Social and Non-Social Abilities Are Differentially Associated to Treatment Gains in Different Domains

Background:  Early intensive behavioural interventions such as the Early Start Denver Model have been shown to improve social and communicative outcomes in autism. However, children with autism display individual differences in response to treatment. Understanding the predictors of differential outcomes is crucial for enabling practitioners to prospectively recommend treatment strategies for specific children in order to increase the overall rate of positives outcomes.

Objectives:  Our aim was to identify the individual differences in early emerging social and cognitive abilities which are associated with differential responses to treatment. To allow for a fine-grained measurement of such abilities we used two novel experimental paradigms.

Methods:  Two experimental tasks assessing early emerging social and non-social cognitive abilities were administered to the 21 children with an ASD enrolled in the MP Wing ASELCC program aged 2- to 5-years. A non-social cognitive measure assessed participants’ ability to engage in purposeful (versus purposeless) actions on objects and a social cognitive measure assessed participants’ ability to focus on social (versus non-social) stimuli in an eye-tracking task.

Based on previous work on early social-cognitive abilities and learning, we tested the hypothesis that individual differences in the ability to engage in purposeful actions would be associated to differential treatment outcomes related to cognitive abilities, while individual differences in visual attention to social stimuli would be related to differential treatment outcomes in communicative and social abilities. The MSEL and ESDM checklist scores at Time 2 (1 year after the start of treatment) were used as the outcome measures.

Results:  Preliminary results (n=21) show that, as predicted, individual differences in the ability to engage in purposeful actions on objects were correlated to differential outcomes in non-verbal Developmental Quotient (r=.8; p<.001), while individual differences in social attention were associated to differential outcomes in verbal Developmental Quotient (r=.7; p<.01). Surprisingly, we found that the ability to engage in purposeful actions was highly correlated to gains in social skills (r=.9; p<.0001) at Time 2, while social attention was not.

Conclusions:  Individual differences in early emerging social and non-social cognitive abilities were differentially associated to gains in different developmental areas. The ability to engage in functional actions with objects appears to be a powerful predictor of both non-social and social gains in our sample. The introduction of theory-driven experimental tasks in treatment studies might allow for a more fine-grained analysis of social-cognitive and learning profiles associated to differential treatment outcomes.