. et al. The Frankfurt early intervention program FFIP for preschool aged children with autism spectrum disorder: a pilot study. J Neural Transm 119, 1011–1021 (2012). https://doi.org/10.1007/s00702-012-0792-0
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DOI: https://doi.org/10.1007/s00702-012-0792-0