Measuring the association between behavioural services and outcomes in young children with autism spectrum disorder.
Across a large Canadian cohort, preschool behavioral services failed to lift adaptive behavior or curb problem behaviors by late elementary school.
01Research in Context
What this study did
Tsiplova et al. (2023) tracked Canadian kids with autism from preschool to age 11. They compared children who got any behavioral services before age 6 with kids who got none. The team looked at everyday living skills and problem behaviors six to eight years later.
What they found
By age 11, both groups looked the same. Kids who received early ABA, speech, or other behavioral help did not score higher on adaptive skills. Behavior problems also stayed level between the two groups.
How this fits with other research
The result lines up with Vinen et al. (2018). That Canadian study also saw no lasting advantage between different preschool programs by school age.
It seems to clash with Haglund et al. (2020), who found small gains on autism severity after a focused NDBI program. The difference: Haglund studied one well-defined model in Sweden, while Kate counted any real-world service across Canada.
Sinai-Gavrilov et al. (2024) showed strong language and social gains after 26 weeks of parent-coached ESDM. Their tight, high-dose coaching differs from the mixed community services Kate captured, explaining the brighter outcome.
Why it matters
For BCBAs, the paper is a wake-up call. Simply providing behavioral hours in typical community settings may not move long-term adaptive scores. You should check dosage, quality, and parent involvement rather than assume service receipt equals progress. Track individual data and adjust plans quickly when growth stalls.
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02At a glance
03Original abstract
BACKGROUND: Children with autism spectrum disorder (ASD) receive a wide range of services. AIMS: To examine the association between behavioural services received by children with ASD between ages 2 and 5 years and outcomes during primary school years. METHODS: A total of 414 preschool-aged children diagnosed with ASD were enrolled at five Canadian sites and were assessed within four months of diagnosis (T1), six months later (T2), 12 months later (T3), at school entry (T4), and then annually (T5-T8) to 11 years of age. The association between the receipt of behavioural services during T1 to T3 and T8 outcomes related to adaptive behaviour and behavioural problems was modelled using linear regressions adjusted for immigrant status, family income, child's age at diagnosis, site, sex assigned at birth, and baseline (T1) outcome. RESULTS: Children who received behavioural services during at least one time period from T1 to T3 did not have significantly different outcomes at T8 than children who did not receive any behavioural services. IMPLICATIONS: Pre-school use of behavioural services was not found to affect outcomes during later childhood. Numerous challenges accompany studies of the association between pre-school service use and later outcomes in a heterogeneous ASD sample. Recommendations for study design are provided.
Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2022.104392