Results of a new community-based randomized clinical trial conducted by researchers at the Institute for Autism Research (iar) at Canisius University found a comprehensive summer treatment (summerMAX) to be highly effective for high-functioning children with autism spectrum disorder (HFASD).
Children with the disorder experience lifelong impairments involving social-communicative functioning and restricted and repetitive interests and behaviors. Despite their significant challenges, there continues to be a severe need for effective comprehensive treatment programs for these children.
The summerMAX program is a comprehensive psychosocial treatment developed by iar co-founders and co-directors Christopher Lopata, PsyD and Marcus L. Thomeer, PhD.
Two prior randomized clinical trials conducted by Lopata and Thomeer at the iar found the summerMAX treatment to be highly effective in improving the social performance and ASD symptoms of children with HFASD. These two prior trials were conducted under highly-controlled university conditions. According to Thomeer, the study’s lead author, “university-based trials often yield positive findings but the treatments are not feasible or as effective when delivered in real-world clinical settings such as community service agencies. Because of this, we conducted a trial to determine whether a local community service agency could feasibly implement the summerMAX treatment and achieve similar outcomes as those found in the two prior university-based trials.”
The iar research team partnered with a local community agency, Autism Services Inc., specializing in services for individuals with ASD and other developmental disabilities, to test the summerMAX program under real-world conditions. “In community effectiveness trials such as this, the key is to have the community agency manage and administer all aspects of the treatment program separate from the program developers,” said Lopata, one of the study authors. “For this study, Autism Services Inc. independently recruited and screened the children, trained their staff, implemented the treatment, and measured the outcomes.”
Following the 5-week summerMAX program, children in the treatment group demonstrated a significantly higher score on a child measure of non-literal language skills, as well as significantly higher parent-ratings for targeted and broad social skills and significantly lower ratings of autism symptoms and withdrawal compared to children in the waitlist control group. Staff clinician ratings also supported these same improvements. Overall, results of this community-based randomized trial were consistent with the results of the two prior university-based trials. “This was an important and exciting finding because it suggested that community agency providers such as Autism Services Inc. can achieve similar treatment gains in applied settings,” said James P. Donnelly, PhD, one of the investigators. Additionally important was the finding that the treatment was very feasible in this real world clinical setting. “Staff clinicians administered the treatment with a very high level of accuracy and parents, children, and staff clinicians reported high levels of satisfaction with the program. This was a critical finding as implementation accuracy and treatment acceptability are often barriers when community agencies attempt to adopt university-developed treatments,” said Thomeer. According to Veronica Federiconi, Executive Director of Autism Services Inc., “we were very pleased with the ability of our staff to accurately implement the summerMAX treatment, as well as with the significant gains made by the children. Programs like summerMAX that can be implemented in community settings like ours are needed to meet the needs of the community.”
A total of 57 children, ages 7-12 years participated, with 28 randomly assigned to receive the treatment and 29 to a waitlist control condition. Children in the treatment were in groups of 5 or 6 children and 3 clinical staff. The treatment was conducted 5 days per week over 5 weeks and targeted clinical and associated features of autism spectrum disorder including social/social-communication skills, non-literal language skills, emotion recognition skills, and interest expansion. Treatment was provided during five 70-minute treatment cycles each day using direct instruction, modeling, role-playing, and performance feedback. A point system was used to reinforce positive social behaviors and reduce autism symptoms and negative behaviors across the treatment day. Weekly parent education was also provided.
Results of this community effectiveness clinical trial appear in the Journal of Clinical Child and Adolescent Psychology (December 2016). According to Thomeer, “summerMAX is the first comprehensive treatment specifically for children with HFASD to be found effective in two university-based randomized trials and a community effectiveness randomized trial.” The study was funded by a grant from The Peter and Elizabeth C. Tower Foundation. “We are enthusiastic to fund studies such as this, that have the potential to positively impact the lives of children with HFASD and their families, as well as foster the dissemination of evidence-based treatments to clinical providers,” said Tracy Sawicki, Executive Director of The Peter and Elizabeth C. Tower Foundation.
For more information regarding the summerMAX treatment program and/or the Institute for Autism Research at Canisius University, call (716) 888-2800 or visit their webpage.
