Coding options
Appendix 6 Study characteristics tables
TABLE 30 Characteristics of included studies
General Intervention details Comparator details
First author (year) Birnbrauer (1993)82
Sampling frame/population
Children who were 24–48 months of age, met DSM-II criteria for pervasive developmental disorder or PDD-NOS, had attained intellectual and adaptive behaviour functioning levels of less than borderline and were free of sensory or physical impairments that would require special materials. Referrals were received from agencies concerned with autism and developmental disabilities, child health centres and medical practitioners in the Perth Metropolitan area
When were participants recruited? NR
How was autism diagnosed? Met the DSMIII-R criteria for pervasive developmental disorder autistic disorder and PDD-NOS How were participants allocated to intervention?
Non-randomised. Allocated on the basis of location and when enrolled; families who met the selection criteria but lived too far away were invited to join the control group
Intervention name
Murdoch Early Intervention Program Is it based on a previous model? Yes
If yes, which model is it based on? Based on Lovaas 198726model, but
differs in several aspects Was the intervention manualised? No
Who delivers the intervention? Volunteer trainers with support from programme co-ordinator and mother Qualifications of the interventionist(s) Recruited from university students. On-the-job training
Length of interventionist(s) experience None required
Number of people delivering the intervention
24
Was the interventionist supervised? Yes
Qualifications of the supervisor Experience with delivering behavioural techniques to children with disabilities
Extent of parental involvement in delivery
Supervisory role
Where was the intervention delivered? Home based
Comparator 1 name Not clearly described Is the comparator ABA based? No
Is it based on a previous model? No
Which model(s) is it based on? TAU
Who delivers the comparator? NR
Qualifications of the interventionist NR
Length of interventionist experience n/a
Number of people delivering the intervention
n/a
Extent of parental involvement in delivery
n/a
Where was the comparator delivered? n/a
What was the planned intensity of the comparator?
n/a
What was the planned duration of the comparator?
Approximately 24 months Were any co-interventions given? NR
TABLE 30 Characteristics of included studies (continued )
General Intervention details Comparator details
What was the planned intensity of intervention?
9–25 hours/week
What was the planned duration of intervention?
Approximately 24 months Were any co-interventions given? NR
First author (year) Cohen (2006)104
Sampling frame/population
Children with a diagnosis of autistic disorder or PDD-NOS, with a pre- treatment IQ > 35 on the BSIDR, chronological age between 18 and 42 months at diagnosis and <48 months at treatment onset, with no severe medical limitation or illness that would preclude a child from participating and residence within 60 km of the treatment agency When were participants recruited? 1995–2000
How was autism diagnosed? Based on an evaluation by an independent licensed psychologist and confirmed by the ADI-R How were participants allocated to intervention?
Parental choice
Intervention name EIBI
Is it based on a previous model? Yes
If yes, which model is it based on? Lovaas/UCLA 198726
Was the intervention manualised? Yes
Who delivers the intervention? Tutors were recruited from the community and were the main providers of direct services. Parents also contributed
Qualifications of the interventionist(s) NR
Length of interventionist(s) experience NR
Number of people delivering the intervention
NR
Was the interventionist supervised? Yes
Qualifications of the supervisor Graduate or Masters level with 2 years experience of EIBI Extent of parental involvement in delivery
Weekly sessions at home
Comparator 1 name
TAU (participants received a number of interventions, including an early start intervention programme, ‘home- based developmental intervention’ or public school special day class using eclectic methodology)
Is the comparator ABA based? NR
Is it based on a previous model? No
Which model(s) is it based on? NR
Who delivers the comparator? Various
Qualifications of the interventionist NR
Length of interventionist experience NR
Number of people delivering the intervention
NR
Extent of parental involvement in delivery
NR
Where was the comparator delivered? Various
What was the planned intensity of the comparator?
NR
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TABLE 30 Characteristics of included studies (continued )
General Intervention details Comparator details
Where was the intervention delivered? Primarily home based, with some peer play and classroom inclusion What was the planned intensity of intervention?
30 hours/week of one to one (20 hours with therapist, > 10 hours with parents) What was the planned duration of intervention?
3 years [17 participants completed 3 years and four did not complete (two at 6 months and two in the second year)]
Were any co-interventions given? NR
What was the planned duration of the comparator?
