from the long term follow up study preliminary report · michael rutter, m.d., frs, anthony bailey,...
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New Data from the Ongoing DIR®/Floortime™ Study Long Term Follow Up StudyLong Term Follow Up Study
Preliminary Report
Eligibility Criteria g yChildren 10 years and older who were diagnosed with ASD d ld d h h d t t di ASD under 4 years old and have had outstanding outcomes after comprehensive intensive treatment, reported by parents, following the DIR®/Floortime™ p y p , g /model.
Social Communication Questionnaire (SCQ)Michael Rutter, M.D., FRS, Anthony Bailey, M.D., and Catherine Lord, Ph.D.
Evaluates communication skills and social functioning in children who may have autism or autism spectrum disorders composed of just 40 yes or no questions disorders ‐ composed of just 40 yes‐or‐no questions. SCQ content parallels that of the ADI‐R, and the agreement between SCQ and ADI‐R scores is high and substantially unaffected by age,
d l l l d f IQ Thi i di h h gender, language level and performance IQ. This indicates that the SCQ is a valid screener, providing a reasonable picture of symptom severity.
Lifetime and Current scores
SCQ Score Differences Between Lifetime and Current
25score of 15 represents
15
20
nt S
core
s
represents the cut off for
ASD
10
15
Ass
essm
en
5
SCQ
Mean for the General Population
010.5 12.4 13.1 13.2 13.9 14.0 14.7 15.8 15.11 16.7 17.0 17.5 17.6 17.8 18.10 19.8 22.1
Subject's Age in Years and Months at Assessment
Current Lifetime
S i l R i S lSocial Responsiveness Scaleby John Constantino, MD
Distinguishes autism spectrum conditions from other child psychiatric conditions by identifying presence and extent of autistic social impairmenth d l f h ld' lthe SRS provides a clear picture of a child's social impairments, assessing social awareness, social information processing, capacity for reciprocal social communication, social anxiety/avoidance and autistic preoccupations and social anxiety/avoidance, and autistic preoccupations and traits. the SRS measures impairment on a quantitative scale across a wide range of severity‐‐which is consistent with recent wide range of severity which is consistent with recent research indicating that autism is best conceptualized as a spectrum condition rather than an all‐or‐nothing diagnosis.
Social Responsiveness Scale (SRS) Scores
90
100
severe range
71
80
70
80
s
mild range
range
37
44 4238
43
53
4643
52
38
48
4145 45
49
40
50
60
S Sc
ores
37 38 38
20
30
40
SR
normal range
0
10
Subjects
BASC‐2
Behavior Assessment System for ChildrenBy Cecil R. Reynolds & Randy W. Kamphaus y y y p
parent and child self‐reports
BASC‐2 Parent ReportAdaptive Scale
Social Skills Leadership
Clinical ScaleInternalizing Problems
DepressionLeadershipActivities of Daily LifeFunctional
DepressionAnxiety
Externalizing ProblemsH i iCommunication HyperactivityAggressionConduct Problems
Behavioral SymptomsAttention ProblemsWithdrawalAtypicality
BASC-2 Parent Rating Adaptive Scalesg p
70
80
60
70
Average Range for
the General
40
50
T-Sc
ores
the General Population
At Risk Range
20
30
T Range
Clinically Significant
Range
0
10
Subjects
BASC-2 Parent Rating for Social Skills and Leadership
80
60
70
Average
40
50
T-Sc
ores
Range for the General Population
At Risk
20
30T At Risk Range
Clinically
0
10
Subjects
Significant Range
Subjects
Social skills Leadership
BASC-2 Parent Rating for Activities of Daily Life and Functional C i tiCommunication
80
60
70
Average Range for the
General
40
50
T-Sc
ores
General Population
At Risk Range
10
20
30T
Clinically Significant
Range
0
10
SubjectsSubjects
Functional communication Activities of daily life
BASC-2 Parent Rating Clinical Scales
80
90
100
Clinically Significant
60
70
80
es
Range
At Risk Range
40
50
T-Sc
ore
Average Range for the
General
10
20
30 Population
0
10
Subjects jExternalizing Problems Internalizing Problems Behavorial Symptoms
BASC-2 Parent Rating for Internalizing Problems
90
100
Clinically Significant
60
70
80
s
Significant Range
At Risk Range
40
50
60
T-Sc
ores Range
Average Range for the
General
10
20
30Population
0
10
Subjects Depression Anxiety
BASC-2 Parent Rating for Externalizing ProblemsBASC 2 Parent Rating for Externalizing Problems
90
100
Clinically
70
80
90Significant
Range
At Risk Range
40
50
60
T-Sc
ores
g
