Each year the Interagency Autism Coordinating Council (IACC), a congressionally-created entity to advance autism research across federal agencies, releases a list of scientific advances that represent significant progress in the field. Included among the efforts selected for 2011 is work by CU Denver School of Education & Human Development researchers Professor Phil Strain (photo) and Ted Bovey.
Their 2011 study supports the effectiveness of an early intervention model for autism spectrum disorder (ASD) designed to be used in an integrated classroom. “A unique contribution made by this study was our careful measurement of the fidelity or accuracy with which the LEAP (Learning Experiences and Alternative Program for Preschoolers and Their Parents) practices were implemented,” said Strain. “Specifically, the data show a direct relationship between teachers’ precise implementation of practices and children’s improvement. Put more bluntly, only when teachers implemented with great precision were changes noted in children’s performance. These treatment fidelity data have profound implications for how the field in general prepares professionals to meet the needs of young children with autism.”
Their results were published in “Randomized, controlled trial of the LEAP model of early intervention for young children with autism spectrum disorders” – Strain PS and Bovey EH. Topics in Early Childhood Special Education. 2011 Nov;31(3):133-154.
Randomized controlled trials (RCTs) are considered to be the gold standard of evidence; however, due to their complexity and cost, only four other RCTs of comprehensive interventions for young children with autism had been completed at the time this article was published. Of these four, all were tested in segregated environments and involved one-on-one instruction at the beginning of the intervention. In contrast, the LEAP preschool model uses teaching opportunities that arise naturally in an integrated setting and incorporates typically developing students by training them to support the social skills development of their peers with ASD. The LEAP model is also the first evidence-based intervention for ASD to be tested in a public school setting.
In the study, they compared the performance of students in 28 classrooms where teachers received personal training and coaching support in the LEAP model over two years to the performance of teachers in 28 classrooms who received only training manuals and written materials. While all children had equivalent skill levels at the start of the intervention, after two years the students in the coached classrooms showed marked improvement in symptoms of autism, cognitive scores, language development, social skills, and a reduction in problem behavior.
The teachers' fidelity to the LEAP strategies predicted the students' level of improvement. “The improvements seen in children who received high fidelity LEAP practices were particularly significant in their breadth, that is, children made progress in their cognitive, language, and social abilities,” said Strain. Also, the cost is much less than other commonly used one-on-one strategies -- an estimated $20,000 per child annually compared to $45,000 - $69,000.
“At this point, we are very fortunate to have received additional federal funding to conduct a three-year follow-up on study participants. While we are only in the first year of this effort we are very excited about the continuing progress of children into the early elementary grades,” said Strain.
The study is available on the IACC website.