3 years [17 participants completed 3 years and four did not complete (two at 6 months and two in the second year)]
Were any co-interventions given? Speech, occupational and behavioural therapy (0–5 hours/week), brief sessions in mainstreamed education
First author (year)
Dawson (2010, 2012);83,106
Sullivan (2014);112Estes (2015)107
Sampling frame/population Children aged between 18 and 30 months diagnosed with autistic disorder or PDD-NOS
Exclusion criteria
Neurodevelopmental disorder, significant sensory or motor
impairment, major physical problems, seizures at time of entry, use of psychoactive medications, history of a serious head injury and/or neurological disease, alcohol or drug exposure during the prenatal period and ratio IQ < 35 (as measured by the MSEL)
When were participants recruited? NR
How was autism diagnosed? Meeting criteria for autism or ASD on the ADOS and a clinical diagnosis based on DSM-IV criteria
How were participants allocated to intervention?
Individually randomised, stratified by IQ and gender
Intervention name ESDM
Is it based on a previous model? Yes
If yes, which model is it based on? ESDM
Was the intervention manualised? Yes
Who delivers the intervention? Therapist for 20 hours/week, parents for anything above that
Qualifications of the interventionist(s) Bachelors degree in education or related field plus 2 months’ training Length of interventionist(s) experience NR
Number of people delivering the intervention
NR
Was the interventionist supervised? Yes
Comparator 1 name
‘Assess and Monitor’ community intervention (interventions delivered by Birth-to-Three centres and individual providers delivering speech and language therapy, occupational therapy and/or ABA treatments) Is the comparator ABA based? Inconsistent
Is it based on a previous model? Variety of interventions designed to ameliorate the impact of autism and enhance functioning
Which model(s) is it based on? n/a
Who delivers the comparator? Various
Qualifications of the interventionist NR
Length of interventionist experience NR
Number of people delivering the intervention
NR
TABLE 30 Characteristics of included studies (continued )
General Intervention details Comparator details
Qualifications of the supervisor Masters degree and 5 years’ experience
Extent of parental involvement in delivery
Minimum of 10 hours/week on top of intervention hours (actual amount was 16.3 hours)
Where was the intervention delivered? Home based
What was the planned intensity of intervention?
30 hours/week one to one (20 hours with therapist, > 10 hours with parents)
What was the planned duration of intervention?
2 years
Were any co-interventions given? 5.2 hours in other therapies (e.g. speech therapy, developmental preschool)
Extent of parental involvement in delivery
NR
Where was the comparator delivered? Various
What was the planned intensity of the comparator?
NR
What was the planned duration of the comparator?
2 years
Were any co-interventions given? NR
First author (year) Eikeseth (2012)84
Sampling frame/population Children diagnosed with autism enrolled at Banyan Centre (Sweden) (intervention); total population of children diagnosed with autism at Akershus University Hospital (Nordbyhagen, Norway) (control) When were participants recruited? Intervention between March 2008 and May 2010; control between 2005 and 2010
How was autism diagnosed? An independent agency prior to referral to the centre, based on the ICD-10 criteria158
How were participants allocated to intervention?
Place of diagnosis
Intervention name
Community school-based EIBI Is it based on a previous model? Yes
If yes, which model is it based on? Lovaas/UCLA 198726
Was the intervention manualised? Yes
Who delivers the intervention? School’s staff as therapists Qualifications of the interventionist(s) None required
Length of interventionist(s) experience None required
Comparator 1 name
Eclectic special education teaching Is the comparator ABA based? Partially
Is it based on a previous model? Yes
Which model(s) is it based on? Eclectic special education teaching model. [The treatment incorporated elements from a variety of different interventions, such as alternative communication, total communication, TEACCH, sensory–motor therapies, ABA, as well as procedures derived from teachers’ own clinical experience]
Who delivers the comparator? Special education teacher and teaching assistant
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TABLE 30 Characteristics of included studies (continued )
General Intervention details Comparator details
Number of people delivering the intervention
NR
Was the interventionist supervised? Yes
Qualifications of the supervisor Bachelors or Masters degree Extent of parental involvement in delivery
10 hours/week
Where was the intervention delivered? School (parents at home)
What was the planned intensity of intervention?
Not stated. Actual received was 15–37 hours/week plus 10 hours/ week of parent involvement What was the planned duration of intervention?
2 years
Were any co-interventions given? NR
Qualifications of the interventionist NR
Length of interventionist experience None required
Number of people delivering the intervention
2
Extent of parental involvement in delivery
NR
Where was the comparator delivered? Preschools or kindergartens What was the planned intensity of the comparator?
Special education teacher worked 3–5 hours/week/child plus teaching assistant was hired to work one to one with the child (but no planned time duration was reported)
What was the planned duration of the comparator?
