Hybrid therapy for treatment of newly diagnosed toddlers with autism spectrum disorders

Abstract Background: Time is of the essence in treating autism spectrum disorders (ASD). Intensive and effective therapies can advance acquisition of adaptive and communication skills during the lag time until entry into a pre-school program. Objective: To jump start treatment in very young toddlers with ASD and good cognitive potential, therapeutic modifications of the Early Start Denver Model (ESDM) were examined. Method: The changes involved more intensive cooperative treatments, with two different therapists (“hybrid”), reinforcing behavioral manipulations with the children. The intensified therapies were to maximize gains over shorter periods of time, dictated by limitations of resources. Results: Thirty children (mean age 24 m., average duration 4.1 m.) improved on their goal attainment scale (GAS) ratings on nearly all functional measures, (p<0.001). Of 23 ADOS scores, 19 improved, the average pre-treatment ADOS score was 17.7 (SD 3.4) and post-treatment 13.3 (SD 5.34). The correlation between GAS and ADOS score improvement was significant (R=0.67, p<0.001). Conclusion: The acceleration in social communication and adaptive skill gains in the treatment of very young children using modifications in treatment therapies already in wide- scale use, indicates the as-yet untapped treatment potential for many young children with ASD.