Article One
Hastings, R, Saville, MA, Jones, EW, Grindle, CF, Hastings, RP, Saville, M, Hughes, JC, Huxley, K, Kovshoff, H, Griffith, GM, Walker-Jones, E, Devonshire, K & Remington, B 2012, ‘Outcomes of a Behavioral Education Model for Children With Autism in a Mainstream School Setting,’ Behavior Modification, vol. 36, no. 3, pp. 298-319.
Title
Outcomes of Behavioral Intervention for Children with Autism in Mainstream Preschool Settings.
Researcher
Sigmund Eldevik, Richard P. Hastings, Erik Jahr & J. Carl Hughes
Date of Publication
07 April 2012
Background Information
The article cited above studies the outcome of 12 children who attended an applied behavioural analysis class for one year. The children between 3 and 7 years showed different reactions to the educational intervention being applied for the same period in the typical school setting. The children were introduced to new skills in the first year and then exposed to another set of skills in the second year.
Hypothesis
This study investigates whether early behavioural interventions are delivered successfully on a large scale and in a typical setting and whether community effectiveness will correspond with the psychological intervention applied to manage autism spectrum disorders.
Method
Interestingly most of the data in this research were collected from home-based EIBI programs that university clinics and community-based agencies had implemented. Therefore the primary purpose of this article was to explain how the EIBI program was implemented in the Oslo mainstream preschool by describing its key features and simultaneously comparing the outcomes from individual children’s data that had been collected for the ten years. Lastly, the article concludes by stating that there were documented positive outcomes from implementing the EIBI program, especially in preschool children, compared to the regular exceptional education nursery treatment results.
Results
The results showed that despite having fewer intervention hours, the level outcomes from the groups indicated positive results, specifically a 19.4% change in the IQ reliable levels. The article argues that Early Intensive Behavioral Intervention (EIBI) ‘s benefits young children with autism and should be implemented on a large scale or typical setting. Through methods such as full-time confinement in a recovery centre or home-based programs that local health care centres can coordinate.
Discussion
It effectively answers the research question of whether EIBI is the most effective autism intervention between the two by explaining the importance of having a 13-hour intervention period per week followed by 3 hours of daily support per day. Its meta-analysis shows how thigh intensity studies resulted in more significant changes in IQ and more significant effect size mainly because of a strong relationship between outcome and the intervention hours. However, the article has shortcomings. Despite the strong relationship between the outcome and intensity, it fails to indicate the standards used to measure the intensity of behavioural change, making the validity of all its results more questionable. Secondly, the article needs to explain the intervention in detail. For example, the staff could have used other techniques, such as incidental teaching.
Evaluation
This article benefits the main study because it provides the much-needed data that statistically indicates how significant gains were visible in children receiving EIBI on their adaptive behaviour and IQ. In general, within the first two years, which is remarkable compared to their counterparts in usual special education. Additionally, this article indicates the differences in communication, socialization, and day-to-day living skills. Considering the low-intensity levels of the intervention, this article’s results indicate meaningful gains in the children’s IQ under the program, even though the weekly intervention hours failed to collate with the outcomes recorded significantly. Reasonably because of the little variability in the intensity of the whole study.
Application
It is recommended for immediate application because it holds considerable promise for better delivery of behavioural interventions for children diagnosed with autism.
Article Two
Leaf JB, Leaf JA, Milne C, Taubman M, Oppenheim-Leaf M, Torres N, Townley-Cochran D, Leaf R, McEachin J, Yoder P; Autism Partnership Foundation. An Evaluation of a Behaviorally Based Social Skills Group for Individuals Diagnosed with Autism Spectrum Disorder. J Autism Dev Disord. 2017 Feb; 47(2):243-259.
Title
An Evaluation of a Behaviorally Based Social Skills Group for Individuals Diagnosed with Autism Spectrum Disorder.
Date of publication
February 2017
Researchers
Leaf JB, Leaf JA, Milne C, Taubman M, Oppenheim-Leaf M, Torres N, Townley-Cochran D, Leaf R, McEachin J, and Yoder P
Background Information
This article is a study that evaluates how individuals diagnosed with autism spectrum disorder react to being put in a social skill group aimed at improving their behaviour progressively. The article uses an analysis model which utilizes random control trials on the said individuals by dividing them into two and placing eight people in the random treatment group. At the same time, the remaining seven were also assigned to a waitlist control group.
Hypothesis
What are the overall purpose of behaviorally based social skill groups and their specific influence on improving social behaviours such as greetings, sharing, and joint attention?
