The effectiveness of a centre-based early intensive behavioural intervention in a young child with autistic disorder.

Abstract

While there is considerable evidence that applied behaviour analysis (ABA) is an efficacious treatment for Autistic Disorder (AD) in a controlled research setting, the effectiveness of current applications of ABA in the South African context have not yet been established. The aim of the present study was to evaluate the effectiveness of an intensive ABA programme for a young child with AD. A single case study was conducted using a within-subject, repeated measures, evaluation design. The ABA treatment, an applied verbal behaviour version ofABA (AVB/ABA), was implemented by behaviour consultants and technicians at TRIAD (Therapy and Research in Autistic Disorders): a private centre in Durban, KwaZulu-Natal, that specialises in the behavioural treatment of children with AD. The subject was a young boy, who was diagnosed with AD at the age of 21 months, initiated treatment at TRIAD at 22 month of age, and underwent 20 hours of treatment per week over a 22 month period. Cumulative outcome data across all learning domains was obtained using the standard outcome measure at the centre: the Assessment of Basic Language and Learning Skills (ABLLS). The ABLLS was administered by a senior behaviour consultant on five occasions, namely at baseline (i.e., at 0 months); at various intervals throughout the intervention (at 2,3, and 14 months); and in the final week of the study period (at 22 months). Results were tabulated and converted into linear graph format by the researcher. In addition, the caregiver was asked to rate the child's progress on a five point Likert scale as a means of establishing the social validity of the behaviour change. Visual inspection of the linear graphs revealed that the subject improved considerably across all ABLLS domains over the 22 month period and the child's caregiver rated that his behaviour had "significantly improved" since the onset of the intervention. In addition, at the end of the 22 month treatment period, the subject was enrolled in a mainstream school with the assistance of an aide and was engaging with same-age peers. The present study thus provides support for the effectiveness of the AVBIABA programme at TRIAD, contributes to the existing ABA outcome literature, and provides further evidence for the efficacy of the AVB approach to ABA. Furthermore, results confirm the role of predictor variables, such as age at onset, hours of treatment, skill acquisition rates, and parental involvement. Finally, given the gains made in the present study, it is suggested that the initial cost of intensive treatment may be economical in the long term.