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Randomized controlled effectiveness trial of executive function intervention for children on the autism spectrum
Author(s) -
Kenworthy Lauren,
Anthony Laura Gutermuth,
Naiman Daniel Q.,
Can Lynn,
Wills Meagan C.,
LuongTran Caroline,
Werner Monica Adler,
Alexander Katie C.,
Strang John,
Bal Elgiz,
Sokoloff Jennifer L.,
Wallace Gregory L.
Publication year - 2014
Publication title -
journal of child psychology and psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.652
H-Index - 211
eISSN - 1469-7610
pISSN - 0021-9630
DOI - 10.1111/jcpp.12161
Subject(s) - autism , psychology , psychological intervention , social skills , intervention (counseling) , cognitive flexibility , autism spectrum disorder , randomized controlled trial , executive functions , clinical psychology , response to intervention , developmental psychology , cognition , psychiatry , medicine , surgery
Background Unstuck and On Target ( UOT ) is an executive function ( EF ) intervention for children with autism spectrum disorders ( ASD ) targeting insistence on sameness, flexibility, goal‐setting, and planning through a cognitive‐behavioral program of self‐regulatory scripts, guided/faded practice, and visual/verbal cueing. UOT is contextually‐based because it is implemented in school and at home, the contexts in which a child uses EF skills. Methods To evaluate the effectiveness of UOT compared with a social skills intervention ( SS ), 3rd–5th graders with ASD (mean IQ = 108; UOT n = 47; SS n = 20) received interventions delivered by school staff in small group sessions. Students were matched for gender, age, race, IQ, ASD symptomotolgy, medication status, and parents' education. Interventions were matched for ‘dose’ of intervention and training. Measures of pre–post change included classroom observations, parent/teacher report, and direct child measures of problem‐solving, EF , and social skills. Schools were randomized and evaluators, but not parents or teachers, were blinded to intervention type. Results Interventions were administered with high fidelity. Children in both groups improved with intervention, but mean change scores from pre‐ to postintervention indicated significantly greater improvements for UOT than SS groups in: problem‐solving, flexibility, and planning/organizing. Also, classroom observations revealed that participants in UOT made greater improvements than SS participants in their ability to follow rules, make transitions, and be flexible. Children in both groups made equivalent improvements in social skills. Conclusions These data support the effectiveness of the first contextually‐based EF intervention for children with ASD . UOT improved classroom behavior, flexibility, and problem‐solving in children with ASD . Individuals with variable background/training in ASD successfully implemented UOT in mainstream educational settings.