Daniel Holzinger1,2,3, Dominik Laister1,2, Giacomo Vivanti4,5, William Joseph Barbaresi6, Johannes Fellinger1,2,7. 1. Hospital of St. John of God, Institute of Neurology of Senses and Language, Linz, Austria. 2. Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria. 3. Institute of Linguistics, University of Graz, Graz, Austria. 4. Early Detection & Intervention Program, AJ Drexel Autism Institute, Drexel University, Philadelphia, PA. 5. Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia. 6. Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA. 7. Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria.
Abstract
OBJECTIVE: To investigate the feasibility and effectiveness of early autism intervention with the Early Start Denver Model (ESDM) implemented with low intensity in a community service in Europe. METHODS:Subjects were boys (n = 13, ages 34-54 months, mean age 43.3 months) consecutively diagnosed with autism spectrum disorder in a regional autism center in Austria. The subjects either received the ESDM intervention for 4.6 hours weekly over 12 months (n = 7) or intervention as usual (n = 6). Feasibility of the ESDM intervention was evaluated by parent and teacher questionnaires, ESDM fidelity measures, and therapists' feedback. Developmental status was assessed through standardized instruments (Mullen Scales of Early Learning [MSEL], Vineland Adaptive Behavior Scales Second Edition, Communicative Development Inventory, Pervasive Developmental Disorder Behavior Inventory [PDDBI], Parenting Sense of Competence Scale) at baseline and after intervention. RESULTS: The ESDM intervention was delivered with high fidelity (>80%) by a newly trained multiprofessional team. Acceptability by parents was rated as high. The ESDM was considered to be compatible with both family and preschool routines without any major adaptations. The ESDM group showed a trend toward improved receptive language (MSEL receptive language; p = 0.09, effect size [ES] = 0.72) and reduction in parent-reported core autism symptoms (PDDBI Autism Composite Score; p = 0.04; ES = 0.95). No such improvement was noted in the control group. CONCLUSION: Low-intensity implementation of the ESDM in a non-English-speaking community service context is feasible. Although outcomes from this small feasibility study should be interpreted with caution, our findings suggest a more favorable response to the ESDM intervention group compared with the control group.
RCT Entities:
OBJECTIVE: To investigate the feasibility and effectiveness of early autism intervention with the Early Start Denver Model (ESDM) implemented with low intensity in a community service in Europe. METHODS: Subjects were boys (n = 13, ages 34-54 months, mean age 43.3 months) consecutively diagnosed with autism spectrum disorder in a regional autism center in Austria. The subjects either received the ESDM intervention for 4.6 hours weekly over 12 months (n = 7) or intervention as usual (n = 6). Feasibility of the ESDM intervention was evaluated by parent and teacher questionnaires, ESDM fidelity measures, and therapists' feedback. Developmental status was assessed through standardized instruments (Mullen Scales of Early Learning [MSEL], Vineland Adaptive Behavior Scales Second Edition, Communicative Development Inventory, Pervasive Developmental Disorder Behavior Inventory [PDDBI], Parenting Sense of Competence Scale) at baseline and after intervention. RESULTS: The ESDM intervention was delivered with high fidelity (>80%) by a newly trained multiprofessional team. Acceptability by parents was rated as high. The ESDM was considered to be compatible with both family and preschool routines without any major adaptations. The ESDM group showed a trend toward improved receptive language (MSEL receptive language; p = 0.09, effect size [ES] = 0.72) and reduction in parent-reported core autism symptoms (PDDBI Autism Composite Score; p = 0.04; ES = 0.95). No such improvement was noted in the control group. CONCLUSION: Low-intensity implementation of the ESDM in a non-English-speaking community service context is feasible. Although outcomes from this small feasibility study should be interpreted with caution, our findings suggest a more favorable response to the ESDM intervention group compared with the control group.
Authors: Dominik Laister; Giacomo Vivanti; Peter B Marschik; Johannes Fellinger; Daniel Holzinger Journal: Front Psychiatry Date: 2021-12-07 Impact factor: 4.157