Average Range for the
General Population
20
30
T Population
0
10
Subjects jHyperactivity Aggression Conduct Problems
BASC-2 Parent Rating for Behavioral Symptoms
110
120
80
90
100
Clinically Significant
Range
50
60
70
T-Sc
ores At Risk Range
Average Range for the
20
30
40
T Range for the General
Population
0
10
20
S bj tSubjects Attention Problems Withdrawal Atypicality
BASC 2 Child Self ReportBASC‐2 Child Self ReportAdaptive Scale Clinical Scale
h l blPersonal AdjustmentSelf‐relianceSelf‐esteem
School ProblemsAttitude to schoolAttitude to teachers
l blInterpersonal relationsRelations with parents
Internalizing ProblemsSense of inadequacyAtypicalityD iDepressionLocus of controlAnxietySocial stressSocial stress
Inattention/Hyperactivity
Attention problemsAttention problemshyperactivity
BASC-2 Child Self-Report Adaptive Scales
70
80
50
60
s
Average Range for
the General
30
40
50
T-Sc
ores Population
At Risk Range
10
20
30
Clinically Significant
Range
0
10
Subjects
Range
BASC-2 Child Self-Report for Self-Reliance and Self-Esteem
0
80
50
60
70
Average Range for the
General
30
40
50
T-Sc
ores
Population
At Risk Range
10
20
30
Clinically Significant
Range
0
Subjects
Self-reliance Self-esteem
BASC-2 Child Self-Report for Relations with Parents and Interpersonal RelationsInterpersonal Relations
70
80
50
60
70
s
Average Range for the
General
30
40
50
T-Sc
ores
General Population
At Risk Range
10
20Clinically
Significant Range
0
Subjects
Interpersonal relatiionships Relations with parents
BASC-2 Child Self-Report Clinical Scalesp
90
100Clinically
Significant
70
80
gRange
At Risk Range
40
50
60
T-Sc
ores
Range
Average Range for the
General
20
30
0T General Population
0
10
SubjectsSubjects School Problems Internalizing Problems Inattention/ Hyperactivity
BASC-2 Child Self-Report for School Problems
90
100
Clinically Significant
60
70
80
s
Significant Range
At Risk Range
40
50
60
T-Sc
ores Range
Average Range for
the General Population
20
30Population
0
10
SubjectsSubjects Attitude to teachers Attitude to school
BASC-2 Child Self-Report for Anxiety and Social Stress
90
100Clinically
Significant
60
70
80
es
Range
At Risk Range
40
50
60
T-Sc
ore
Average Range for
the General Population
10
20
30p
0
10
Subjects Anxiety Social Stress
BASC-2 Child Self-Report for Depression and Locus of Control
90
100
Clinically Significant
60
70
80
s
gRange
At Risk Range
40
50
60
T-Sc
ores
Average Range for
the General Population
20
30
p
0
10
SubjectsSubjects Depression Locus of Control
BASC-2 Child Self-Report for Atypicality and Sense of Inadequacyq y
90
100Clinically
Significant
60
70
80
s
gRange
At Risk Range
40
50
60
T-Sc
ores Range
Average Range for
the General
10
20
30 Population
0
10
Subjects
Sense of Inadequacy Atypicality
BASC-2 Child Self-Report for Inattention and Hyperactivity
90
100
Clinically Significant
60
70
80
s
gRange
At Risk Range
40
50
60
T-Sc
ores Average
Range for the General Population
20
30
0
10
SubjectsSubjects Hyperactivity Attention problems
Current Academic & Social FunctioningSocial Functioning
Sample: 17 males, 1 female
Current Academic Functioning
Over half started Kindergarten 1 year late
94% (17/18) currently in mainstream education
55% attend public school; 45% private55% attend public school; 45% private
2 participants currently in college
77% doing “excellent” in school
Academic Achievements…Received prize for highest grade in physicsLead role in school playLead role in school playStraight A studentPublished poemPublished poemHonors EnglishEarly SAT & eligible for gifted courses at college Early SAT & eligible for gifted courses at college
Therapies
Sample: 22 males, 1 female
THERAPIES USED % UsedTHERAPIES USED % Used FLOORTIME 100.00%
SPEECH & LANGUAGE 100.00%
OT/Sensory Motor 100.00%
Nutritional Therapy 80.00%
Auditory Training 78.95%y g
Family Counseling 76.47%
Other 73.33%
Vi l S ti l 63 16%Visual - Spatial 63.16%
Problem Solving Activities 52.94%
Social Skills Groups 50.00%
Interactive Metronome 45.00%
Behavioral Therapies 38.89%
Psychotherapy 35.00%y pyBiomedical Interventions 31.58%
Lessons Learned
Sample: 17 males, 1 female
Top 3 Most Helpful Therapies18
14
16
10
12
8
10
4
6
0
2
Floortime OT/Sensory Int Speech/Language Nutrition Auditory Training Visual Spatial Secretin Lindamood Bell Ny statin
Graph shows how many times each therapy was ranked in top 3