Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article
Free AccessOriginal Article

Case-control study of the low intensive autism-specific early behavioral intervention A-FFIP: Outcome after one year

Published Online:April 11, 2019https://doi.org/10.1024/1422-4917/a000661

Abstract

Abstract. Abstracts: Objective: In current international research, early intervention in children with autism-spectrum disorder (ASD) focuses on naturalistic developmental behavioral interventions (NDBI). The manualized Frankfurt Early Intervention Program for preschool-aged children with ASD (A-FFIP) implements NDBI principles within a low-intensity approach of 2 h intervention/week. The present case-control study established effect sizes of change in autistic symptoms, comorbid behavioral problems as well as IQ after one year. Methodology: An intervention group (N = 20; age: 3.4–7.9 years) and a treatment-as-usual control group (N = 20; age: 3.2–7.3 years) of children with ASD were matched for developmental and chronological age. The outcome measures used were the ADOS severity score, the Child Behavior Checklist, and cognitive development. Results: After one year, the A-FFIP group showed a trend towards greater improvement in autistic symptoms (η2 = .087 [95 %-CI: .000–.159]) and significantly greater improvements in cognitive development (η2 = .206 [CI: .012–.252]) and global psychopathology (η2 = .144 [CI: .001–.205]) compared to the control group. Conclusion: The efficacy of A-FFIP should be established in a larger, sufficiently powered, randomized controlled study.


Autismus-spezifische, verhaltenstherapeutische Frühintervention (A-FFIP): Ergebnisse einer Fall-Kontroll-Studie nach einem Jahr

Zusammenfassung.Fragestellung: Frühförderansätze für Kinder mit Autismus-Spektrum-Störung (ASS), die entwicklungsorientiert vorgehen und verhaltenstherapeutische Techniken in der natürlichen Lernumgebung des Kindes einsetzen, stehen aktuell im Zentrum internationaler Forschung. Das manualisierte Frankfurter Frühinterventionsprogramm für Vorschulkinder mit ASS (A-FFIP) arbeitet mit diesen Grundsätzen im Rahmen einer niederfrequenten Förderung von 2 Stunden/Woche. In der vorliegenden Fall-Kontroll-Studie werden Effektgrößen bezüglich der Entwicklung der autistischen Symptomatik, komorbider Verhaltensprobleme sowie IQ nach 1-jähriger A-FFIP Förderdauer im Vergleich zur Standardbehandlung beschrieben. Methodik: Therapie- (N = 20; Alter 3.4–7.9 Jahre) und Kontrollgruppe (N = 20; Alter 3.2–7.3 Jahre), die die ortsübliche Intervention erhielt, waren zu Beginn der Intervention bezüglich Entwicklungsalter und Alter gematcht. Untersuchte Zielgrößen waren der ADOS-Schweregradindex, die Child Behavior Checklist und die kognitive Entwicklung. Ergebnisse: Nach 1-jähriger Förderung zeigte die A-FFIP-Gruppe einen Trend zu einer stärkeren Verbesserung der autistischen Symptomatik (η2 = .087 [CI: .000–.159]), sowie eine stärkere Verbesserung der kognitiven Entwicklung (η2 = .206 [CI: .012–.252]) und globalen Psychopathologie (η2 = .144 [CI: .001–.205]) als die Kontrollgruppe mit jeweils mittleren bis hohen Effektgrößen. Schlussfolgerung: A-FFIP sollte bezüglich seiner Effektivität in einer größeren randomisiert-kontrollierten Studie mit ausreichender Teststärke untersucht werden.

Literature

  • Achenbach, T. M. (1998). Elternfragebogen über das Verhalten von Kindern und Jugendlichen; Deutsche Bearbeitung der Child Behavior Checklist (CBCL/4-18) [German version of the Child Behavior Checklist 4–18]. Köln: Arbeitsgruppe Kinder-, Jugend- und Familiendiagnostik. First citation in articleGoogle Scholar

  • Achenbach, T. M. (2002). Child Behavior Checklist 1 ½–5. Deutsche Fassung Elternfragebogen für Klein- und Vorschulkinder [German version of the Child Behavior Checklist 1 ½–5]. Köln: Arbeitsgruppe Kinder-, Jugend- und Familiendiagnostik. First citation in articleGoogle Scholar

  • Aman, M. G., Singh, N. N., Steward, A. W. & Field, C. J. (1985). The aberrant Behavior Checklist: A behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency, 89(5), 485–491. First citation in articleMedline, Google Scholar

