In 1999 the IBI initiative was launched in Ontarion. It was based on research evidence and stakeholder consultations. About 20 agencies have been involved in the program. These agencies included mental health centres, centres for children with physical and\or developmental disabilities, and children’s hospitals. The regions were of different sizes and with different amount of inhabitants. In the program took place about 800 children. There was the same number of the clinical staff.
The purpose of the study was to describe the outcomes of the children participating in the Ontario program. The two questions of the program were the following: Did children show statistically significant and clinically significant changes on developmental and diagnostic measures from the time they entered the program to the time they were discharged? In other words the purpose of the program was to find out if such the severity of autism, cognitive level, adaptive level, and rate of development change during children’s participation in the IBI program? The second question was: What was the range of progress/outcomes seen at exit? In other words it meant “did any children resemble the “best outcomes” reported in the literature?”.
This study reports on the outcomes of 332 children, aged 2-7 years, enrolled in a program. File review data at intake and exit were compared on a group basis as well as on an individual basis. There was a considerable heterogeneity in outcome, as expected, and children were classified into seven categories of progress/outcome. The majority of children (75%) showed some gains during IBI and 11% achieved average functioning. Although the study has clear methodological limitations (chiefly the lack of a comparison group), it suggests that IBI can be implemented effectively in a large, community-based program.
Autism severity was measured with the help of Childhood Autism Rating Scale at both intake and discharge for virtually all children.
Cognitive level was investigated on the basis of the research of 163 children (49%) an intake and 265 (85%) at exit.The tests that were applied were the following: the Mullen Scales of Early Learning, the Bayley Scales of Infant Development, the Wechsler Preschool and Primary Scale of Intelligence, the Stanford-Binet Intelligence Scale: Fourth Edition; or another test.
Adaptive levels were assessed, at intake and exit, for the vast majority of children, based on the Vineland Adaptive Behavior Scales, a semi-structured interview conducted by a trained interviewer with parents.
Rate of development change estimates the rates based on the VABS ABS Age Equivalent score by the child’s age at the time (e.g. a 24-month child who started with the ABC of 12 month would have an initial developmental rate of 50).
Results.
Autism severity. Statistically significant improvement in Total CARS scores was clearly apparent from intake to discharge, decreasing from about 36 to 31, on average. Looking at individual data for CARS Categories, of those children who scored in the mild/moderate autism range at intake (n = 48); 44% were in the non-autism range at discharge; 46% were still in the same mild/moderate range; and 10% were now in …