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Published in: Child and Adolescent Psychiatry and Mental Health 1/2010

Open Access 01-12-2010 | Research

Intensive intervention for children and adolescents with autism in a community setting in Italy: a single-group longitudinal study

Authors: Marco Valenti, Renato Cerbo, Francesco Masedu, Marco De Caris, Germana Sorge

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2010

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Abstract

Background

Previous studies have shown favourable results with intensive behavioural treatment for children with autism: evidence has emerged that treatment can be successfully implemented in a community setting and in adolescent participants. The aim of this study was to describe the 2-year adaptive functioning outcome of children and adolescents with autism treated intensively within the context of special autism centres, as well as to evaluate family satisfaction with the activity of the centres.

Methods

Sixty participants with autism (20 females and 40 males, aged between 4 and 18 years) attending the semi-residential rehabilitation centres for autism located in the Abruzzo region (Central Italy) were followed up and their adaptive functioning was evaluated both at baseline and after one and two years using the Vineland Adaptive Behaviour Scales (VABS). Parents' satisfaction with the service was evaluated using the Orbetello Satisfaction Scale for Children and Adolescent Mental Health.

Results

The increase in VABS scores was significant on several domains in the different gender and age categories. It is worth noting that male children had improved a great deal (roughly, an effect size >0.20) in the domains of communication, daily living and motor skills (effect sizes 0.34, 0.45 and 0.27 respectively) whereas in male adolescents, a notable increase in VABS scores was recorded in the domain of socialization only (effect size 0.23). On the other hand, adaptive behaviour in female children increased in the domains of socialization and motor skills (effect sizes 0.27 and 0.42 respectively) whereas in female adolescents, good results were achieved in the domains of daily living, socialization and motor skills (effect sizes 0.22, 0.26 and 0.20 respectively).
The level of satisfaction of users of the service over time was found to be substantial, even when they had recently started the program.

