Ændringer i autismeklassifikation i forbindelse med tidlig intervention: prædiktorer og resultater

Kategori: Effektstudie

68 børn med diagnosen infantil autisme i alderen 18-35 måneder har deltaget i en effektstudie. Børnene fik enten en centerbaseret, tidlig adfærdsanalytisk intervention eller en eklektisk intervention, men undersøgelsen sammenligner ikke de to interventionsformer. Børnene blev testet for autistiske symptomer (ADOS), kognitive evner (Mullen) og for social adaption (Vineland) inden interventionen og igen efter 1 års intervention. På opfølgningstidspunktet blev børnene opdelt i to grupper: den uforandrede gruppe på 53 børn, hvis autismeklassifikation ikke var ændret, og en gruppe på 15 børn, hvis autismediagnose var ændret til enten den bredere kategori autismespektrumforstyrrelse eller som ikke længere var diagnosticeret. De to grupper af børn adskilte sig ved interventionens start fra hinanden udelukkende på sproglige forudsætninger - især med hensyn til receptiv sprogforståelse. Børnene i den uforandrede gruppe gjorde også fremskridt i løbet af interventionsperioden men ikke i et omfang, som resulterede i en ændring af diagnosen.

Emneord: © 2011 ABAforum

Ben Itzchak, E. and D.A. Zachor (2009). Change in autism classification with early intervention: Predictors and outcomes. Research in Autism Spectrum Disorders, 3(4), 967-976.

The current study characterized stability and changes of autism diagnostic classification with intervention in very young children and examined pre-treatment predictors and post-intervention outcome. Sixty-eight children diagnosed with autism, aged 18-35 months (M = 25.4, SD = 4.0) participated in the study. Children underwent comprehensive evaluations at pre-intervention time (T1) and after 1 year of intervention (T2). The evaluation included autism classification based on Autism Diagnosis Observation Schedule (ADOS) original algorithm, cognitive abilities (Mullen) and adaptive skills evaluation (Vineland). At T2, two groups were identified: the Unchanged group (n = 53) remained in the same autism classification and the Improved group (n = 15) changed classification to Autism Spectrum Disorder (ASD) (n = 13) or Off Spectrum (n = 2). The verbal domain scores at T1 was the only significant variable that distinguished the two groups. Specifically, the Improved group had better receptive language scores than the Unchanged group. The Improved group gained significantly more than the Unchanged group in all the outcome measures (cognitive, adaptive and reduction of stereotyped behaviors). Two distinct subtypes of autism were identified, one with stable autism symptomatology, poor verbal abilities and limited cognitive and adaptive gains, and a second type with better baseline verbal abilities and overall better response to intervention.

Redaktionen / 25.10.2009