Effectiveness of Early Low Intensity Multifaceted Autism Intervention (ELIMA) for Preschool Children with Autistic Spectrum Disorder

INTRODUCTION: Autism Spectrum Disorder (ASD) is a life-long neurodevelopment disorder characterized by impairments in social interaction, verbal and non-verbal communication, and a restricted repetition of activities and interests. Many international studies have proven the efficacy of developmental interventions and have recommended such interventions as an integral part of the treatment of children with ASD. Majority of these interventions are high in their intensity (mean of 30 hours per week). The current study aimed to evaluate the effectiveness of a low intensity intervention over 12 months in children belonging to the age group of 2 to 6 years diagnosed with autism.

OBJECTIVES: To assess the outcome of Early Low Intensity Multifaceted Autism Intervention (ELIMA) program on Autistic symptoms and Developmental domains

METHODOLOGY: This was a prospective observational study, done in the Child Development Centre, Pushpagiri Institute of medical sciences, Thiruvalla, Kerala during December 2017 to May 2019. Sample size was 32 and children between 2 – 6 years diagnosed with ASD, enrolled for treatment program in CDC were studied. They were initially assessed by CARS (Childhood Autism Rating Scale). Their developmental quotient in each developmental domain (gross motor, fine motor, personal social) was found out using DDST (Denver Developmental Screening Test). Receptive language quotient and expressive language quotient was found out using REELS (Receptive – Expressive Emergent Language Scale). These children were followed throughout the ELIMA program. After 12 months of therapy each of them was reassessed using the same tools. Scores before and after the intervention was entered in MS excel and analysis was done using SPSS software. Test of significance used to calculate p value was Wilcoxon Signed rank test.

RESULTS: Each child received an average 5.89 hours of intervention per week for 12 months. Their mean CARS score reduced from 35.55(SD- 1.69) to 31.7(SD-1.91) after 12 months of therapy and the significance was high (p<0.001). This significant decrease in scores suggests that there is significant reduction in severity of autism symptoms in the subjects. There was statistically significant improvement in all the development domains (p<0.001). Compared to motor domains it is found that the rate of improvement is more in personal social and language domains.

CONCLUSION: Early low Intensity Multifaceted Autism Intervention – ELIMA, reduces the severity of autism in children between 2 and 6 years significantly. This intervention program also helps in significant improvement of all the four developmental domains, in children with ASD.