Method
The individuals assigned to treatment groups were exposed to 32 hours per week of intervention sessions and underwent behaviour change procedures. By reading this article, the reader can identify those blind evaluators were used to measure the behavioural change in all individuals immediately after being subjected to the intervention. The results showed that all the individuals under the program significantly improved their social behaviour. The study’s rationale states that behaviour-based skill groups are established on the philosophy of behaviour, which means that behaviour results from individual interaction with the environment. This article finds out that the response probability is influenced by a reinforcement event and decreased by an alternative punishing event. This article aims to determine the purpose of behaviour-based skill groups in improving certain social behaviours such as greeting, attention, and social learning. Therefore the article discovers that the implementation of individual subject designs results in the high implementation of behavioural social skills’ consequences. An example of losing graciously is used whereby the learner plays a poker card game with their teacher and is monitored on how they react when to lose.
Results
The findings show that using single-subject treatment designs alongside group designs, the implementation of behaviorally based social skills. It can be a great success since it is an effective method that can play a significant role in improving the social behaviour of individuals who have been diagnosed with autism. This article recommends using specific interventions such as discrete trial teaching and video modelling, which results in these individuals engaging in behaviours like gameplay, joint attention, and better social language. The results also indicate that individuals enrolled in behaviorally based social skill group interventions develop overall high social behaviours compared to those who did not join such groups. They also maintain such behaviours for longer than the latter, even in strange settings.
Discussion
From the discussion above and from the context of social groups, professionals should be sufficiently trained in the social development curriculum to ensure that the teachings they disseminate are helpful and functional. They should also be conversant with how to handle parents raising children diagnosed with ASD. The training should also be intensive, translating to 40 hours of general training in behaviour analytic principles. It can extend to more than 1500 hours based on how the individual will respond to scenarios and questions.
Evaluation
It is essential to understand that when measuring the level of improvements in social behaviour, one must first evaluate the improvement based on observable behaviours before monitoring mental interpretations of behaviour. Therefore this article concludes that researchers are tasked to use a combination of measures to measure these improvements, i.e., sharing, joint attention, and social communication. Other areas to access include interactions, the ability to indulge in play, and the development of friendships. If researchers want to evaluate general/ naturalistic probes, they should subject the learners to display their targeted social behaviour without necessarily providing them with further information, especially in video modelling.
Application
It should be applied soon since a professional should possess specific certifications, qualifications, and credentials before implementing behaviorally-based social skill groups for individuals diagnosed with ASD.
Article Three
Estes A, Munson J, Rogers SJ, Greenson J, Winter J, Dawson G. Long-term outcomes of early intervention in 6-year-old children with an autism spectrum disorder. J Am Acad. Child Adolescent Psychiatry 2015; 54:580-587.
Title
Long-term outcomes of early intervention in 6-year-old children with an autism spectrum disorder.
Researchers
Annette Estes, Jeffrey Munson, Sally J Rogers, Jessica Greenson, Jamie Winter, and Geraldine Dawson.
Date of Publication
2015 28 April.
Background Information
Rather than providing information about autism, this article plays a crucial role in investigating why there are increased questions surrounding the superiority of early interventions in children who have been diagnosed with autism spectrum disorders as compared to usual treatment procedures. The study, therefore, narrows down to their effect on language, cognitive ability, and adaptive behaviour through a systematic review of randomized controlled trials. Thirty-nine children with ASD examined who were aged between 18-30 months and showed tangible evidence of efficacy after treatment.
Research Question
Searched for autism, developmental disorders, and autism spectrum disorder on Google scholar, MEDLINE PubMed, and PsycINFO. The main research question is, “what are the general outcomes of early interventions on children with autism spectrum disorder, specifically those aged six years?”
Method
The children assessed were aged six years, and they settled on those who had completed the intervention two years before. The analysis was conducted across multiple domains of clinicians who needed to be made aware of the status of previous interventions.
Results
The children on early interventions averagely maintained the improvements in behaviour that they had gained two years after being subjected to the program. Some unusual behaviours they maintained are; intellectual ability, symptom severity, adaptive behaviour, and coping well in a challenging environment. However, two years later, the ESDM group also demonstrated high core autism symptoms compared to the group under standard treatment and community intervention. Notably, the two groups showcased little difference in intellectual ability and functioning for children aged six years. Additionally, both groups received equal intervention hours, but the ESDM group recorded fewer hours during post-follow-up sessions.
Discussion
The results above indicate that the gains acquired from early interventions are maintained for more than two years later. Secondly, the core autism symptoms showed much improvement within the ESDM group compared to the COM group; the improvement was interestingly recorded when the ESDM group was subjected to significantly fewer hours.
