This retrospective study examined predictors of outcome for children With autism folloWing 6 and 12 months of early intensive behavioral intervention. Potential predictor variables included pretreatment functioning, age at onset of treatment, treatment intensity, family involvement, and physical characteristics (e.g., brain abnormalities, dysmorphology). For the 19 study participants, presence of dysmorphic features Was the only variable that predicted response to treatment after 6 months (R2 = .58). Dysmorphology Was associated With Worse outcomes. After 12 months, both dysmorphology and a history of regression predicted poorer response to treatment (R2 = .67). Children Who made the most progress in treatment had pretreatment language skills and normal physical features. Dysmorphic features in children With autism may represent abnormalities in prenatal development that are associated With poorer child outcomes.
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References
1.
Aase, J.M. (1990). Diagnostic dysmorphology. New York: Plenum Press.
2.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author .
3.
Anderson, S.R., Avery, D.L., KiPietro, E.K., Edwards, G.L., & Christian, W.P. (1987). Intensive home-based early intervention with autistic children. Education and Treatment of Children, 10, 352—366.
4.
Anderson, S.R., & Romanczyk, R.G. (1999). Early intervention for young children with autism: Continuum-based behavioral models. Journal of the Association for Persons with Severe Handicaps, 24, 162—173.
5.
Bailey, A., Phillips, W., & Rutter, M. (1996). Autism: Toward an integration of clinical, genetic, neuropsychological, and neurobiological perspectives. Journal of Child Psychology and Psychiatry, 37, 89—126.
6.
Beglinger, L.J., & Smith, T.H. (2001). A review of subtyping in autism and proposed dimensional classification model. Journal of Autism and Developmental Disorders, 31, 411—422.
7.
Bristol, M., Cohen, D., Costello, E., Denckla, M., Eckberg, T., Kallen, R., et al. (1996). State of the science in autism: Report to the National Institutes of Health. Journal of Autism and Developmental Disorders, 26, 121—154.
8.
Fenske, E., Zalenski, S., Krantz, P., & Mc-Clannahan, L. (1985). Age at intervention and treatment outcome for autistic children in a comprehensive intervention program . Analysis and Intervention in Developmental Disabilities , 5, 49—58.
9.
Gillberg, C. (1991). Outcome in autism and autistic-like conditions . Journal of the American Academy of Child and Adolescent Psychiatrty, 30, 375—382.
10.
Gillberg, C., & Coleman, M. (1992). The biology of the autistic syndromes (2nd ed., Vol. 1). London: MacKeith Press.
11.
Gresham, F., & MacMillan, D. (1997). Autistic Recovery? An analysis and critique of the empirical evidence on the Early Intervention Project. Behavior Disorders, 22, 185— 201.
12.
Gresham, F., & MacMillan, D. (1998). Early Intervention Project: Can its claims be substantiated and its effects replicated?Journal of Autism and Developmental Disorders, 28, 5—13.
13.
Groden, G., Dominique, D., Chesnick, M., Groden, J., & Baron, G. (1983). Early intervention with autistic children: A case presentation with pre-program, program, and follow-up data. Psychological Reports, 53, 715—722.
14.
Hall, J.G., Froster-Iskenius, U.G., & Allanson, J.E. (1989). Handbook of normal physical measurements. New York: Oxford University Press.
15.
Jones, K.L. (1997). Smith's recognizable patterns of human malformation (5th ed.). Philadelphia: WB Saunders.
16.
Kazdin, A. (1993). Replication and extension of behavior treatment of autistic disorder. American Journal on Mental Retardation , 97, 377—379.
17.
Leaf, R., & McEachin, J. (1999). A work in progress: Behavior management strategies and a curriculum for intensive behavioral treatment of autism. New York: DRL Books.
18.
Lotter, V. (1978). Follow-up studies. In M. Rutter & E. Schopler (Eds.), Autism: A reappraisal of concepts and treatment (pp. 475—495). New York: Plenum Press.
19.
Lovaas, O. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3—9.
20.
Luiselli, J., Cannon, B., Ellis, J., & Sisson, R. (2000). Home-based behavioral intervention for young children with autism/pervasive developmental disorder: A preliminary evaluation of outcome in relation to child age and intensity of service delivery. Autism, 4, 426—438.
21.
Maurice, C., Green, G., & Luce, S. (1996). Behavioral interventions for young children with autism: A manual for parents and professionals. Austin: PRO-ED .
22.
McEachin, J., Smith, T., & Lovaas, O. (1993). Long-term outcome for children with autism who received early intensive behavior treatment. American Journal on Mental Retardation, 97, 359—372.
23.
Miles, J., Hadden, L., Takahashi, T., & Hillman, R. (2000). Head circumference is an independent clinical finding associated with autism. American Journal of Medical Genetics, 95, 339—350.
