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Distinct Patterns Of Treatment Response Using The Early Start Denver Model With Young Children With Autism Spectrum Disorder: A Cluster Analysis

Godel Michel, Robain François, Kojovic Nada, Franchini Martina, Wood de Wilde Hilary, Schaer Marie

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AbstractEvidence-based, early intervention significantly improves developmental outcome in young children with autism. Despite having an overall positive impact on most children, there is high interindividual heterogeneity of response to treatment, and it is currently not possible to predict whether a child will make significant progress in early intervention based on their profile of symptoms at diagnosis. In this study, we analyze developmental trajectories of preschoolers with autism who received 2 years of intervention using the Early Start Denver Model (ESDM) approach in Geneva, Switzerland (n = 47). Our aim was to identify early predictors of response to treatment. We applied cluster analysis to distinguish between 3 subgroups based on cognitive level at intake, and rates of cognitive change over the course of treatment. The first subgroup of children only had a mild cognitive delay at intake, and nearly no cognitive delay by the end of treatment (Higher Cognitive at baseline: HC). The children in the two other subgroups all presented with severe cognitive delay at baseline, however, they had two very different patterns of response to treatment. The majority significantly improved developmental scores within their first year of intervention (Optimal Responders: OptR). Whereas a minority of children showed little to no improvement over the course of treatment (Minimal Responders: MinR). Our findings suggest that children who end up having a more optimal two-year treatment outcome show rapid developmental improvement. Inversely, less significant progress by the sixth month of intervention may predict a less optimal short-term response to treatment.