  • Berubé, R.L. & Achenbach, T.M. (2010). Bibliography of published studies using the Achenbach System of Empirically Based Assessment: 2006 Edition. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families; 2010. Available online at www.ASEBA.org. First citation in articleGoogle Scholar

  • Bölte, S. & Poustka, F. (2006). Fragebogen zur sozialen Kommunikation: Autismus Screening, FSK, Manual: Deutsche Fassung des Social Communication Questionnaire (SCQ) von Michael Rutter, Anthony Bailey und Catherine Lord [German version of the SCQ]. Bern: Huber. First citation in articleGoogle Scholar

  • Bölte, S. & Poustka, F. (2008). Skala zur Erfassung sozialer Reaktivität: Dimensionale Autismus-Diagnostik. Deutsche Fassung der Social Responsiveness Scale (SRS) von N. Constantino und Christian P. Gruber [German version of the SRS]. Bern: Huber Hogrefe. First citation in articleGoogle Scholar

  • Bölte, S., Rühl, D., Schmötzer, G. & Poustka, F. (2006). Diagnostisches Interview für Autismus – revidiert, ADI-R. Deutsche Fassung des Autism Diagnostic Interview–Revised (ADI-R) von Michael Rutter, Ann Le Couteur und Catherine Lord. Manual [German version of the ADI-R]. Bern: Huber Hogrefe. First citation in articleGoogle Scholar

  • Colombi, C., Narzisi, A., Ruta, L., Cigala, V., Gagliano, A. & Pioggia, G. & Prima Pietra Team. (2018). Implementation of the Early Start Denver Model in an Italian community. Autism, 22, 126–133. First citation in articleCrossref Medline, Google Scholar

  • Dawson, G. & Bernier, R. (2013). A quarter century of progress on the early detection and treatment of autism spectrum disorder. Development and Psychopathology, 25, 1455–1472. First citation in articleCrossref Medline, Google Scholar

  • Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J. & Greenson, J., et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125, e17. First citation in articleCrossref Medline, Google Scholar

  • Devescovi, R., Monasta, L., Mancini, A., Bin, M., Vellante, V. & Carrozzi, M., et al. (2016). Early diagnosis and Early Start Denver Model intervention in autism spectrum disorders delivered in an Italian Public Health System service. Neuropsychiatric Disease and Treatment, 12, 1379–1384. First citation in articleCrossref Medline, Google Scholar

  • Elsabbagh, M., Bailey, A. J., Divan, G., Koh, Y.-J., Kim, Y. S. & Kauchali, S., et al. (2012). Global prevalence of autism and other pervasive developmental disorders. Autism Research, 5, 160–179. First citation in articleCrossref Medline, Google Scholar

  • Falkmer, T., Anderson, K., Falkmer, M. & Horlin, C. (2013). Diagnostic procedures in autism spectrum disorders: A systematic literature review. European Child and Adolescent Psychiatry, 22, 329–340. First citation in articleCrossref Medline, Google Scholar

  • Freitag, C. M., Feineis-Matthews, S., Valerian, J., Teufel, K. & Wilker, C. (2012). The Frankfurt early-intervention program FFIP for preschool-aged children with autism spectrum disorder: A pilot study. Journal of Neural Transmission, 119, 1011–1021. First citation in articleCrossref Medline, Google Scholar

  • Gotham, K., Pickles, A. & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disor- ders. Journal of Autism and Developmental Disorders, 39, 693–705. First citation in articleCrossref Medline, Google Scholar

  • Green, J., Charman, T., McConachie, H., Aldred, C., Slonims, V. & Howlin, P., et al. (2010). Parent-mediated communication-focussed treatment in children with autism (PACT): A randomised controlled trial. The Lancet, (375), 2152–2160. First citation in articleCrossref, Google Scholar

  • Grzadzinski, R., Carr, T., Colombi, C., McGuire, K., Dufek, S. & Pickles, A., et al. (2016). Measuring changes in social communication behaviors: Preliminary development of the Brief Observation of Social Communication Change (BOSCC). Journal of Autism and Developmental Disorders, 46, 2464–2479. First citation in articleCrossref Medline, Google Scholar

  • Ingersoll, B. (2012). Brief report: Effect of a focused imitation intervention on social functioning in children with autism. Journal of Autism and Developmental Disorders, 42, 1768–1773. First citation in articleCrossref Medline, Google Scholar

