Bibliography: More is Not Better, Children with Autism Spectrum Disorders Research

The following information has been adapted from a bibliography originally compiled by Robin McWilliam and Amy M. Casey, Vanderbilt University Medical Center, 2004. The studies below: 1) support the use of naturalistic interventions with families of children with autism spectrum disorder; and/or 2) raise significant questions about the quality of studies supporting the use of professionals to implement high intensity therapy programs.

Anderson, S.R., Avery, D.L., & DiPietro, E.K., Edwards, G.L., & Christian, W.P. (1987). Intensive home-based intervention with autistic children. Education and Treatment of Children, 10, 352-366.

Birnbrauer, J.S., & Leach, D.J. (1993). The Murdoch Early Intervention Program after two years. Behaviour Change, 10, 63-74.

Boyd, R.D. & Corley, M.J. (2001). Outcome survey of early intensive behavior intervention for young children with autism in a community setting. Autism, 5, 430-441.

Lovaas, O.I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3-9.

Note: Highly criticized study design (see comments such as Shopler). Experimental group (40 hours of therapy/week) had higher educational placement and IQ scores than did control group (10 hours of therapy/week) Did you know that parents were asked to quit their jobs for duration of the study? Did you know that no changes were noticed in communication and problem behaviors? Did you know that many participants received this intervention for ???? years?

Luiselli, J.K., O'Malley Cannon, B., Ellis, J.T., & Sisson, R.W. (2000). Home-based behavioral intervention for young children with autism/pervasive developmental disorder: A preliminary evaluation of outcome in relation to child age and intensity of service delivery. Autism, 4, 426-438.

McEachin, J.J., Smith, T., & Lovaas, O.I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97, 359-372.

Note: Follow-up with original Lovaas (187) participants. Experimental group still had higher educational placement and significantly higher mean IQ; maintained gains from evaluation at age of seven years. From this study and original Lovaas study, we do not know whether the interventions must be delivered by professionals rather than natural caregivers.

Shopler, E., Short, A., & Mesibov, G. (1989). Relation of behavioral treatment to "normal functioning": Comment on Lovaas. Journal of Consulting and Clinical Psychology, 57, 162-164.

Note: Critique of Lovaas (1987) study.

Sheinkopf, S.J., & Siegel, B. (1998). Home-based behavioral treatment of young children with autism. Journal of Autism and Developmental Disorders, 28, 15-23.

Smith, T., Groen, A.D., & Wynn, J.W. (2000). Randomized trial of intensive early intervention for children with pervasive developmental disorder. American Journal on Mental Retardation, 105, 269-285.

Note: No difference between groups on adaptive behavior and problem behaviors.

Experimental group (30 hours therapy/week) did have statistically significant higher IQ, visual-spatial skills, and language development scores than control group (5 hours parent training/week). No treatment fidelity data on what parents did with their training. Sampling for study was questionable (i.e., assignment of groups, IQ cut-offs yielding those with most favorable prognosis.

Stone, W.L. & Yoder, P.J. (2001). Predicting spoken language level in children with autism spectrum disorders. Autism, 5, 341-361.

Note: Hours of participation in other therapies and educational intervention did not correlate significantly with follow-up expressive language. Intervention measure was number of hours of speech/language therapy received in the 52 weeks between ages of two and three years. The independent variable was number of sessions, NOT intensity; also dependent variable was standardized measures not functional outcomes.