Comprehensive Synthesis of Early Intensive Behavioral interventions
Thoughts on the article; Reichow, B., & Wolery, M. (2009). Comprehensive Synthesis of Early Intensive Behavioral interventions for Young Children with Autism Based on the UCLA Young Autism Project Model. Journal of Autism and other Developmental Disorders, 39; 23-41.
This recently published (at least online) article takes the goal of providing a comprehensive synthesis of the studies done on EIBI since Lovaas (1987) ground breaking article; investigating the experimental methods, participants, and intervention program of these studies. The synthesis also provides an analysis of the effects of EIBI. To do this the synthesis by the authors conducted the synthesis on multiple levels: (a) descriptive analysis, (b) effect size analyses, and (c) a Meta analysis.
The synthesis article outlines in detail its methology, which makes this article a specially useful tool in both implementing EIBI and designing future research and program development. The synthesis also provides several useful conclusions and results. I will only comment on those I found most interesting, so I strongly advice professionals and service providers to study this article in full text.
The synthesis made a rating of the 13 included studies methodological qualities. This is of course an extremely important feature, and it’s therefore somewhat disappointing that only three (23%) of the studies reached the highest rating of strong methodological quality, and a total of five (38%) was rated with the lowest rating. This strongly calls for more and methodological high quality research on EIBI, if the field shall succeed in providing real evidence for the effectiveness of EIBI it will need more good research studies.
But of course many of the elements defining good metology are somewhat hard to do. One of the key features of experimental design is comparison-groups with random assignment. In real service providing day-to-day business it’s not easy to conduct, as it mean that some of the children referred to treatment will receive no treatment or a treatment that has even weaker empirical support. Combined with another finding in this synthesis; that there appear to be a possible strong link between intensity (both weekly hours, and months of treatment) and IQ-gains. The possibility to use a design using a waiting group of children is strongly reduced. But I recently got information that a research-group is planning to do a study with this design.
Another point made bye the authors is that the reported child measures are insufficient. And I strongly agree. The studies, and in the clinical work, it should be possible to extend the child measures. I’m not a supporter of excluding the measures that are being reported in these studies, but to extend them with as these authors state it; “data of children’s functional performance on key variables in natural settings.”
It is also quite interesting that the only continuous variable that had a statistically significant relationship with children’s change in IQ was the supervisor training model, pointing in favor of the UCLA model. Eikeseth and his colleagues has done a study examining the relationship between hours of supervision and children outcome, finding that hours of supervision is related to the children’s outcomes. As my work includes giving supervision and organize supervision I find this result very interesting, and I am looking really forward to more research regarding the role of supervision, both intensity and quality, in the children outcome.
And it’s always nice to get confirmation that EIBI is so far a good intervention for children with ASD, although it is always in need for development;
“Descriptive analyses were conducted for the samples receiving EIBI for placement, psychopathology, and diagnostic reclassification. Analyses of these data support the conclusion that EIBI is an effective intervention for many children with autism. “ (p.32)
Related posts:
- Early Intensive Behavioral Interventions for Children with Autism – Supervision
- Special Report: Early Intensive Behavioral Intervention Based on Applied Behavior Analysis among Children with Autism Spectrum Disorders
- Early and intensive behavioral intervention for autism: A survey of clinical practices