Galli Carminati, G., Gerber, F., Baud, M.A., & Baud, O. (2007).  Evaluating the effects of a structured program for adults with autism spectrum disorders and intellectual disabilities.  Research in Autism Spectrum Disorders, 1, 256-265.

This article was hard to follow - I think there were a few things that were lost in translation.

• prevention of ASD is impossible
• focus needs to be on treatment and evaluation
• most of the literature is geared toward younger children
  • the majority of people with ASD are adults? Really?
  • it's a major social problem
  • programs are rare in Switzerland
  • many kids did not receive early intervention
  • have a lot of behavioral disorders
  • home and community intervention is difficult
• structured programs are clinically effective
  • decrease in behavioral disorders is linked to educators presence and environment
• cohort 1 - outside of the home; cohort 2 - work inside of the apartment
• this study - wanted to observe behavioral disorders, which are the cause of exclusion
  • looking longitudinally at behavioral problems in a TEACCH-like environment
  • structured teaching
  • objective is autonomy
  • insure that the same staff follows the individuals across time - continity
• programs put together with the PEP-R and individualized
  • adapted to the needs and abilities of each student
• current study - longitudinal prospective design
  • checked problem behavior every 3 months with ABC
  • CARS administed as well
• participants
  • cohort 1 - 10 individuals
  • cohort 2 - 9 individuals
    • ASD and intellecutal disabilities - determined by ICD-10 criteria
• Measures
  • ABC
  • number of team hours of staff
  • CARS
• cohorts - data collected on two separate points in time
• Results
  • Cohort 1
    • ABC mean scores - irregular tendency - decreasing
      • decrease only significant for social withdrawl
    • no change in CARS scores
  • Cohort 2
    • increase in behavioral issues in time 3
    • no statistically significant changes
    • no change in CARS scores
  • comparison of Cohort 1 and 2 - done through "rapid descriptive analysis"?
  • social withdrawl - decreases for Cohort 1 to join Cohort 2
    • no statistical differences between the groups except on the irritability scale
  • no difference in presence and problem behavior
• Discussion
  • decrease in social withdrawl (not regression towards the mean?)
  • most factor scores stable
  • decreased between time 3 and time 9 - time 10 factors increased
    • could be the introduction of a new apartment
    • reorganization of the environment
    • time 10 - staff change as well
  • problems are more stable in cohort 2
  • comparison of cohorts
    • cohort 2 - less social withdrawl
    • educator presence lower in cohort 1 than in cohort 2
    • presence influences social withdrawal?  I don't see this in the data
    • no diffference in whether time present influence problem behavior
      • small sample might have not had enough power
      • location might have been an issue
  • limitations
    • evaluation tool - ABC might bot be comprehensive enough
    • medication changes over time
  • strengths
    • longitudingal and prospective
    • no extra contact with the residents
  • next study - control groups with matched pairs