Project Description:
The project addresses the critical issue of minimal treatment response in ASD early intervention by engaging in the first large-scale effort to examine the prevalence, profiles and mechanisms of children who show minimal spoken language improvement in response to treatment. The rationale for focusing on children who remain minimally verbal despite receiving intervention is that failure to acquire language during preschool years is associated with poor long-term outcomes in ASD (Pickles et al., 2014).
The project provides the first large-scale examination of the prevalence, characterization and mechanisms of minimal response to early intervention in ASD, with a focus on the spoken language domain. This will be achieved through the creation of an aggregate dataset from multiple early intervention programs involving an overall sample of 1326 well characterized preschoolers with ASD who received, in average, 20 h/week of Early Intensive Behavioral Intervention (Lovaas, 2003), Naturalistic Developmental Behavioral interventions (Schreibman et al. 2015) or evidence-supported practices (Wong et al., 2015), for approximately 1 year.
Aim 1. We will determine the prevalence of children who remain minimally verbal despite receiving evidence-supported early intervention targeting spoken language.
Aim 2. We will characterize empirically derived profiles of minimal-responders in the language domain through the analysis of variables that distinguish treated minimally verbal children who show language improvements from those who continue to be minimally verbal after treatment.
Aim 3. We will identify potential mechanisms of child minimal intervention response by testing predictions from social, cognitive and motor accounts of language impairment in ASD.
Results of this project have the potential to foster major changes in current approaches to early intervention. As previously mentioned, fine-grained phenotypic characterization of subgroups of individuals who do not respond to established treatments in key targeted domains has been a critical step to inform development of new targeted interventions and treatment algorithms across a variety of medical and psychiatric conditions (OReardon & Amsterdam, 2001; Bloch et al., 2006), leading to improved treatment outcomes (Buckley & Gaughran, 2014; Riva Posse et al., 2012; Yoruk et al., 2017). In the ASD field, despite a long history of concerns about poor intervention response, the scarcity of information on the prevalence, characteristics and mechanisms responsible for suboptimal treatment response results in limited knowledge on how to promote positive outcomes for subgroups of children who are more in need of intervention. Therefore, novel insights on the scope, characterization and mechanisms of poor response to intervention in the language domain achieved by the current project will move the field beyond anecdotal accounts into a detailed examination of such phenomenon using large-scale empirical data.
Keyword(s):
autism, diagnostics, speech delay, early childhood
Target Audience:
Professionals and Para-Professionals, Children/Adolescents with Disabilities/SHCN, Legislators/Policy Makers