Evaluation
This study examined the role early interventions play on children when initiated at an early age and their long-term effects on the developmental course of autism, and the study shows that.
Application & implications
This early intervention should be applied immediately because of its potential to improve adaptive behaviour and autism symptom severity.
Article Four
Dawson G, Jones EJ, Merkle K, Venema K, Lowy R, Faja S, et al. Early behavioural intervention is associated with normalized brain activity in young children with autism. J Am Acad Child Adolescent Psychiatry 2012; 51:1150-1159.
Title
Early behavioural intervention is associated with normalized brain activity in young children with autism.
Researchers
Geraldine Dawson, Emily J H Jones, Kristen Merkle, Kaitlin Venema, Rachel Lowy, Susan Faja, Dana Kamara, Michael Murias, Jessica Greenson, Jamie Winter, Milani Smith, Sally J Rogers, and Sara J Webb
Date of Publication
18 August 2018
Background Information
Autism spectrum disorder (ASD) is typically characterized by social communication and interaction impairment resulting in stereotypes, presenting a serious public health challenge. Having been approved by the University of Washington’s institutional review board, this study embarked on a randomized controlled trial to evaluate the efficacy of a detailed developmental behaviour intervention called the Early Start Denver Model (ESDM). Therefore, this study aims to determine how and whether ESDM application can result in gains in IQ, adaptive behaviour, and language, specifically in children. This also goes beyond its scope to explain another secondary outcome measurement known as EEG activity within the trial. Great interest is therefore directed on whether these early interventions can alter the trajectory of children’s brain development.
Research Questions
- What is the efficacy of the comprehensive developmental behavioural intervention, namely the Early Start Denver Model (ESDM), in improving the general outcome of young children diagnosed with ASD?
- What are the typical patterns of EEG activity in children diagnosed with ASD, and how do they respond to various stimuli?
Method
The study collected data from 48 children aged 18-30 months with any persuasive developmental disorder or autistic disorders. They were recruited by local hospitals, preschools, and autism organizations, and they were supposed to be residing within 30 minutes travelling radius of Washington University. An exclusion criterion was also implemented, highlighting seizures, motor and sensory impairment, and significant physical complications. The developing children were then marched with the chronological age of children with ASD during EEG assessment. These children’s age range was between 48-63 months. They also had relatives who had ASD; hence they fall under the Vineland Adaptive Behavior Scales. The male-to-female ratio was 3.5:1 while their ethnicities in percentages were white 72, the remaining 15% represented Asian 12.5 and Latino 12.5 other multi-races
Results
Overall, the ESDM group exhibited a higher level of improvement in, i.e. adaptive social behaviours and language compared to the community intervention cohort. Typical children from the ESDM group also indicated higher cortical activation and a shorter NC latency, while the group under community intervention showed the opposite pattern. Significant cortical activation was demonstrated while viewing objects and improved social behaviour while meeting new faces, while low latency was demonstrated from their event-related potential.
Discussion
As indicated in the results section, the children subjected to ESDM intervention significantly improved their language, adaptive behaviour, and IQ. This was identified by conducting a brain measurement activity in response to meeting new faces at social places versus the stimuli of non-social things like new toys. The experiment showed high perceptual processing of new social faces compared to objects due to these children having close attention and engagement, social stimuli, and better cognitive processing.
Evaluation
From the discussion above, this was successful research because the findings show that early behavioural intervention in children diagnosed with ESDM plays a significant role in brain development normalized patterns, which results in high IQ levels and social behaviour.
Application & implications
It has positive implications, especially on language and IQ; hence it should be implemented soonest.
Article Five
Eapen, V., Črnčec, R., & Walter, A. (2013). Clinical outcomes of an early intervention program for preschool children with an autism spectrum disorder in a community group setting. BMC Pediatrics, 13(1), 1–9.
Title
Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting.
Researchers
Valsamma Eapen, Rudi Črnčec & Amelia Walter
Date of Publication
07 January 2013
Background Information
This article argues that existing information indicates that the Early Start Denver Model (ESDM) and several other early intervention programs can play a significant role in realizing positive outcomes in children diagnosed with Autism Spectrum Disorder (ASD). However, there is an underlying problem of having resource-intensive one-on-one clinical intervention programs which cannot be availed readily within the communities. This has resulted in many children are
Hypothesis
This is a pre-post study of children who had been treated with ESDM.