2 years
Were any co-interventions given? NR
First author (year) Eikeseth (2002, 2007)85,95
Sampling frame/population
Children from Akershus and Vestfold, Norway, with a diagnosis of childhood autism (ICD-10), with a chronological age between 4 and 7 years at the time of intake, and without any major medical conditions other than autism When were participants recruited? November 1995–November 1998 How was autism diagnosed? ADI-R and an independent child clinical psychologist
Intervention name
Intensive behavoural treatment based on the UCLA treatment model (EIBI)
Is it based on a previous model? Yes
If yes, which model is it based on? Lovaas et al. 1981,159and Lovaas and
Leaf 1981160
Was the intervention manualised? Yes
Who delivers the intervention? Therapist/special education teacher
Comparator 1 name
Intensive eclectic special education Is the comparator ABA based? Partially
Is it based on a previous model? Partially
Which model(s) is it based on? Included elements from a variety of different interventions, such as project TEACCH (Schopler et al. 1983161), sensory–motor therapies
(Ayres 1972162) and ABA (Lovaas
et al. 1981159), as well as methods
derived from personal experience continued
TABLE 30 Characteristics of included studies (continued )
General Intervention details Comparator details
How were participants allocated to intervention?
Availability of qualified supervisors for behavioural treatment
Qualifications of the interventionist(s) None required
Length of interventionist(s) experience None required
Number of people delivering the intervention
NR
Was the interventionist supervised? Yes
Qualifications of the supervisor Bachelors or Masters degree Extent of parental involvement in delivery 4 hours/week
Where was the intervention delivered? Public kindergartens and elementary schools
What was the planned intensity of intervention?
Minimum 20 hours/week What was the planned duration of intervention?
1 year
Were any co-interventions given? NR
Who delivers the comparator? Therapist/special education teacher Qualifications of the interventionist NR
Length of interventionist experience NR
Number of people delivering the intervention
NR
Extent of parental involvement in delivery
NR
Where was the comparator delivered? Public kindergartens and elementary schools
What was the planned intensity of the comparator?
Minimum 20 hours/week
What was the planned duration of the comparator?
1 year
Were any co-interventions given? NR
First author (year) Eldevik (2012)86
Sampling frame/population Children with ASD aged between 2 and 6 years, receiving > 5 hours/ week of intervention at an EIBI centre and children receiving TAU in their local mainstream school When were participants recruited? January 2000–February 2011 How was autism diagnosed? ADI-R
Intervention name EIBI
Is it based on a previous model? Yes
If yes, which model is it based on? Widely used EIBI manuals (Leaf and McEachin 1999;163Lovaas et al. 1981,
2003;159,164Maurice et al. 1996;165
Sundberg and Partington 1998166)
Was the intervention manualised? Yes
Comparator 1 name TAU (eclectic)
Is the comparator ABA based? Partially
Is it based on a previous model? Partially
Which model(s) is it based on? Eclectic special education teaching model (alternative communication, ABA, total communication, sensory– motor therapies, programmes based on the principles from TEACCH, as
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TABLE 30 Characteristics of included studies (continued )
General Intervention details Comparator details
How were participants allocated to intervention?
Cohort
Who delivers the intervention? Therapists recruited from preschool staff
Qualifications of the interventionist(s) NR
Length of interventionist(s) experience NR
Number of people delivering the intervention
Two or three
Was the interventionist supervised? Yes
Qualifications of the supervisor Bachelors degree and 2–10 years’ experience with EIBI
Extent of parental involvement in delivery
Encouraged to ensure generalisation and maintenance of skills at home Where was the intervention delivered? Mainstream preschool
What was the planned intensity of intervention?
NR
What was the planned duration of intervention?
2 years
Were any co-interventions given? NR
well as other methods that were incorporated based on the personal experience of the particular special education teacher and staff) Who delivers the comparator? Preschool staff
Qualifications of the interventionist NR
Length of interventionist experience NR
Number of people delivering the intervention
NR
Extent of parental involvement in delivery
NR
Where was the comparator delivered? Mainstream preschool
What was the planned intensity of the comparator?
NR
What was the planned duration of the comparator?
2 years
Were any co-interventions given? NR
First author (year) Farrell (2005)87
Sampling frame/population
EIBI group: children whose parents had lobbied for the intervention. Comparator: children selected by educational psychologist contributing to a statutory assessment
Intervention name EIBI
Is it based on a previous model? Yes
If yes, which model is it based on? Lovaas 198726
Comparator 1 name
Lancashire Under Fives Autism Project
Is the comparator ABA based? Partially
Is it based on a previous model? Yes
TABLE 30 Characteristics of included studies (continued )
General Intervention details Comparator details
When were participants recruited? 1999
How was autism diagnosed? Educational psychologist How were participants allocated to intervention?
