Improvement of Autism Symptoms After Comprehensive Intensive Early Interventions in Community Settings

Abstract

Background: Preschool children with autism in southern Sweden participated in a comprehensive Naturalistic Developmental Behavioral Intervention (NDBI) program. Aims: To evaluate the ongoing NDBI program by comparing the pre- and postintervention outcomes in terms of improved autism symptom severity. Method: The improvement of Autism Diagnostic Observation Schedule (ADOS-R) test results between baseline and evaluation among children participating in the NDBI program ( n = 67) was compared with the results among children receiving community treatment as usual ( n = 27) using analysis of covariance. Results: The study showed that children in the NDBI group improved their ADOS-R total scores between baseline and evaluation (−0.8 scores per year; 95% CI [−1.2, −0.4]), whereas no improvement was detected in the comparison group (+0.1 scores per year; 95% CI [−0.7, +0.9]). The change in the NDBI group versus the change in the comparison group was statistically significant after adjusting for possible confounders as well. Children in the NDBI group also significantly improved their ADOS severity scores, but the scores were not significantly different from those of the comparison group. Conclusions: The results from the current naturalistic study must be interpreted cautiously, but they do support earlier studies reporting on improvement of autism symptoms after early intensive interventions. Results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. The results do indicate that children with autism benefit from participating in early comprehensive intensive programs.