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Intervention for Optimal Outcome in Children and Adolescents with a History of Autism

Orinstein, Alyssa J. MA; Helt, Molly MA; Troyb, Eva MA; Tyson, Katherine E. MA; Barton, Marianne L. PhD; Eigsti, Inge-Marie PhD; Naigles, Letitia PhD; Fein, Deborah A. PhD

Journal of Developmental & Behavioral Pediatrics: May 2014 - Volume 35 - Issue 4 - p 247–256
doi: 10.1097/DBP.0000000000000037
Original Article

Objective: Autism spectrum disorders (ASDs) were once considered lifelong disorders, but recent findings indicate that some children with ASDs no longer meet diagnostic criteria for any ASD and reach normal cognitive function. These children are considered to have achieved “optimal outcomes” (OO). The present study aimed to retrospectively examine group differences in the intervention history of children and adolescents with OO and those with high-functioning autism (HFA).

Method: The current study examined intervention histories in 25 individuals with OO and 34 individuals with HFA (current age, 8–21 years), who did not differ on age, sex, nonverbal intelligence, or family income. Intervention history was collected through detailed parent questionnaires.

Results: Children in the OO group had earlier parental concern, received earlier referrals to specialists, and had earlier and more intensive intervention than those in the HFA group. Substantially more children with OO than HFA received applied behavior analysis (ABA) therapy, although for children who received ABA, the intensity did not differ between the groups. Children in the HFA group were more likely to have received medication, especially antipsychotics and antidepressants. There were no group differences in the percent of children receiving special diets or supplements.

Conclusion: These data suggest that OO individuals generally receive earlier, more intense interventions, and more ABA, whereas HFA individuals receive more pharmacologic treatments. Although the use of retrospective data is a clear limitation to the current study, the substantial differences in the reported provision of early intervention, and ABA in particular, is highly suggestive and should be replicated in prospective studies.

Department of Psychology, University of Connecticut, Storrs, CT.

Address for reprints: Alyssa J. Orinstein, MA, Department of Psychology, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269; e-mail:

Supported by the National Institutes of Mental Health grant (R01MH076189).

Disclosure: The authors declare no conflict of interest.

Received September , 2013

Accepted December , 2013

© 2014 by Lippincott Williams & Wilkins