Conclusions

Our results support the implementation of special autism treatment community centres, based on a parent co-directed rehabilitative, intensive and early intervention. Further experimental research designed to document the effectiveness of services provided to children and adolescents with autism in the community is recommended.
Literature
1.
go back to reference Williams JG, Higgins JP, Brayne CE: Systematic review of prevalence studies of autism spectrum disorders. Arch Dis Child. 2006, 91 (1): 8-15. 10.1136/adc.2004.062083.PubMedCentralCrossRefPubMed Williams JG, Higgins JP, Brayne CE: Systematic review of prevalence studies of autism spectrum disorders. Arch Dis Child. 2006, 91 (1): 8-15. 10.1136/adc.2004.062083.PubMedCentralCrossRefPubMed
2.
go back to reference Case-Smith J, Arbesman M: Evidence-based review of interventions for autism used in or of relevance to occupational therapy. Am J Occup Ther. 2008, 62 (4): 416-29.CrossRefPubMed Case-Smith J, Arbesman M: Evidence-based review of interventions for autism used in or of relevance to occupational therapy. Am J Occup Ther. 2008, 62 (4): 416-29.CrossRefPubMed
3.
go back to reference Greenspan SI, Wieder S: The child with special needs. 1998, Perseus Book; Reading; Massachussetts Greenspan SI, Wieder S: The child with special needs. 1998, Perseus Book; Reading; Massachussetts
4.
go back to reference Gutstein SE: Autism Aspergers: solving the relationship puzzle. 2000, Future Horizon Incorporated; Arlington Gutstein SE: Autism Aspergers: solving the relationship puzzle. 2000, Future Horizon Incorporated; Arlington
5.
go back to reference King GA, King SA, Rosembaum PL: How mothers and fathers view professional caregiving for children with disabilities. Dev Med Child Neurol. 1996, 38: 397-400. 10.1111/j.1469-8749.1996.tb15098.x.CrossRefPubMed King GA, King SA, Rosembaum PL: How mothers and fathers view professional caregiving for children with disabilities. Dev Med Child Neurol. 1996, 38: 397-400. 10.1111/j.1469-8749.1996.tb15098.x.CrossRefPubMed
6.
go back to reference Prizant BM, Wetherby AM: Understanding the continuum of discrete-trial traditional behavioral to social-pragmatic developmental approaches in communication enhancement for young children with autism/PDD. Semin Speech Lang. 1998, 19 (4): 329-52. 10.1055/s-2008-1064053.CrossRefPubMed Prizant BM, Wetherby AM: Understanding the continuum of discrete-trial traditional behavioral to social-pragmatic developmental approaches in communication enhancement for young children with autism/PDD. Semin Speech Lang. 1998, 19 (4): 329-52. 10.1055/s-2008-1064053.CrossRefPubMed
7.
go back to reference Maurice C, Green G, Luce SC: Behavioral intervention for young children with autism: a manual for parents and professionals. Pro-Ed; Austin. 1996 Maurice C, Green G, Luce SC: Behavioral intervention for young children with autism: a manual for parents and professionals. Pro-Ed; Austin. 1996
8.
go back to reference Magiati I, Charman T, Howlin P: A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist nursery provision for children with autism spectrum disorders. J Child Psychol Psychiatry. 2007, 48 (8): 803-12. 10.1111/j.1469-7610.2007.01756.x.CrossRefPubMed Magiati I, Charman T, Howlin P: A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist nursery provision for children with autism spectrum disorders. J Child Psychol Psychiatry. 2007, 48 (8): 803-12. 10.1111/j.1469-7610.2007.01756.x.CrossRefPubMed
9.
go back to reference Cohen H, Amerine-Dickens M, Smith T: Early intensive behavioral treatment: replication of the UCLA model in a community setting. J Dev Behav Pediatr. 2006, 27 (2 Suppl): S145-55. 10.1097/00004703-200604002-00013.CrossRefPubMed Cohen H, Amerine-Dickens M, Smith T: Early intensive behavioral treatment: replication of the UCLA model in a community setting. J Dev Behav Pediatr. 2006, 27 (2 Suppl): S145-55. 10.1097/00004703-200604002-00013.CrossRefPubMed
10.