24.
Miles, J., & Hillman, R. (2000). Value of a clinical morphology examination in autism. American Journal of Medical Genetics, 91, 245—253.
25.
Miles, J., Takahashi, T., Bagby, S., Sahota, P., & Hillman, R. (2004). Essential vs. complex autism: Definition of fundamental prognostic subtypes. Manuscript submitted for publication.
26.
Nordin, V., & Gillberg, C. (1998). The long-term course of autistic disorders: Update on follow-up studies. Acta Psychiatrica Scandinavica, 97, 99—108.
27.
Ozonoff, S., & Cathcart, K. (1988). Effectiveness of a home program intervention for young children with autism. Journal of Autism and Developmental Disorders, 28, 31— 32.
28.
Perry, R., Cohen, I., & DeCarlo, R. (1995). Case study: Deterioration, autism, and recovery in two siblings. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 232—237.
29.
Prizant, B.M., Wetherby, A.M., & Rydell, P.J. (2000). Communication intervention issues for children with autism spectrum disorders. In A. M. Wetherby & B. M. Prizant (Eds.), Communication and language intervention series: Vol. 9. Autism spectrum disorders: A transactional developmental perspective (pp. 193—224). Baltimore : Brookes.
30.
Robbins, F., Dunlap, G., & Plienis, A. (1991). Family characteristics, family training, and the progress of young children with autism. Journal of Early Intervention , 15, 173—184.
31.
Rogers, S. (1998). Empirically supported comprehensive treatments for young children with autism. Journal of Clinical Child Psychology, 27, 168—179.
32.
Rutter, M. (1970). Autistic children: Infancy to adulthood. Seminar in Psychiatry, 2, 435—450.
33.
Schopler, E., Reichler, R., & Renner, B.R. (2002). The childhood autism rating scale. Los Angeles: Western Psychological Services.
34.
Schreibman, L. (2000). Intensive behavioral/ psychoeducational treatments for autism: Research needs and future directions. Journal of Autism and Developmental Disorders, 30, 373—378.
35.
Sheinkopf, S., & Siegel, B. (1998). Home-based behavioral treatment of young children with autism. Journal of Autism and Developmental Disorders , 28, 15—23.
36.
Shinnar, S., Rapin, I., Arnold, S., Tuchman, R., Shulman, L., Ballaban-Gil, K., et al. (2001). Language regression in childhood. Pediatric Neurology, 24, 185—191.
37.
Shonkoff, J., Hauser-Cram, P., Krauss, M., & Upshur, C. (1988). Early intervention efficacy research: What have we learned and where do we go from here?Topics in Early Childhood Special Education, 8, 81—93.
38.
Slaughter, A., Takahashi, T.N., Hillman, R.E., & Miles, J.H. (2000). Females with autism: A genetic study. American Journal of Human Genetics, 63, 26.
39.
Smith, T. (1999). Outcome of early intervention for children with autism. Clinical Psychology: Science and Practice, 6(1), 33—49.
40.
Smith, T., Eikeseth, S., Klevstrand, M., & Lovaas, O.I. (1997). Intensive behavioral treatment for preschoolers with severe mental retardation and pervasive developmental disorder. American Journal on Mental Retardation, 102, 238—249.
41.
Smith, T., Groen, A.D., & Wynn, J.W. (2000). Randomized trial of intensive early intervention for children with pervasive developmental disorder. American Journal on Mental Retardation, 105, 269—285.
42.
Sparrow, S.S., Balla, D.A., & Cicchetti, D.V. (1984). Vineland interview edition: Expanded form manual. Circle Plains, MN: American Guidance Service.
43.
Stevens, M.C., Fein, D.A., Dunn, M., Allen, D., Waterhouse, L.H., Feinstein, C., et al. (2000). Subgroups of children with autism by cluster analysis: A longitudinal examination. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 346— 352.
44.
Tuchman, R.F., & Rapin, I. (1997). Regression in pervasive developmental disorders: Seizures and epileptiform electroencephalogram correlates. Pediatrics, 99, 560—566.
45.
Venter, A., Lord, C., & Schopler, E. (1992). A follow-up study of high-functioning autistic children. Journal of Child Psychiatry, 33, 489—507.
46.
Volkmar, F.R., & Nelson, D.S. (1990). Seizure disorders in autism. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 127—129.
47.
Wing, L., & Atwood, A. (1987). Syndromes of autism and typical development. In D. J. Cohen & A. Donnelan (Eds.), Handbook of autism (pp. 3—17). New York: Wiley.
48.
Wolf, L., & Goldberg, B. (1986). Autistic children grow up: An eight to twenty-four year follow-up study. Canadian Journal of Psychiatry, 31, 550—556.