Cohort/parental preference
Was the intervention manualised? Yes
Who delivers the intervention? Therapists with parental support Qualifications of the interventionist(s) NR
Length of interventionist(s) experience NR
Number of people delivering the intervention
Up to five
Was the interventionist supervised? Yes
Qualifications of the supervisor NR
Extent of parental involvement in delivery
NR
Where was the intervention delivered? Home
What was the planned intensity of intervention?
At least 30 hours
What was the planned duration of intervention?
2 years
Were any co-interventions given? NR
Which model(s) is it based on? Lancashire Under Fives Autism Project
Who delivers the comparator? Teaching assistants
Qualifications of the interventionist NR
Length of interventionist experience NR
Number of people delivering the intervention
NR
Extent of parental involvement in delivery
NR
Where was the comparator delivered? School
What was the planned intensity of the comparator?
School full time
What was the planned duration of the comparator?
2 years
Were any co-interventions given? NR
First author (year)
Haglund (2017, conference abstract only)88
Sampling frame/population
Children with ASD aged ≤ 6 years in Skane county, Sweden
When were participants recruited? Autumn 1998–spring 2005
Intervention name
Comprehensive intensive early interventions
Is it based on a previous model? Yes
If yes, which model is it based on? NDBI programme described by Schreibman et al.28
Comparator 1 name TAU
Is the comparator ABA based? No
Is it based on a previous model? Variety of interventions designed to ameliorate the impact of autism and enhance functioning
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TABLE 30 Characteristics of included studies (continued )
General Intervention details Comparator details
How was autism diagnosed? DSM-IV/ICD 10
How were participants allocated to intervention?
Parental preference: children of parents rejecting the ABA-based intervention acted as the comparator group
Was the intervention manualised? Yes
Who delivers the intervention? Therapists/parents
Qualifications of the interventionist(s) Preschool teaching/educational background
Length of interventionist(s) experience NR
Number of people delivering the intervention
NR
Was the interventionist supervised? Yes
Qualifications of the supervisor NR
Extent of parental involvement in delivery
Some
Where was the intervention delivered? Combination
What was the planned intensity of intervention?
15–25 hours/week
What was the planned duration of intervention?
2 years
Were any co-interventions given? NR
Which model(s) is it based on? None
Who delivers the comparator? NR
Qualifications of the interventionist NR
Length of interventionist experience NR
Number of people delivering the intervention
NR
Extent of parental involvement in delivery
NR
Where was the comparator delivered? NR
What was the planned intensity of the comparator?
NR
What was the planned duration of the comparator?
2 years
Were any co-interventions given? NR
First author (year) Hayward (2009)99
Sampling frame/population
Children who joined the UK Young Autism Project
Intervention name EIBI, clinic managed
Is it based on a previous model? Yes
Comparator 1 name EIBI, parent managed Is the comparator ABA based? Yes
TABLE 30Characteristics of included studies (continued )
General Intervention details Comparator details
When were participants recruited? NR
How was autism diagnosed? ICD-10 (confirmed with ADI-R) How were participants allocated to intervention?
By catchment area
If yes, which model is it based on? UCLA
Was the intervention manualised? Yes
Who delivers the intervention? Therapists
Qualifications of the interventionist(s) NR
Length of interventionist(s) experience NR
Number of people delivering the intervention
Two to five
Was the interventionist supervised? Yes
Qualifications of the supervisor >3 years’ clinical experience as an EIBI tutor and senior tutor Extent of parental involvement in delivery
NR
Where was the intervention delivered? Home
What was the planned intensity of intervention?
NR (37 hours actual)
What was the planned duration of intervention?
1 year
Were any co-interventions given? NR
Is it based on a previous model? Yes
Which model(s) is it based on? UCLA
Who delivers the comparator? Therapists
Qualifications of the interventionist NR
Length of interventionist experience NR
Number of people delivering the intervention
Two to five
Extent of parental involvement in delivery NR
Where was the comparator delivered? Home
What was the planned intensity of the comparator?
NR (34 hours actual)
What was the planned duration of the comparator?
1 year
Were any co-interventions given? NR
First author (year)
Howard (2005, 2014)105,108
Intervention name
Early intensive behaviour analytic treatment
Comparator 1 name
Autism educational programming: eclectic autism-specific classroom- based intervention
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TABLE 30 Characteristics of included studies (continued )
General Intervention details Comparator details
Sampling frame/population
Children with ASD referred by non- profit agencies under contract with the State of California Department of Developmental Services
When were participants recruited? 1996–2003
How was autism diagnosed? DSM-IV by independent examiner How were participants allocated to intervention?
Cohort
Is it based on a previous model? Yes
If yes, which model is it based on? UCLA
Was the intervention manualised? Yes
Who delivers the intervention? Trained therapists
Qualifications of the interventionist(s) Undergraduate students
Length of interventionist(s) experience NR
Number of people delivering the