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 four novel experimental paradigms.

Methods: The experimental tasks assessing early emerging social and non-social cognitive abilities were administered to the 25 children with an ASD enrolled in the MP Wing ASELCC program aged 2- to 5-years. The Functional Use of Objects task assessed participants’ ability to engage in purposeful (versus purposeless) actions on objects. The Social Understanding task assessed the ability to anticipate others’ goals on an eye-tracking task. The Social Attention measure assessed the amount of attention to social versus non-social stimuli in the same eye-tracking paradigm. Finally a behavioural task assessed imitation abilities.

Given the importance of these early emerging abilities for social learning, we tested the hypothesis that children who show more advanced skills in the four specified areas will derive the most benefit from the ESDM program in terms of developmental and behavioural gains.

Results: Our analyses show that functional use of objects and imitation predicted gains in nonverbal DQ (r=.8 and.7 respectively; p<.005), whilst social understanding was a significant predictor of verbal DQ (r=.5; p<.05). Surprisingly, individual differences in social interest were not associated with developmental gains.

Conclusions: Individual differences in early emerging social and non-social cognitive abilities were differentially associated to gains in different developmental areas. These preliminary data suggest that the ESDM might be particularly beneficial to children whose cognition is more “organized” around goals, as reflected in the use objects in a goal-directed way, the understanding of goals behind others‟ actions and the imitation of others‟ goal-directed actions. 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.

: