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. 2024 May 30:15:1358419.
doi: 10.3389/fpsyt.2024.1358419. eCollection 2024.

Cognitive, behavioral and socio-communication skills as predictors of response to Early Start Denver Model: a prospective study in 32 young children with Autism Spectrum Disorder

Lisa Asta  1 , Tiziana Di Bella  2 , Francesca La Fauci Belponer  2 , Marianna Bruschetta  2 , Silvia Martines  2 , Enrica Basile  2 , Maria Boncoddo  3 , Fabiana Bellomo  2 , Francesca Cucinotta  4 , Arianna Ricciardello  2 , Laura Turriziani  5 , Costanza Colombi  6 , Federico Banchelli  7   8 , Riccardo Cuoghi Costantini  7   8 , Roberto D'Amico  7   8 , Antonio M Persico  1   9
Affiliations

Cognitive, behavioral and socio-communication skills as predictors of response to Early Start Denver Model: a prospective study in 32 young children with Autism Spectrum Disorder

Lisa Asta et al. Front Psychiatry. .

Abstract

Introduction: The effectiveness of early interventions in young autistic children is well established, but there is great interindividual variability in treatment response. Predictors of response to naturalistic developmental behavioral interventions (NDBI), like the Early Start Denver Model (ESDM), are needed.

Methods: We conducted an exploratory study to prospectively seek predictors of response in 32 young children treated with ESDM after receiving an ASD diagnosis. All children were less than 39 months old (mean age: 29.7 mo), and received individualized ESDM for nine months. Tests were administered at the beginning, after 4 months, and at the end of treatment.

Results: Four children (12.5%) were "strong responders", 8 children (25.0%) were "moderate responders", and 20 children (62.5%) were "poor responders". A more favorable response to ESDM was significantly predicted by higher PEP-3 Expressive Language, Receptive Language, Cognitive Verbal/Preverbal, Visuo-Motor Imitation scores, higher GMDS-ER Personal/Social, and VABS-II Communication scores, by lower ADI-R C restricted/stereotypic behaviors, and by joint attention level.

Discussion: Most predictors showed a linear association with increasing response to ESDM, but GMDS-ER Personal-Social and joint attention level predicted strong response, while PEP-3 receptive language equally predicted moderate or strong response. Although larger samples will be necessary to reach definitive conclusions, in conjunction with prior reports our findings begin providing information able to assist clinicians in choosing the most appropriate treatment program for young autistic children.

Keywords: ESDM; Early Start Denver Model; NDBI; autism; early intervention; naturalistic developmental behavioral interventions; predictors.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Group-wise mean (± S.D.) scores at baseline (T0) and post-treatment (T2) for: (A) Autism Diagnostic Observation Schedule – 2nd (ADOS-2), (B) Griffith Mental Developmental Scales-Extended Revised (GMDS-ER), (C) PsychoEducational Profile – 3 (PEP-3), and (D) Vineland Adaptive Behavior Scale-II (VABS-II). *P<0.05, (*)P=0.05.
Figure 2
Figure 2
Proportions of strong, moderate, and poor responders to ESDM (n = 32).
Figure 3
Figure 3
Pre-treatment mean (± S.D.) scores for the PEP-3 subscales: (A) Cognitive Verbal/Preverbal (CVP), (B) Visual Motor Imitation (VMI), (C) Expressive Language (EL), and (D) Receptive Language (RL), in Strong, Moderate and Poor Responders to ESDM. OR, odds ratio.
Figure 4
Figure 4
Pre-treatment (A) joint attention level, and mean (± S.D.) scores for (B) GMDS-ER Personal-Social subscale, (C) VABS-II Communication subscale, and (D) ADI-R C subscale – Repetitive, Restricted and Stereotyped Patterns of Behavior. OR: odds ratio. ** overall P<0.01. ▲ pairwise Strong Responders vs Poor Responders P<0.05.
Figure 5
Figure 5
Graphical representation of principal component analysis (PCA). Dimension 1 was statistically significant (p = 0.01).
See this image and copyright information in PMC

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