An Examination of Predictors of Social Intervention Response for Elementary Aged Children with Autism

Background:  

The autism spectrum is unique due to the significant heterogeneity in both onset as well as presentation observed in diagnosed individuals. Interventions, especially those that target social skills, are not universally effective across the autism spectrum due in part to the heterogeneity of symptom severity. Although previous research has identified several characteristics that may be predictive of improved treatment outcomes, this research does not distinguish phenotypically distinct subtypes and may not inform treatment decisions.  Given the limited information on targeting social competency interventions for autism, the purpose of this study was to examine behavioral phenotypes present in the subtype of individuals with high functioning autism within the context of an established social program (Social Competency Intervention for Elementary Aged Children: SCI-E).  

Objectives:  

The objectives of this study were to examine the extent to which characteristics of elementary aged participants with autism predict treatment responsivity as well as to identify possible distinct behavioral phenotypes present in the study sample that can support intervention responsivity and treatment needs.   

The following research questions were investigated:

1. To what extent do pre-intervention characteristics predict treatment responsivity?
2. What are the specific characteristics associated with children with autism who demonstrate differing levels of responsiveness?
3. To what extent do pre-intervention behavioral phenotypes predict treatment responsivity?

Methods:  

This quasi-experimental study investigated the characteristics of a group of children with autism that may be predictive of treatment responsivity within the context of the SCI-E program. Participants included 13 males and 5 females (n=18) with an autism spectrum diagnosis between the ages of 6 and 11 years (M= 8 years 9 months) with estimated full scale IQ’s ranging from 77 to 132 (M= 99). The program consisted of a ten-week program with hour-long sessions twice per week targeting conversation, emotion regulation and problem solving skills.

Behavioral phenotypes were identified through analyses of participant profiles based on pre-intervention characteristics as well as following intervention based on treatment responsivity.  Intervention outcomes were determined through the use of pre/post assessments including both direct participant performance measures and parent report measures. 

Results:  

The results of this study indicate that low pre-treatment ASD specific impairments (symptom severity scores) and Theory of Mind abilities were predictive of intervention outcomes. An initial exploration into behavioral phenotypes within the context of the SCI-E program yielded four distinct groups of participants that significantly differed based on overall level of intelligence as well as on measures of symptom severity.  

Conclusions:  

This study identified a complex and varied profile of characteristics and responsivity within the sample of children with autism that will inform researchers as to the efficacy of the SCI-E program as well as assist with treatment decisions for participants.  The use of specific research examining responsivity and behavioral phenotypes throughout the stages of efficacy research has the potential to increase the specificity of social intervention research and improve outcomes for individuals on the autism spectrum.