Number and controllability of reinforcers as predictors of individual outcome for children with autism receiving early and intensive behavioral intervention: A preliminary study

Although Early and Intensive Behavioral Intervention (EIBI) is an effective treatment for many children with autism, there is a substantial individual difference in outcome. This study was designed to investigate whether treatment gains were associated with the number and type of stimuli that function as reinforcers for 21 preschool-aged children with autism. Children with a large repertoire of socially mediated reinforcers benefited more from treatment. Children with many stereotypic behaviors, assumed to be an effect of a larger repertoire of automatic reinforcers, exhibited less benefit from treatment. These two dimensions taken together explained 49.9% of the variation in treatment gains for children after one year of EIBI. Due to the retrospective and indirect design of the study, results are to be interpreted with caution.

► There is a consistent and unexplained variation in outcome for children with autism who are treated with behavioral interventions.
► We investigated the number and type of reinforcers for children as a possible predictor.
► Children who were reinforced by many socially mediated stimuli such as praise, food, music, etc., exhibited larger treatment gains.
► Children who were reinforced by stimuli generated by their own stereotypic behaviors gained less from treatment.
► Future studies could replicate this finding in a truly predictive design, and find ways to increase the repertoire of socially mediated reinforcers for children with autism.