(PS11-D95) The Impact of Behavioral Interventions on Multiple Domains of Functioning in Children with Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a developmental disability affecting about 1 in 54 children and is frequently associated with impaired behavioral, psychosocial functioning, and reduced quality of life. Research has shown that children with ASD frequently experience difficulties with academic performance, communication, and adaptive functioning. Evidence-based behavioral interventions may help alleviate some of these challenges, including improving cognitive, behavioral, and communication skills, but there is a lack of research addressing which domains of child functioning are improved most by behavioral interventions. Thus, the current study examined the impact of behavioral interventions on specific domains of child functioning and the impact of behavioral interventions combined with other interventions (e.g., speech therapy) on different domains of functioning and quality of life in children with ASD.

Participants included the guardians of 402 children with ASD on the Registry to receive specialized services through the Maryland ASD waiver program, if they are deemed eligible and when a spot becomes available. Families reported that their child has received varying amounts of different non-Waiver interventions while on the Registry. Children from these families were predominantly male (82.87%) with a mean age of 14.27 (SD = 2.92) years. The guardians were predominantly female (85.35%) with a mean age of 46.72 (SD = 8.21) years. The Autism Services and Supports: Impact on Families Survey (ASIF) was completed by guardians to assess ASD symptoms, involvement in behavioral interventions, child improvement within functional domains, and family quality of life.

Results indicated that greater number of behavioral interventions (p = .004) received were associated with greater progress in academic performance [F(6, 290) = 2.31, p = .03, R² = .05]. While behavioral interventions were not significantly related to progress in independent living (p  = .88), speech therapy (p = 0.01) emerged as a significant predictor of progress [F(6, 290) = 2.78,  p = 0.01, R² = .05]. Models including behavioral interventions and other interventions (i.e., speech therapy) were not significant for progress in social communication. Both behavioral interventions (p < .001) and speech therapy (p < 0.001) were significantly associated with overall family quality of life [F(6, 265) = 4.40, p < .001, R² = .09].

Findings suggest that a greater number of behavioral interventions for children with ASD are associated with greater improvement in academic performance, but not greater improvements in independent living and social communication skills. Thus, more understanding is needed for why interventions did not impact independent living and social communication difficulties. Consistent with previous research, behavioral interventions alone may not be sufficient for improving multiple domains of functioning in children with ASD. Interestingly, speech therapy emerged as having a significant impact on progress in independent living. In order to improve more areas of functioning in individuals with ASD, future research and clinical endeavors should evaluate the effect of augmenting existing behavioral treatments with speech therapy interventions.