Efficacy of Early Intervention Program: Evidence From Behavioral, Cognitive and Socio-Emotional Evaluations

Background:  Based on the experience and practice of a multidisciplinary team we have developed an early intervention program including Exchange and Developmental Therapy. This program aimed to develop psychophysiological functions required to improve communication abilities. This study reports the psychological and behavioural outcomes of a group of children with autism enrolled in this program.

Objectives:  The aim of this study was to investigate the development of children with basic disorders of infantile autism such as impairment in social interactions and communication and resistance to change, using a new and complete assessment battery.

Methods:  29 children, aged from 2 to 8 years, with severe autism (DSM-IV T-R, APA, 2000, ADI-R, Le Couteur et al., 1989 and CARS, Childhood Autism Rating Scale, Schopler et al., 1986) and moderate to severe mental retardation (Brunet-Lézine scale-Revised, 1997 - French adaptation of Gesell scales, 1947) were recruited. We examined cognitive and socio-emotional skills using a recently validated scale, the (SCEB) (Adrien,2007 ; Thiébaut et al., 2010). Changes in autistic symptomatology were evaluated with the BSE scale (Behavioural Summarized Evaluation scale revised) (Barthélémy et al., 1997). The two types of assessment were performed at the beginning of treatment and then another developmental assessment was performed 10 months later, followed by behavioural evaluations every month. We compared clinical data at different times in the assessment process for each child.

Results:  The results showed that this combined developmental and behavioral assessment could reveal not only general progress in cognitive and socio-emotional skills but also decreases in autistic symptomatology. Progress was different from one child to another and seemed dependent on the initial severity of the mental retardation. Finally, although overall retardation did not change, significant reduction in autistic behaviours occurred with therapy.

Conclusions:  These results confirmed previous studies (Rogers, 1996; Schreibman, 1996; Adrien et al., 2002-b; Blanc et al., 2003; Howlin, 2005, Magiati, 2007 ; Wallace and Rogers, 2010) and indicated the value of this assessment battery which explores both the cognitive and socio-emotional development of the child and also follows the evolution of the autistic symptomatology. Moreover, this study identified functions sensitive and resistant to the intensive program including Exchange and Developmental Therapy, EDT, indicating directions for prevention and early intervention.