In a second randomized clinical trial, researchers at the Institute for Autism Research at Canisius College have found a comprehensive summer treatment (summer Max) to be highly effective for children with high-functioning autism spectrum disorders (HFASDs). Children with the disorders endure lifelong impairments involving social and social-communicative functioning and restricted and repetitive interests and behaviors. Despite their significant needs, few comprehensive programs have been developed and validated for children with HFASDs.
Results of this randomized clinical trial found the comprehensive summer treatment to be effective in improving the social performance and clinical symptoms of children with HFASDs. According to Marcus L. Thomeer, PhD and Christopher Lopata, PsyD, the study's lead authors, the findings, which appeared in the journal, Psychology in the Schools (December 2012), supports and extends the findings of a previous randomized trial that initially demonstrated the efficacy of the manualized treatment.
Following the 5-week program, children in the treatment group demonstrated significantly higher scores on child measures of non-literal language skills and knowledge of appropriate social behaviors, as well as significantly higher parent-ratings for targeted and broader social skills and significantly lower ratings of autism symptoms compared to children in the control group. Secondary staff ratings corroborated the significant gains reported by parents. A follow-up assessment 2-3 months post-treatment for the treatment group indicated that the significant gains in social functioning were maintained, and a positive trend suggested that the reduction in autism symptoms continued.
According to Thomeer, "the increase in child understanding along with the increase in parent ratings of social and social-communication skills suggests that the children in treatment acquired new skills and social-cognitive understanding and translated those into effective social performance outside the treatment setting. This is an important finding as generalization of skills and behaviors beyond the treatment setting are a major obstacle for children with HFASDs." The significant decrease in autism symptoms following treatment is also noteworthy as few treatments have been able to reduce these long-term impediments to daily functioning.
One improvement over the previous trial was the addition of follow-up measures in the current study. "The follow-up measures allowed us to determine that the positive treatment effects on social performance continued to be present 2-3 months after the treatment ended," said Lopata. "Although not as robust as the social gains, the children in the treatment group also continued to show reduced autism symptoms." Results of these two randomized clinical trials provide strong evidence of the effectiveness of this unique comprehensive summer treatment for children with HFASDs. Thomeer noted that "this is the first comprehensive treatment specifically for children with HFASDs to be found effective in two randomized trials."
A total of 35 children, ages 7-12 years participated, with 17 randomly assigned to receive the treatment and 18 to a wait-list control condition. Children in the treatment were in groups of six children and three clinical staff. The treatment was conducted five days per week over five weeks and targeted clinical and associated features of autism spectrum disorders including social skills, non-literal language skills, emotion recognition skills, and interest expansion.
Treatment was provided during five, 70-minute treatment cycles each day using direct instruction, modeling, role-playing, and performance feedback. Each treatment cycle consisted of 20-minutes of skills instruction followed by a 50-minute therapeutic activity designed to practice and reinforce target skills. A point system was used to reinforce positive social behaviors and reduce autism symptoms and negative behaviors across the treatment day. Weekly parent education was also provided.
- Marcus L. Thomeer, Christopher Lopata, Martin A. Volker, Jennifer A. Toomey, Gloria K. Lee, Audrey M. Smerbeck, Jonathan D. Rodgers, Christin A. McDonald, Rachael A. Smith. Randomized Clinical Trial Replication of a Psychosocial Treatment for Children with High-Functioning Autism Spectrum Disorders. Psychology in the Schools, 2012; 49 (10): 942 DOI: 10.1002/pits.21647
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