Mega-analytic support for Early Start Denver Model, age at intervention start, and pre-intervention developmental level as factors differentiating early intervention outcomes in autism

  1. Veronica Mandelli
  2. Elena Maria Busuoli
  3. Michel Godel
  4. Nada Kojovic
  5. Yana Sinai-Gavrilov
  6. Tali Gev
  7. AEIR Consortium
  8. Annarita Contaldo
  9. Eric Courchesne
  10. Karen Pierce
  11. Ofer Golan
  12. Antonio Narzisi
  13. Filippo Muratori
  14. Costanza Colombi
  15. Sally J. Rogers
  16. Giacomo Vivanti
  17. Marie Schaer
  18. Liliana Ruta
  19. Michael V. Lombardo
0 evaluations Published on
Read the full article Related papers
This article on Sciety

Abstract

Objective

Autism early intervention meta-analyses have provided initial answers to questions such as ‘what types of interventions work’ and ‘for what outcomes’? However, we also want to know ‘for whom’ is early intervention most effective for? Mega-analysis can offer up complementary insights to meta-analyses regarding the ‘what works’ and ‘for what’, while also offering unique insights into the ‘for whom’ question.

Methods

Here we conduct a mega-analysis with linear mixed effect modeling on AEIR consortium early intervention datasets totaling n=645 children spanning several countries (e.g., USA, Switzerland, Italy, Israel, and Australia). Early Start Denver Model (ESDM) and other non-ESDM approaches (e.g., EIBI, NDBI, other community/treatment as usual approaches) was evaluated as contrasting intervention types. Models also evaluated intervention intensity, type, participant sex, age at intervention start, and pre-intervention developmental quotient. Subscales of Mullen Scales of Early Learning (MSEL), Vineland Adaptive Behavior Scales (VABS), and Autism Diagnostic Observation Schedule (ADOS) were utilized as outcome measures.

Results

Neither intervention intensity nor participant sex affected outcomes. ESDM showed faster growth in language and non-verbal cognition compared to non-ESDM intervention. Irrespective of intervention type, earlier intervention start was associated with increased MSEL and VABS scores and decreased ADOS severity. Growth trajectories on the MSEL also varied by pre-intervention developmental quotient, with higher quotients predicting faster growth irrespective of intervention type.

Conclusions

Age at intervention start and pre-intervention developmental quotient are important individualized factors that predict early intervention response. ESDM also impacts language, non-verbal cognition, and core autism features.

Related articles

Related articles are currently not available for this article.