Quality of Early Intensive Behavioral Intervention as a Predictor of Children's Outcome

Research has directed surprisingly little attention to the quality of Early Intensive Behavioral Intervention (EIBI) in autism spectrum disorder (ASD) as a potential predictor of outcome. Therefore, using a preschool delivery model within a sample of 30 children, we examined the predictive power of EIBI quality on treatment outcome. EIBI quality was assessed at baseline by the York Measure of Quality of Intensive Behavioral Intervention (YMQI) and treatment outcome was evaluated after a period of 4 to 6 months using a battery of behavioral tests and scales to evaluate treatment success. Multinomial logistic regressions demonstrated that general EIBI quality predicted clinically significant change at follow-up. Particularly improvements in basic language and learning skills and global clinical impression were observed. Specific quality indicators that influenced overall treatment success were treatment organization, teaching level and differential reinforcement. In addition to previously examined predictors of EIBI treatment effects, such as child characteristics and intervention quantity, our findings highlight the importance of adequate EIBI quality assurance.

Cross-Cultural Validation of the York Measure of Quality of Intensive Behavioral Intervention

Early intensive behavioral intervention (EIBI) is widely applied in young children with autism spectrum disorder. Little research has addressed the significance of adherence to EIBI practices for treatment outcomes. The York Measure of Quality of Intensive Behavioral Intervention (YMQI) was designed to assess EIBI quality delivery in Ontario, Canada. The objective of this study was to examine the cross-cultural validity of the YMQI in a clinical Swedish community sample of 30 boys and four girls with autism aged 2.5 to 6 years. Internal consistency was alpha = .87 for the full scale YMQI. Interrater reliability among three raters on 97 video-recorded therapy sequences was .71 (intraclass correlation coefficient [ICC]), and intrarater reliability of two raters re-scoring 15 sequences after 6 months was ICC = .87. The convergent validity of the YMQI with EIBI expert ratings was r = .49. Findings endorse the psychometric properties of the YMQI and its usability outside of Anglo-Saxon countries.