Smith, T. (1999). Outcome of early intervention for children with autism. Clinical Psychology: Science and Practice, 6, 33-49.

III. Overview:

Autism is a severely debilitating psychological disorder striking in early childhood. The vast majority of children who become autistic remain so for the rest of their lives. The disorder is characterized by, among other symptoms, communicative deficits, social apathy and isolation, repetitive and stereotyped behaviors, low IQ, and self-injurious behaviors. Medical interventions have shown only limited utility; most attempts at intervention have centered on behavioral strategies.

IV. General Method:

Smith's article is a critical review of the 12 peer-reviewed outcome studies on early intervention for autism that have been published since 1980. Nine of these studies were behavior-analytic in orientation, 1 involved Project TEACCH, and 2 involved Colorado Health Sciences.

V. Conclusions and Implications:

Although all outcome studies have reported moderate to substantial gains in IQ and social skills, methodological problems in many of these studies limit the conclusions that may be drawn from them. In general, these problems center on the following issues: large individual differences in response to treatment, lack of rigorous experimental design, reliable on-going assessment, replication of treatment conditions, and lack of follow-up (11 of the 12 studies) after treatment for autism was terminated. However, one behavior-analytic study, known as the UCLA project, produced long-lasting treatment effects and was fairly methodologically rigorous. (The UCLA project involved an intensive, 40 hour/week intervention lasting two or more years for 19 subjects with autism (and involved comparison to appropriate control groups)). Other behavior-analytic approaches, which were shorter in duration, appear to produce at least some short-term gains in functioning.