Community-Based Early Intervention For Children With Autism Spectrum Disorder

One in 68 children has been identified with Autism Spectrum Disorder (ASD), a disorder defined by 1) deficits in social-communication and social interactions and 2) restricted, repetitive patterns of behavior, interests or activities. Research has shown that children with ASD who receive high-quality early intervention (EI) services in university-based research trials can make large gains in cognitive, communication, and adaptive behaviors skills, with positive long term effects. However, less is known about the outcomes for the over 50,000 children who receive EI in community settings. This dissertation provides initial evidence of the current state of community-based EI for children with ASD. Chapter 1 presents a meta-analysis of cognitive, communication, social, and adaptive behavior outcomes for children with ASD in community-based EI programs, and demonstrates that the gains made in the community are much smaller than those observed in university-based trials. In Chapter 2, prospective, longitudinal data collected from a local EI system is studied to understand which characteristics of preschool EI predict cognitive gains for 79 preschoolers with ASD that received publicly-funded services in classroom placements. The best predictor of gains was the utilization of recommended intervention practices to support the development of social and peer relationships. Chapter 3 discusses measurement of executive functioning (EF) among preschoolers with ASD, as executive functioning skills likely play an important role in response to EI. However existing EF measures have not been validated for use with low-functioning, nonverbal preschoolers with ASD. Results are presented from the development and the validation of a battery of nonverbal, performance-based EF tasks. These measures can be utilized in future community-based treatment trials