Individual Behavioural Profiles and Predictors of Outcomes to the Early Start Denver Model Intervention

Background: Differential responsiveness to intervention programs in toddlers and pre-schoolers with Autism Spectrum Disorders (ASD) might be related to several factors, including pre-treatment cognitive and adaptive skills, communication abilities and individual behavioural characteristics.

Objectives:  to investigate (i) factors associated with treatment effectiveness and (ii) behavioural profiles associated with response to the Early Start Denver Model (ESDM) intervention.

Methods: 20 ASD toddlers and pre-schoolers, aged 18-44 months participated in the “Prima Pietra” Project at the Pervasive Healthcare Centre (PHC), National Research Council of Italy, Messina, where an ESDM based intervention in which therapists were learning the model (“Learning ESDM” treatment) was applied. Children received between 5 to 10 hrs of treatment per week. Diagnostic assessment at baseline and after 3 months of treatment comprised the Autism Diagnostic Observation Schedule (ADOS), the Griffiths Mental Development Scale (GMDS), the Vineland Adaptive Behaviour Scale (VABS), the MacArthur Communicative Development Inventory and the Social Communication Questionnaire. The child’s behavioural profile was assessed using the Child Behaviour Checklist 1½–5 (CBCL 1½–5). The correlations between putative predictors and outcome measures (in terms of change scores between pre- and post-treatment) after 3 months of treatment were analyzed and a linear regression on those predictors that showed a significant correlation with the outcome measures was performed. 

Results: Baseline receptive language was positively correlated with and predicted gains in the general developmental quotient (GDQ) and gains in the personal-social skills and language were positively correlated with emotional reactivity and anxiety problems at baseline. Furthermore, aggressive behaviours were negatively correlated with ADOS scores at baseline and predicted a lower gain in personal-social skills after 3 months of treatment. 

Conclusions: Our results suggest that individual behavioural profiles and receptive language abilities at baseline correlate with and predict outcomes at 3 months of an ESDM treatment.