What are appropriate goals for educational services provided to young children with autistic spectrum disorders, and how are the goals best measured as outcomes in scientific studies, so that effectiveness of various programs may be determined?
At the root of questions about the most appropriate educational interventions for autistic spectrum disorders are differences in assumptions about what is possible and what is important to give students with these disorders through education. The appropriate goals for educational services for children with autistic spectrum disorders are the same as those for other children: personal independence and social responsibility. These goals imply progress in social and cognitive abilities, verbal and nonverbal communication skills, and adaptive skills; reduction of behavioral difficulties; and generalization of abilities across multiple environments.
A large body of research has demonstrated substantial progress in response to specific intervention techniques in relatively short periods of time (e.g., several months) in many specific areas, including social skills, language acquisition, nonverbal communication, and reductions in challenging behaviors. Longitudinal studies over longer periods of time have documented changes in IQ scores and in core deficits (e.g., joint attention), in some cases related to treatment, that are predictive of longer-term outcomes. However, children’s outcomes are variable, with some children making substantial progress and others showing very slow gains. Although there is evidence that interventions lead to improvements, there does not appear to be a clear, direct relationship between any particular intervention and children’s progress. Thus, while substantial evidence exists that treatments can reach short-term goals in many areas, gaps remain in addressing larger questions of the relationships between particular techniques and specific changes.
The committee recommends that ongoing measurement of treatment objectives and progress be documented frequently across a range of skill areas in order to determine whether a child is benefiting from a particular intervention and that the intervention be adjusted accordingly. Appropriate objectives should be observable, measurable behaviors and skills. These objectives should be able to be accomplished within a year and be anticipated to affect a child’s participation in education, the community, and family life.