LEAP – USA(Using Science-based Approaches)

Three Year Follow-up Outcomes for Children with

Autism in LEAP's Randomized Trial

Phillip S. Strain & Ted BoveyUniversity of Colorado Denver

LEAP – USAUsing Science-based Approaches

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

The Mitten

LEAP – USAUsing Science-based Approaches

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

Parent Coaching

Parent Coaching - 2

LEAP – USAUsing Science-based Approaches

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 isn’t sufficient

LEAP – USAUsing Science-based Approaches

Top 12 Findings, cont

5. Typical children are not harmed. In fact, they turn-out to be more socially competent than age cohorts.

6. No correlation between severity and outcome.

7. After two years vast majority of children do not reach diagnostic threshold on CARS

8. Family participation reduces depression and stress.

LEAP – USAUsing Science-based Approaches

Top 12 Findings, cont

9. Family skill training results in changes in child appropriate behavior and compliance.

10.Preschoolers in year two can learn to self-monitor and self-reinforce classroom behavior.

11.Children make, on average, one to two months developmental progress per month enrolled.

12.Sustainability of outcomes is closely linked to quality of contemporaneous environment.

Child Outcomes After 2 Years of Study ParticipationFull Replication 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 < .05, ** p < .01 comparing for full replication and for manuals only group = Mean differences between initial assessment and Year 2 data.a = Standard scoreb = Age (months developmental) equivalentc = Percentile rank score

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)

Case Study 1

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** < 2 14 66

SSRS – Negative Behaviors** 75 75 55

Case Study 2

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

Case Study 3

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 <16

Severity Twins In Inclusion Vs. Segregated Elem.

Settings

PS ExitCARS

3rd Grade CARS

Segregated(Less than 79%

Inclusion)

Included80% or More

Pair 1 33 31 19

Pair 2 33 29 22

Severity Twins In Inclusion Vs. Segregated Elem.

Settings

PS ExitCARS

3rd Grade CARS

Segregated(Less than 79%

Inclusion)

Included80% or More

Pair 3 28 25 15

Pair 4 38 38 25

Additional Data for “Twin” Pairs

KTEA* Leiter R** TOLD***

Pair 1I 116 113 107

S 92 60 82

Pair 2I 113 128 102

S 94 105 97

Pair 3I 144 121 120

S 86 77 73

Pair 4I 125 111 119

S 62 48 65* KTEA Brief Achievement Composite** Leiter R Brief IQ Score*** TOLD 4 Spoken Language Composite