Table 20.

2   Criteria for establishing empirical support for treatment efficacy (Nathan and Gorman (2002, 2007)
Author(s) and Year Sample Outcome measures Treatment procedures Findings Nathan and Gorman
(2002, 2007) criteria
Denver Model/Early Start Denver Model (ESDM)
Rogers et al. 2006 10 ss, aged 20–65 mos.; Collected within 3 weeks of Single-subject design (A-B-A) No differences in acquired lang. Type 2 study:
(Denver Model) all male; all nonverbal last tx session: ADOS, SCQ, using randomization to either skills by group; by end of tx, + RCT,
MSEL, VABS–Interview Denver Model or PROMPT; 8/10 children used 5 + novel, + Blind assessments,
Edition, CDI, intervention 12 weekly 1-h sessions; for functional words spontaneously + Incl/excl criteria,
hx, play-based speech probes; Denver Model condition, and spoke multiple times per + Standardized dx
collected during weekly tx parents were present and active hour battery, + Comparison
sessions: speech samples; col- in sessions, and were expected group,
lected at 3 mos. to deliver treatment objectives + Tx fidelity,
45 min/day; for PROMPT + Tx manual
condition, parents observed
sessions via video, and were
expected to work on children’s
word development 30 min/day
Vismara et al. 2009 8 ss, aged 10–36 mos., Coding of parent–child play Nonconcurrent multiple base- Child’s production of spontane- Type 2 study:
(ESDM) seven had diagnosis and therapist-child play line design; parents attended ous functional verbal utterances − RCT,
of autism; one child for number of spontaneous 1-h clinic visit/week for 12 increased w/ parent and therapist  + /-Blind assessments
diagnosed with autism functional verbal utterances weeks to receive one-on-one once tx began; 7/8 children (not blind to tx, but
at 18 mos. at conclusion and imitative acts; ADOS and parent training in ESDM demonstrated consistent increase blind to order of
of tx but showed sig- MSEL; CBRS; ESDM Fidelty in imitative behaviors; number session),
nificant signs consistent Scale for parent implementa- of children’s spontaneous verbal + Incl/excl criteria,
with autism at time of tion of model utterances showed largest gain − Standardized dx
enrollment once parents met ESDM fidelity; battery,
7/8 parents acquired mastery − Comparison group,
of ESDM techniques at fidelity + Tx fidelity,
level of 85 % or above by 6th tx − Tx manual
session and maintained through
follow up
20  Developmental Approaches to Treatment of Young Children with Autism Spectrum Disorder
399
Table 20.2   (continued)
400

Author(s) and Year Sample Outcome measures Treatment procedures Findings Nathan and Gorman
(2002, 2007) criteria
Dawson et al. 2010 48 ss, aged 18–30 mos.; Collected at study entry and Randomized to either ESDM At end of 2 yrs. of tx ESDM Type 1 study:
(ESDM) 3.5 males for every then at the end of 1 year of group or A/M community group showed significantly + RCT,
1 female in study; tx and 2 years of tx: ADI-R, tx group; ESDM condition improved cognitive ability + Blind assessments,
diagnosed with ASD or ADOS, MSEL, VABS-Inter- included: 2-h session with (MSEL) mostly due to recep- + Incl/excl criteria,
PDD-NOS; stratified view Edition, RBS trained therapist 2X/day 5 days/ tive and expressive language + Standardized dx
randomization on basis week for 2 years (actual mean improvements and significantly battery,
of composite IQ at entry h = 15.2 h/wk), parent training improved adaptive behavior + Comparison group,
2X/mo and were expected to (VABS) when compared to A/M + Tx fidelity,
use ESDM strategies during group; children in the ESDM + Tx manual
daily activities (actual mean group were more likely to
h = 16.3  h/wk), multidisci- experience a change in diagnosis
plinary team, individualized from autism to PDD-NOS than
tx objectives; A/M community A/M group
condition included: compre-
hensive diagnostic evaluations,
referral to community providers
for intervention commonly
available in the community
(actual mean h of individual
tx = 9.3 h/wk) (actual mean hrs
of group tx = 9.3 h/wk)
Developmental Individual-Differences, Relationship-Based Model (DIR/FLOORTIME)
Hilton and Seal 2 ss, aged 2 yrs; mono- CBCS; coded videos of sx for One twin received DIR and one Slight gain in communication Type 3 Study:
2007 zygotic twin brothers communication and behavior received ABA; each received 2 composite score for ABA child + RCT,
data; mother’s journal recorded 1-h weekly sessions adminis- and slight loss for DIR child; +/-Blind assessments
tx sessions and perceptions of tered by clinicians; 16/18 ses- contrasted gains and losses in (-for CSBS, + for
child progress sions each; both also received 6 of 7 CSBS subscales; coded video coding);
speech therapy 2X/wk behavioral data showed increase − Inc/excl criteria,
in number and duration of crying − Standardized dx
episodes in ABA child, but none battery,
in DIR participant + Comparison group,
− Tx fidelity,
+ Tx manual
A. L. Wagner et al.
Table 20.2   (continued)
Author(s) and Year Sample Outcome measures Treatment procedures Findings Nathan and Gorman
(2002, 2007) criteria
Pajareya and Nop- 32 ss, aged 2–6 yrs of Primary outcome measure: Added new DIR/Floortime Intervention group showed Type 1 study:
maneejumruslers age; all met DSM-IV FEAS; CARS; and FEDQ tx to see if there would be significantly greater decrease + RCT,
2011 criteria for autistic additional benefits over routine in overall autistic severity w/ + Blind assessments,
disorders; 8:1 male to clinical care; stratified random CARS; statistically significant + Incl/excl criteria,
female ratio assignment based on age and gain in FEDQ filled out by par- − Standarized dx
symptom severity; control ents; parents who added in home battery,
group got typical treatment as DIR/Floortime for 10 h + /week + Comparison group,
usual in Thailand (20–40 h of had better tx delivery fidelity + Tx fidelity,
ABA), experimental group got than those who did less, but not + Tx manual
supplemental DIR Floortime sig. difference
tx administered to parents (no
direct contact with children in
this condition); 1 day train-
ing workshop + 3 h DVD
lecture + 1.5  h one-on-one
session, families to deliver
20 h/week of tx at home (actual
amount = 15.2  h/wk);
Solomon et al. 2007 68 ss, aged 18 mos to 6 FEAS caregiver and child PLAY Project Home Consulta- No change in parents’ FEAS Type 3 study:
yrs at time of diagnosis sections; subjective ratings tion Project = 1 day parent train- scores before and after PLAY; − RCT,
with autistic disorder, by home consultants on 6 pt ing workshop; 3–4 h/monthly increase in child’s total and + Blind assessments,
PDD-NOS, or Asperg- scale of Greenspan’s functional home visits by consultants for scaled FEAS scores over 1 year + Inc/excl criteria,
er’s syndrome developmental levels (FDL); parent training, videotaping, period; 45 % of children made − Standardized dx
parent satisfaction of PLAY and child assessment; parent- “good” to “very good” functional battery,
project on 4-pt Likert scale led tx for min of 15 h/week; tx developmental progress; overall − Comparison group,
given for 1 year parent-reported satisfaction with + Tx fidelity,
PLAY project was 90 % + Tx manual
20  Developmental Approaches to Treatment of Young Children with Autism Spectrum Disorder
401