  • Kaale, A., Fagerland, M. W., Martinsen, E. W. & Smith, L. (2014). Preschool-based social communication treatment for children with autism: 12-month follow-up of a randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 188–198. First citation in articleCrossref Medline, Google Scholar

  • Kaale, A., Smith, L. & Sponheim, E. (2012). A randomized controlled trial of preschool based joint attention intervention for children with autism. Journal of Child Psychology and Psychiatry, 53, 97–105. First citation in articleCrossref Medline, Google Scholar

  • Kasari, C., Freeman, S. & Paparella, T. (2006). Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. Journal of Child Psychology and Psychiatry, 47, 611–620. First citation in articleCrossref Medline, Google Scholar

  • Kasari, C., Paparella, T., Freeman, S. & Jahromi, L. B. (2008): Language outcome in autism: Randomized comparison of joint attention and play interventions. Journal of Consulting and Clinical Psychology 76, 125–137. doi: 10.1037/0022-0​06X.76.1.125. First citation in articleCrossref Medline, Google Scholar

  • Kasari, C., Gulsrud, A., Freeman, S., Paparella, T. & Hellemann, G. (2012) Longitudinal Follow-Up of Children With Autism Receiving Targeted Interventions on Joint Attention and Play. Journal of the American Academy of Child & Adolescent Psychiatry 51, 487–495. doi: 10.1016/j.jaac.2012.02.019. First citation in articleCrossref Medline, Google Scholar

  • Kasari, C., Gulsrud, A., Paparella, T., Hellemann, G. & Berry, K. (2015). Randomized comparative efficacy study of parent-mediated interventions for toddlers with autism. Journal of Consulting and Clinical Psychology, 51, 487–495. First citation in articleGoogle Scholar

  • Kitzerow, J., Teufel, K., Wilker, C. & Freitag, C. M. (2016). Using the brief observation of social communication change (BOSCC) to measure autism-specific development. Autism Research, 9, 940–950. First citation in articleCrossref Medline, Google Scholar

  • Kitzerow, J., Wilker, C., Teufel, K., Soll, S., Schneider, M. & Westerwald, E., et al. (2014). Das Frankfurter Frühinterventionsprogramm (FFIP) für Vorschulkinder mit Autismus-Spektrum-Störungen: Erste Ergebnisse zur Sprachentwicklung [Frankfurt Early Intervention Program (FFIP) for preschoolers with autism spectrum disorders (ASD): First results for language development]. Kindheit und Entwicklung, 23, 34–41. First citation in articleLink, Google Scholar

  • Lord, C., Rutter, M., DiLavore, P. C. & Risi, S. (1999). ADOS. Autism diagnostic observation schedule: Manual. Los Angeles, CA: Western Psychological Services. First citation in articleGoogle Scholar

  • Lord, C., Rutter, M. & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685. First citation in articleCrossref Medline, Google Scholar

  • Lord, C., Wagner, A., Rogers, S., Szatmari, P., Aman, M. & Charman, T., et al. (2005). Challenges in evaluating psychosocial interventions for autistic spectrum disorders. Journal of Autism and Developmental Disorders, 35, 695–708. First citation in articleCrossref Medline, Google Scholar

  • McConachie, H. & Fletcher-Watson, S. (2015). Building capacity for rigorous controlled trials in autism: The importance of measuring treatment adherence. Child: Care, Health and Development, 41, 169–177. First citation in articleCrossref Medline, Google Scholar

  • McConachie, H., Parr, J. R., Glod, M., Hanratty, J. Livingstone, N. & Oono, I. P. et al.. (2015): Systematic review of tools to measure outcomes for young children with autism spectrum disorder. Health Technology Assessment 19 (41), 1–506. doi: 10.3310/hta19410. First citation in articleCrossref, Google Scholar

  • Nakagawa, S. & Cuthill, I. C. (2007). Effect size, confidence interval and statistical significance: A practical guide for biologists. Biological Reviews, 82, 591–605. First citation in articleCrossref Medline, Google Scholar

  • Oono, I. P., Honey, E. J. & McConachie, H. (2013). Parent-mediat- ed early intervention for young children with autism spec- trum disorders (ASD). Evidence-Based Child Health, 8, 2380–2479. First citation in articleCrossref, Google Scholar

  • Pickles, A., Le Couteur, A., Leadbitter, K., Salomone, E., Cole-Fletcher, R. & Tobin, H., et al. (2016). Parent-mediated social communication therapy for young children with autism (PACT): Long-term follow-up of a randomised controlled trial. The Lancet, 388(10059), 2501–2509. First citation in articleCrossref Medline, Google Scholar