Method
With a mean age of 49.6 months, the research involved 26 children, a total of which 21 were male. An early intervention program called ESDM integrated relationship and developmental-based approaches with applied behaviour analysis. The children were subjected to these interventions while hosted in a childcare centre. The program was divided into two. The first session lasted 15-20 hours, and the second lasted two hours. A one-on-one ESDM intervention characterized the latter. The programs then lasted for ten months, and the benefits of it were measured by the Mullen Scales of Early Learning (MSEL) as a developmental assessment. Two questionnaires were also utilized, namely the Vineland Adaptive Behaviour Scales and the Social Communication Questionnaire, which were to be filled out by the parents.
Results
The results indicated that it was evident statistically that there was an interventional improvement in preschool-going children’s performance in receptive language, visual reception, and the domains of excessive language alongside their intellectual functioning in general. Results from the questionnaires being filled out by the parents depicted that they reported a significant improvement in their children’s motor and receptive communication skills. Alternatively, they identified a significant drop in autism features, specifically those on the SCQ. Although these results should be confirmed only by utilizing a controlled study experiment, they showed that medium-sized effects were recorded in excess primarily because of maturation.
Discussion
From the results above, this article concludes that the use of predominantly group-based intervention in community dissemination of the ESDM is an effective method that makes it possible for ESDM to be accessible to various communities in the childcare setting. Such interventions have shown potential clinical and economic benefits for the children, parents, and community. However, further studies have indicated a need to incorporate a controlled group, precisely one with standardized ASD assessments.
Evaluation
Since the findings show that preschool going children who have been diagnosed with ASD and who are receiving the ESDM intervention in groups are showing significant clinical gains, then this article’s research question is fully answered because it shows that ESDM has successfully managed to enhance social skills such as communication and receptive language.
Application
Early intervention programs being investigated herein have shown significant positive outcomes; hence they should be implemented almost immediately to help children diagnosed with an autism spectrum disorder to manage their condition.
Comparison
Applied Behavior Analysis
| Similarities | Differences | |
| Article No: 1 | 1. The study investigated applied behaviour analysis.
2. The results were measured during the intervention, before and after. 3. The results indicated significant improvements. |
1. The sample size was 31 children.
2. The children were not randomly assigned to groups because an intake score was used. |
| Article No: 2 | 1. The study investigated applied behaviour analysis.
2. The intervention outcome was measured throughout the process. 3. Significant improvements were recorded. |
1. The sample size was eight individuals.
2. The method used is a randomized control trial. |
Early Start Denver Model (ESDM)
| Similarities | Differences | |
| Article No:3 | 1. This is a randomized clinical trial for the Early Start Denver Model (ESDM).
2. The intervention was carried out for two years. 3. The children were put in a preschool-aged children’s care Centre |
1. The sample size had 39 children.
2. The intervention was carried out for two years. 3. The results showed improved adaptive behaviour, intellectual ability, and symptom severity. |
| Article No: 4 | 1. This is a randomized clinical trial for the Early Start Denver Model (ESDM).
2. The intervention was carried out for two years. 3. The children were put in a preschool-aged children’s care Centre. |
1. The sample size had 48 children.
2. There were significant improvements in autism symptoms, language, IQ, and social and adaptive behaviours. 3. |
| Article No: 5 | 1. This is a randomized clinical trial for the Early Start Denver Model (ESDM).
2. The children were put in a preschool-aged children’s care Centre. 3. |
1. The sample size had 26 children.
2. The intervention period was conducted for ten months. 3. There were recorded improvements in receptive language, visual reception, and intellectual functioning. |
Reference List
Grindle CF, Hastings RP, Saville M, Hughes JC, Huxley K, Kovshoff H, et al. Outcomes of a behavioural education model for children with autism in a mainstream school setting. Behav Modif 2012; 36:298-319.
Leaf JB, Milne C, Taubman M, Oppenheim-Leaf M, Torres N, et al. An evaluation of a behaviorally based social skills group for individuals diagnosed with an autism spectrum disorder. J Autism Dev Disord 2017; 47:243-259
Estes A, Munson J, Rogers SJ, Greenson J, Winter J, Dawson G. Long-term outcomes of early intervention in 6-year-old children with an autism spectrum disorder. J Am Acad Child Adolesc Psychiatry 2015; 54:580-587.
Dawson G, Jones EJ, Merkle K, Venema K, Lowy R, Faja S, et al. Early behavioural intervention is associated with normalized brain activity in young children with autism. J Am Acad Child Adolesc Psychiatry 2012; 51:1150-1159.
Eapen, V., Črnčec, R., & Walter, A. (2013). Clinical outcomes of an early intervention program for preschool children with an autism spectrum disorder in a community group setting. BMC Pediatrics, 13(1), 1–9.
write