go back to reference Reichow B, Wolery M: Comprehensive Synthesis of Early Intensive Behavioral Interventions for Young Children with Autism Based on the UCLA Young Autism Project Model. J Autism Dev Disord. 2009, 39: 23-41. 10.1007/s10803-008-0596-0.CrossRefPubMed Reichow B, Wolery M: Comprehensive Synthesis of Early Intensive Behavioral Interventions for Young Children with Autism Based on the UCLA Young Autism Project Model. J Autism Dev Disord. 2009, 39: 23-41. 10.1007/s10803-008-0596-0.CrossRefPubMed
11.
go back to reference Shea V: A perspective on the research literature related to early intensive behavioural intervention (Lovaas) for young children with autism. Autism. 2004, 8 (4): 349-67. 10.1177/1362361304047223.CrossRefPubMed Shea V: A perspective on the research literature related to early intensive behavioural intervention (Lovaas) for young children with autism. Autism. 2004, 8 (4): 349-67. 10.1177/1362361304047223.CrossRefPubMed
12.
go back to reference McEachin JJ, Smith T, Lovaas OI: Long-term outcome for children with autism who received early intensive behavioral treatment. Am J Ment Retard. 1993, 97 (4): 359-72.PubMed McEachin JJ, Smith T, Lovaas OI: Long-term outcome for children with autism who received early intensive behavioral treatment. Am J Ment Retard. 1993, 97 (4): 359-72.PubMed
13.
go back to reference Reinke T: States increasingly mandate special autism services. Insurers are being handed some treatment responsibility for this complex disorder, but some say that it is an educational, not medical, task. Manag Care. 2008, 17 (8): 35-6. 39PubMed Reinke T: States increasingly mandate special autism services. Insurers are being handed some treatment responsibility for this complex disorder, but some say that it is an educational, not medical, task. Manag Care. 2008, 17 (8): 35-6. 39PubMed
14.
go back to reference Bryson SA, Corrigan SK, McDonald TP, Holmes C: Characteristics of children with autism disorders who received services through community mental health centers. Autism. 2008, 12 (1): 65-82. 10.1177/1362361307085214.CrossRefPubMed Bryson SA, Corrigan SK, McDonald TP, Holmes C: Characteristics of children with autism disorders who received services through community mental health centers. Autism. 2008, 12 (1): 65-82. 10.1177/1362361307085214.CrossRefPubMed
15.
go back to reference Cerbo R, De Caris M, De Laurenzi V, Di Giovanni C, Gabrielli M, Sorge G, Valenti M: Un progetto per la presa in carico di bambini e ragazzi autistici. Una concreta esperienza di 5 anni nella Regione Abruzzo. G Neuropsichiatr Età Evol. 2008, 28: 167-184. Cerbo R, De Caris M, De Laurenzi V, Di Giovanni C, Gabrielli M, Sorge G, Valenti M: Un progetto per la presa in carico di bambini e ragazzi autistici. Una concreta esperienza di 5 anni nella Regione Abruzzo. G Neuropsichiatr Età Evol. 2008, 28: 167-184.
16.
go back to reference Lord C, Rutter M, DiLavore PC, Risi S: Autism Diagnostic Observation Schedule. Edizione Italiana. Edited by: Tancredi R, Saccani M, Persico AM, Parrini B, Igliozzi R, Faggioli R. 2005, Giunti O.S., Firenze Lord C, Rutter M, DiLavore PC, Risi S: Autism Diagnostic Observation Schedule. Edizione Italiana. Edited by: Tancredi R, Saccani M, Persico AM, Parrini B, Igliozzi R, Faggioli R. 2005, Giunti O.S., Firenze
17.
go back to reference Rutter M, Le Couteur A, Lord C: Autism Diagnostic Interview - Revised. Edizione Italiana. Edited by: Faggioli R, Saccani M, Persico AM, Tancredi R, Parrini B, Igliozzi R. 2005, Giunti O.S., Firenze Rutter M, Le Couteur A, Lord C: Autism Diagnostic Interview - Revised. Edizione Italiana. Edited by: Faggioli R, Saccani M, Persico AM, Tancredi R, Parrini B, Igliozzi R. 2005, Giunti O.S., Firenze
18.
go back to reference Wechsler D: Weschsler Intelligence Scale for Children - III. Edizione Italiana. Edited by: Orsini L, Picone S. 2006, Giunti O.S., Firenze Wechsler D: Weschsler Intelligence Scale for Children - III. Edizione Italiana. Edited by: Orsini L, Picone S. 2006, Giunti O.S., Firenze
19.
go back to reference Sparrow SS, Balla DA, Cicchetti DV: Vineland adaptive behavior scales. Circle Pines. 1984, MN: American Guidance Service Sparrow SS, Balla DA, Cicchetti DV: Vineland adaptive behavior scales. Circle Pines. 1984, MN: American Guidance Service
