Early Intervention: The Tizard Centre Study

Mother and child with autismProject Area: This project compared implementation and outcomes for Son-Rise, ABA and control group in children and adults with autism. Underlying familial and autism characteristics were examined

Lead Beadle-Brown

Institution: The Tizard Centre, University of Kent

Status: Completed

Impact: This project provided information about the responses of children parents to specific intervention and further evidence that no one intervention will be suited to all children or families.

Details of the study

Beadle-Brown J., Dorey H., and Murphy G. 2004 Early intervention for autism study. Canterbury : the Tizard Centre (University of Kent)

The initial study completed by Beadle-Brown et al (2004) was a follow-up to the reported success of the Applied Behavioural Analysis, set out by Lovaas in his 1987 work, including substantial gains in measured cognitive ability.

The study examined the factors affecting parental choice of an early intervention (with a focus upon parenting style); and the outcomes for children participating in programmes following ABA or SonRise (Option) principles.

21 families took part in the study, 10 in the SonRise group, 6 in the ABA group, and 5 controls. All the children (18 boys and 3 girls) had a diagnosis of ASD, and average age at the start of the intervention was 47 months (with a range of 25 to 68 months).

The hours devoted to the ABA intervention ranged from 18-39 and the range for the SonRise intervention was 4-60 hours !

The majority of families were also undertaking additional interventions such as dietary regimes, PECS, speech and language therapy, and cranial osteopathy.
The period between baseline and follow-up assessment ranged from 6 to 9 months, with measures including the Vineland Adaptive Behaviour Scales, Leiter Performance Scale, Reynell Language Scale, parental questionnaires, and observations of social interactions

In respect of the findings from this initial study concerning factors in choice of intervention, it had been hypothesised that ABA choice would reflect a more directive style of parenting while SonRise choice would reflect a more permissive style; but this pattern was not observed. There was a mixture of parenting styles in each group with the tentative conclusion, therefore, that parenting style does not influence choice of intervention (with the acknowledgement that a pattern may exist but that the questionnaire methodology was not sufficiently sensitive to detect it).

It appeared that word of mouth was the most common route by which parents became aware of interventions, and it was recognised that most parents would not have access to formal evaluations of interventions published in research journals.

In respect of outcomes, none of the 3 groups showed any significant changes (either for the better or worse) in adaptive behaviour or personal/social sufficiency.

With regard to changes in symptoms (behavioural difficulty), there was observed to be a positive change among the SonRise children in respect of the "quality of social interaction" with a shift from "aloof" to "passive". This reflected an increased willingness in the children to accept interaction with others albeit still showing reluctance to initiate social contact.

In respect of changes in cognitive skills, the only observable changes were in terms of the number of items attempted which provided a measure of improvement in attention span or in willingness to participate. All groups showed some improvement in the number of items attempted but the difference did not reach a statistically-significant level.

There were also found to be no significant improvements in language usage or social behaviour.

The authors concluded that, contrary to anticipation, there were no real changes between or within groups, with the children on ABA or SonRise not outperforming the control group.
The authors referred to the small sample sizes as partial explanation for the lack of significant outcomes (and one might also note both the short period of intervention, and the low intensity in some cases), with the plan to extend this current pilot study.

However, the conclusion drawn by the authors that some children may respond better than others to early intervention can be seen as helpful in reinforcing the principle of there being no single type of treatment that is appropriate for all children.
Instead, it is necessary to recognise individual and familial strengths, weaknesses, and circumstances in planning an individual programme whose various elements are chosen to reflect these permutations of variables - especially the idiosyncratic profiles of disabilities and comorbidities displayed by the children.

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01 Jun 2015