Three Year Follow-up Outcomes for Children with Autism in LEAP's Randomized Trial

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Three Year Follow-up Outcomes for Children with
Autism in LEAP's Randomized Trial

• Phillip S. Strain Ted Bovey
• University of Colorado Denver

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Key Intervention Components

• Teaching typically-developing peers to facilitate
  the social and language skills of children with
  autism
• Functional goals and objectives determined
  largely by family requests
• Embedding ongoing learning opportunities into
  typical preschool routines

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The Mitten
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Key Intervention Components, cont

• Transdisciplinary model of service delivery
• Ongoing, daily data collection used to drive
  intervention
• Using a broad array of evidence-based practices
  (PECS, PRT, Errorless Learning, Incidental
  Teaching, Peer-Mediated Intervention)
• Structured parent skill training curriculum

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Parent Coaching
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Parent Coaching - 2
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Top 12 Findings from LEAP Research (Single Case
Quasi-experimental

1. Day-one intervention effects on peer-mediated
   social skills.
2. With two years of intervention about 50 of
   target children engage in positive interactions
   at levels equivalent to typical peers.
3. Social effects last up to 6 years post
   intervention.
4. Inclusion, proximity, modeling isnt sufficient

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Top 12 Findings, cont

1. Typical children are not harmed. In fact, they
   turn-out to be more socially competent than age
   cohorts.
2. No correlation between severity and outcome.
3. After two years vast majority of children do not
   reach diagnostic threshold on CARS
4. Family participation reduces depression and
   stress.

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Top 12 Findings, cont

1. Family skill training results in changes in child
   appropriate behavior and compliance.
2. Preschoolers in year two can learn to
   self-monitor and self-reinforce classroom
   behavior.
3. Children make, on average, one to two months
   developmental progress per month enrolled.
4. Sustainability of outcomes is closely linked to
   quality of contemporaneous environment.

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Child Outcomes After 2 Years of Study
Participation
Full Replication Full Replication Full Replication Manuals Only Manuals Only Manuals Only
Mean SD ? Mean SD ? ES
CARS 32.9 3.9 -6.1 34.6 4.2 -2.8 .59
PLS-4 (Total Language Score)b 51.3 8.1 18.5 43.8 7.7 9.4 .92
Mullen ELCa 68.5 7.5 8.9 61.4 9.0 -1.8 .89
Visual Receptionb 52.7 11.5 20.4 46.3 11.6 11.7 .80
Fine Motorb 43.3 5.2 11.4 39.8 4.9 5.0 .81
Receptive Languageb 49.3 7.9 18.5 40.7 7.7 7.3 .89
Expressive Languageb 38.7 6.4 9.8 35.9 4.4 5.6 .60
SSRS Positivec 42.1 12.6 28.6 32.7 11.9 12 1.22
SSRS Negativec 56.5 4.2 -7.0 49.1 4.1 -4.3 .62
ES Effect size difference between ? for full
replication and ? for manuals only group p lt
.05, p lt .01 comparing ? for full replication
and ? for manuals only group ? Mean differences
between initial assessment and Year 2 data. a
Standard score b Age (months developmental)
equivalent c Percentile rank score
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LEAP Follow Up Measures

• Educational Placement
• Quality of Classroom Rating
• Childhood Autism Rating Scale (CARS)
• Social Skills Rating Scale (SSRS)
• Kaufman Test of Educational Achievement - Brief
  (KTEA Brief)
• Test of Language Development (TOLD)
• Leiter (Brief IQ)

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Case Study 1
Preschool Preschool Follow Up
Measure Entry Exit
Age 3yr 1mo. 4yr 7 mo. 7yr 3mo.
Placement LEAP LEAP 100 Gen Ed.
CARS 47.5 34 23
Language PLS 4 (Total Language Score) 50 75
Language TOLD (Spoken Language Composite) 91
Cognitive Mullen (Early Learning Composite) 49 60
Cognitive Leiter (Brief IQ) 91
Academic KTEA (Brief Achievement Composite) 102
Vineland (Adaptive Behavior) NA
SSRS Positive Social Behaviors lt 2 14 66
SSRS Negative Behaviors 75 75 55
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Case Study 2
Preschool Preschool Follow Up
Measure Entry Exit
Age 3yr 0mo. 4yr 8mo. 7yr 8mo.
Placement LEAP LEAP 100 Gen Ed
CARS 42.5 28 16
Language PLS 4 (Total Language Score) 52 93
Language TOLD (Spoken Language Composite) 94
Cognitive Mullen (Early Learning Composite) 64 62
Cognitive Leiter (Brief IQ) 91
Academic KTEA (Brief Achievement Composite) 105
Vineland (Adaptive Behavior) 99
SSRS Positive Social Behaviors 5 88 NA
SSRS Negative Behaviors 47 15 NA
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Case Study 3
Preschool Preschool Follow Up
Measure Entry Exit
Age 3yr 5mo. 5yr 0mo. 7yr 11mo.
Placement LEAP LEAP 100 Gen Ed
CARS 39.5 26.5 22.5
Language PLS 4 (Total Language Score) 51 89
Language TOLD (Spoken Language Composite) 107
Cognitive Mullen (Early Learning Composite) 53 73
Cognitive Leiter (Brief IQ) 95
Academic KTEA (Brief Achievement Composite) 124
Vineland (Adaptive Behavior) 115
SSRS Positive Social Behaviors 6 88 61
SSRS Negative Behaviors 68 15 lt16
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Severity Twins In Inclusion Vs. Segregated Elem.
Settings
PS Exit CARS 3rd Grade CARS 3rd Grade CARS
PS Exit CARS Segregated (Less than 79 Inclusion) Included 80 or More
Pair 1 33 31 19
Pair 2 33 29 22
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Severity Twins In Inclusion Vs. Segregated Elem.
Settings
PS Exit CARS 3rd Grade CARS 3rd Grade CARS
PS Exit CARS Segregated (Less than 79 Inclusion) Included 80 or More
Pair 3 28 25 15
Pair 4 38 38 25
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Additional Data for Twin Pairs
KTEA Leiter R TOLD
Pair 1 I 116 113 107
Pair 1 S 92 60 82
Pair 2 I 113 128 102
Pair 2 S 94 105 97
Pair 3 I 144 121 120
Pair 3 S 86 77 73
Pair 4 I 125 111 119
Pair 4 S 62 48 65
KTEA Brief Achievement Composite Leiter R
Brief IQ Score TOLD 4 Spoken Language
Composite