20.
go back to reference Newsom C, Hovanitz CA: Autistic disorder. Assessment of childhood disorders. Edited by: Mash EJ, Terdal LG. 1997, New York: Guilford, 3: 408-452. Newsom C, Hovanitz CA: Autistic disorder. Assessment of childhood disorders. Edited by: Mash EJ, Terdal LG. 1997, New York: Guilford, 3: 408-452.
21.
go back to reference Fenton G, D'Ardia C, Valente D, Del Vecchio I, Fabrizi A, Bernabei P: Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism. 2003, 7 (3): 269-87. 10.1177/13623613030073004.CrossRefPubMed Fenton G, D'Ardia C, Valente D, Del Vecchio I, Fabrizi A, Bernabei P: Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism. 2003, 7 (3): 269-87. 10.1177/13623613030073004.CrossRefPubMed
22.
go back to reference Sparrow SS, Balla DA, Cicchetti DV: Vineland adaptive behavior scales. Intervista, forma completa. Edited by: Balboni G, Pedrabissi L. 2008, Firenze; Giunti O.S. Sparrow SS, Balla DA, Cicchetti DV: Vineland adaptive behavior scales. Intervista, forma completa. Edited by: Balboni G, Pedrabissi L. 2008, Firenze; Giunti O.S.
23.
go back to reference Klin A, Saulnier CA, Sparrow SS, Cicchetti DV, Volkmar FR, Lord C: Social and communication abilities and disabilities in higher-functioning individuals with autism spectrum disorders: The Vineland and ADOS. J Autism Developm Dis. 2007, 37: 748-759. 10.1007/s10803-006-0229-4.CrossRef Klin A, Saulnier CA, Sparrow SS, Cicchetti DV, Volkmar FR, Lord C: Social and communication abilities and disabilities in higher-functioning individuals with autism spectrum disorders: The Vineland and ADOS. J Autism Developm Dis. 2007, 37: 748-759. 10.1007/s10803-006-0229-4.CrossRef
24.
go back to reference MacLean JE, Szatmari P, Jones MB, Bryson SE, Mahoney WJ, Bartolucci G, Tuff L: Familial factors influence level of functioning in pervasive developmental disorder. J Am Acad Child Adolesc Psychiatry. 1999, 38: 746-753. 10.1097/00004583-199906000-00023.CrossRefPubMed MacLean JE, Szatmari P, Jones MB, Bryson SE, Mahoney WJ, Bartolucci G, Tuff L: Familial factors influence level of functioning in pervasive developmental disorder. J Am Acad Child Adolesc Psychiatry. 1999, 38: 746-753. 10.1097/00004583-199906000-00023.CrossRefPubMed
25.
go back to reference Gillham JE, Carter AS, Volkmar FR, Sparrow SS: Toward a developmental operational definition of autism. Annual progress in child psychiatry and child development: 2000-2001. Edited by: Hertzig ME, Farber EA. 2003, New York, NY: Brunner-Routledge, 363-381. Gillham JE, Carter AS, Volkmar FR, Sparrow SS: Toward a developmental operational definition of autism. Annual progress in child psychiatry and child development: 2000-2001. Edited by: Hertzig ME, Farber EA. 2003, New York, NY: Brunner-Routledge, 363-381.
26.
go back to reference Mazefsky CA, Williams DL, Minshew NJ: Variability in Adaptive Behavior in Autism: Evidence for the Importance of Family History. J Abnorm Child Psychol. 2008, 36 (4): 591-599. 10.1007/s10802-007-9202-8.PubMedCentralCrossRefPubMed Mazefsky CA, Williams DL, Minshew NJ: Variability in Adaptive Behavior in Autism: Evidence for the Importance of Family History. J Abnorm Child Psychol. 2008, 36 (4): 591-599. 10.1007/s10802-007-9202-8.PubMedCentralCrossRefPubMed
27.
go back to reference Garland AF, Aarons GA, Hawley KM, Hough RI: Relationship of youth satisfaction with mental health services and changes in symptoms and functioning. Psychiatr Serv. 2003, 54 (11): 1544-6. 10.1176/appi.ps.54.11.1544.CrossRefPubMed Garland AF, Aarons GA, Hawley KM, Hough RI: Relationship of youth satisfaction with mental health services and changes in symptoms and functioning. Psychiatr Serv. 2003, 54 (11): 1544-6. 10.1176/appi.ps.54.11.1544.CrossRefPubMed
28.
go back to reference Lambert W, Saltzer MS, Bickman I: Clinical outcome, consumer satisfaction and ad hoc ratings of improvement in children's mental health. J Consult Clin Psychol. 1998, 66 (2): 270-9. 10.1037/0022-006X.66.2.270.CrossRefPubMed Lambert W, Saltzer MS, Bickman I: Clinical outcome, consumer satisfaction and ad hoc ratings of improvement in children's mental health. J Consult Clin Psychol. 1998, 66 (2): 270-9. 10.1037/0022-006X.66.2.270.CrossRefPubMed