  • Reichow, B. (2012). Overview of meta-analyzed in early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders (42)(4), 512–520. First citation in articleCrossref, Google Scholar

  • Reichow, B., Barton, E. E., Boyd, B. A. & Hume, K. (2012). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, (10). First citation in articleCrossref, Google Scholar

  • Reuner, G., Rosenkanz, J., Pietz, J. & Horn, R. (2008). Bayley-II: Bayley Scales of Infant Development (2nd ed) [German version of the Bayley Scales II]. Frankfurt: Pearson. First citation in articleGoogle Scholar

  • Rogers, S. J. & Dawson, G. (2010). Early Start Denver Model for young children with autism: Promoting language, learning, and engagement. New York: Guilford. First citation in articleGoogle Scholar

  • Rogers, S. J. & Vismara, L. A. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child and Adolescent Psychology, 37, 8–38. First citation in articleCrossref Medline, Google Scholar

  • Rühl, D., Bölte, S., Feineis-Matthews, S. & Poustka, F. (2004). ADOS: Diagnostische Beobachtungsskala für autistische Störungen; Manual. dt. Fassung der Autism Diagnostic Observation Schedule von Catherine Lord, Michael Rutter, Pamela C. Dilavore und Susan Risis [German version of the ADOS]. Bern: Huber. First citation in articleGoogle Scholar

  • Salomone, E., Beranova, S., Bonnet-Brilhault, F., Briciet Lauritsen, M., Budisteanu, M. & Buitelaar, J., et al. (2015). Use of early intervention for young children with autism spectrum disorder across Europe. Autism, 20, 233–249. First citation in articleCrossref Medline, Google Scholar

  • Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J. & McGee, G. G., et al. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45, 2411–2428. First citation in articleCrossref Medline, Google Scholar

  • Solomon, R., Van Egeren, Laurie A., Mahoney, G., Quon Huber, Melissa S. & Zimmerman, P. (2014). PLAY Project Home Consultation Intervention Program for Young Children with autism spectrum disorders. Journal of Developmental and Behavioral Pediatrics, 35, 475–485. First citation in articleCrossref Medline, Google Scholar

  • Sparrow, S. S., Balla, D. A., Cicchetti, D. V. & Doll, E. A. (2005). Vineland adaptive behavior scales (Vineland-II) (2nd ed). Minneapolis, MN: Pearson. First citation in articleGoogle Scholar

  • Tellegen, P. J., Laros, J. A. & Petermann, F. (2007). SON-R 2 ½–7: Non-verbaler Intelligenztest; Testmanual mit deutscher Normierung und Validierung [German version of the SON-R 2 ½–7]. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Vismara, L. A., Colombi, C. & Rogers, S. J. (2009). Can one hour per week of therapy lead to lasting changes in young children with autism? Autism, 13, 93–115. First citation in articleCrossref Medline, Google Scholar

  • Warren, Z., McPheeters, M. L., Sathe, N., Foss-Feig, J., Glasser, A. & Veenstra-VanderWeele, J. (2011). A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics, 127, e1303–e1311. First citation in articleCrossref Medline, Google Scholar

  • Weinmann, S., Schwarzbach, C., Begemann, M., Roll, S., Vauth, C. W. S. N. & Greiner, W. (2009). Verhaltens- und fertigkeitenbasierte Frühintervention bei Kindern mit Autismus [German HTA report about early interventions for children with autism]. Health Technology Assessment. Deutsche Agentur für HTA des Deutschen Instituts für medizinische Dokumentation und Information, doi 10.3205/hta000072L First citation in articleGoogle Scholar

  • Weitlauf, A. S., McPheeters, M. L., Peters, B., Sathe, N., Travis, R. & Aiello, R., et al. (2014). Therapies for children with autism spectrum disorder. Comparative Effectiveness Review, No. 137; Report No.: 14-EHC036-EF. Rockville, MD. First citation in articleGoogle Scholar

  • Wetherby, A. M., Guthrie, W., Woods, J., Schatschneider, C., Holland, R. D., Morgan, L. & Lord, C. (2014). Parent-implemented social intervention for toddlers with autism: An RCT. Pediatrics, 134, 1084–1093. doi 10.1542/peds.2014-0757 First citation in articleCrossref Medline, Google Scholar