title: Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder.
abstract: OBJECTIVE
  We prospectively examined evidence for the sustained effects of early intervention based on a follow-up study of 39 children with ASD who began participation in a randomized clinical trial testing the effectiveness of the Early Start Denver Model (ESDM) at age 18 to 30 months. The intervention, conducted at a high level of intensity in-home for 2 years, showed evidence of efficacy immediately posttreatment.
  
  
  METHODS
  This group of children was assessed at age 6 years, 2 years after the intervention ended, across multiple domains of functioning by clinicians naive to previous intervention group status.
  
  
  RESULTS
  The ESDM group, on average, maintained gains made in early intervention during the 2-year follow-up period in overall intellectual ability, adaptive behavior, symptom severity, and challenging behavior. No group differences in core autism symptoms were found immediately posttreatment; however, 2 years later, the ESDM group demonstrated improved core autism symptoms and adaptive behavior as compared with the community-intervention-as-usual (COM) group. The 2 groups were not significantly different in terms of intellectual functioning at age 6 years. Both groups received equivalent intervention hours during the original study, but the ESDM group received fewer hours during the follow-up period.
  
  
  CONCLUSIONS
  These results provide evidence that gains from early intensive intervention are maintained 2 years later. Notably, core autism symptoms improved in the ESDM group over the follow-up period relative to the COM group. This improvement occurred at the same time that the ESDM group received significantly fewer services. This is the first study to examine the role of early ESDM behavioral intervention initiated at less than 30 months of age in altering the longer-term developmental course of autism.
authors.affiliation: University of Washington Autism Center and University of Washington, Seattle. Electronic address: estesa@uw.edu.
authors.forename: Annette
authors.initials: A
authors.lastname: Estes
authors.affiliation: University of Washington Autism Center and University of Washington, Seattle.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Munson
authors.affiliation: University of California, Davis.
authors.forename: Sally J
authors.initials: SJ
authors.lastname: Rogers
authors.affiliation: University of Washington Autism Center and University of Washington, Seattle.
authors.forename: Jessica
authors.initials: J
authors.lastname: Greenson
authors.affiliation: Weill-Cornell Medical College, New York City.
authors.forename: Jamie
authors.initials: J
authors.lastname: Winter
authors.affiliation: Duke University, Durham, NC.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Dawson
mesh_terms: D000223:Adaptation, Psychological; D000067877:Autism Spectrum Disorder / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009922:Oregon; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014861:Washington
keywords: autism; early; intervention; long-term; outcomes