29.
go back to reference Gigantesco A, Camuffo M, Mirabella F, Morosini P: Parental evaluation of child and adolescent mental health services: a multicentre study. Ann Ist Super Sanità. 2005, 41 (4): 501-513.PubMed Gigantesco A, Camuffo M, Mirabella F, Morosini P: Parental evaluation of child and adolescent mental health services: a multicentre study. Ann Ist Super Sanità. 2005, 41 (4): 501-513.PubMed
30.
go back to reference Stallard P: Validity and reliability of the Parent Satisfaction Questionnaire. Br J Clin Psychol. 1996, 35 (Pt 2): 311-8.CrossRefPubMed Stallard P: Validity and reliability of the Parent Satisfaction Questionnaire. Br J Clin Psychol. 1996, 35 (Pt 2): 311-8.CrossRefPubMed
31.
go back to reference Buscaglia G, Carolei A, Baldazzi F, Marinoni A, Ferro AM: Surveying participants' and family members' satisfaction: the experience of the Mental Health Department in Savona. Epidemiol Psichiatr Soc. 2004, 13 (3): 158-68.CrossRefPubMed Buscaglia G, Carolei A, Baldazzi F, Marinoni A, Ferro AM: Surveying participants' and family members' satisfaction: the experience of the Mental Health Department in Savona. Epidemiol Psichiatr Soc. 2004, 13 (3): 158-68.CrossRefPubMed
32.
go back to reference Fleiss JL, Cohen J: The equivalence of weighted kappa and the intraclass correlation coefficient as measures of reliability. Educ Psychol Measurement. 1973, 33: 613-619. 10.1177/001316447303300309.CrossRef Fleiss JL, Cohen J: The equivalence of weighted kappa and the intraclass correlation coefficient as measures of reliability. Educ Psychol Measurement. 1973, 33: 613-619. 10.1177/001316447303300309.CrossRef
33.
go back to reference Twisk JWR: Applied Longitudinal Data Analysis for Epidemiology. 2003, Cambridge, UK: Cambridge University Press Twisk JWR: Applied Longitudinal Data Analysis for Epidemiology. 2003, Cambridge, UK: Cambridge University Press
34.
go back to reference Hedges L, Olkin I: Statistical models for meta-analysis. 1985, New York: Academic Press Hedges L, Olkin I: Statistical models for meta-analysis. 1985, New York: Academic Press
35.
go back to reference Piven J, Harper J, Palmer P, Arndt S: Course of behavioural change in autism: a retrospective study of high-IQ adolescents and adults. J Am Acad Child Adolesc Psychiatry. 1996, 35: 523-529. 10.1097/00004583-199604000-00019.CrossRefPubMed Piven J, Harper J, Palmer P, Arndt S: Course of behavioural change in autism: a retrospective study of high-IQ adolescents and adults. J Am Acad Child Adolesc Psychiatry. 1996, 35: 523-529. 10.1097/00004583-199604000-00019.CrossRefPubMed
36.
go back to reference Bradley EA, Summers JA, Wood HL, Bryson SE: Comparing rates of psychiatric and behaviour disorders in adolescents and young adults with severe intellectual disability with and without autism. J Autism Dev Disord. 2004, 34: 151-161. 10.1023/B:JADD.0000022606.97580.19.CrossRefPubMed Bradley EA, Summers JA, Wood HL, Bryson SE: Comparing rates of psychiatric and behaviour disorders in adolescents and young adults with severe intellectual disability with and without autism. J Autism Dev Disord. 2004, 34: 151-161. 10.1023/B:JADD.0000022606.97580.19.CrossRefPubMed
37.
go back to reference Micacchi G, Giuliani A, Cerbo R, Sorge G, Valenti M: Physical activity in youngsters with autism: a critical review of literature. Ital J Sport Sci. 2006, 13: 37-43. Micacchi G, Giuliani A, Cerbo R, Sorge G, Valenti M: Physical activity in youngsters with autism: a critical review of literature. Ital J Sport Sci. 2006, 13: 37-43.
Metadata
Title
Intensive intervention for children and adolescents with autism in a community setting in Italy: a single-group longitudinal study
Authors
Marco Valenti
Renato Cerbo
Francesco Masedu
Marco De Caris
Germana Sorge
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2010
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/1753-2000-4-23

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