Baseline IQ Scores As A Predictor Of Treatment Outcome

It has been our experience that while baseline IQ testing can be predictive when children test in the higher ranges, it may not be as informative when children test in the lower ranges. That is, we have had experience where some of our clients, whose initial baseline test scores were in the moderately or severely retarded range, tested in the normal range of cognitive functioning after 2 or more years of treatment. Likewise, we have treated children with baseline IQs in the mildly retarded range who have never achieved normal cognitive functioning.

The Diagnostic and Statistical Manual of Mental Disorders - 4th Edition (DSM-IV) states that approximately 85% of the children diagnosed with autism also are diagnosed as mentally retarded. The majority of these function in the moderately retarded range (standard IQ scores between 35-55).

Therapeutic PATHWAYS Baseline IQ Data

The baseline IQ data for 20 children entering treatment with Therapeutic PATHWAYS are as follows:

• mean average IQ pretreatment standard IQ score = 56

• 5% of the children enter with IQ scores in the normal range of mental functioning (IQ scores = 85 and above)

• 5% enter with IQ scores in the borderline retarded range of mental functioning (IQ scores = 70 - 85)

• 32% enter with IQ scores in the mildly retarded range of mental functioning (IQ scores = 55 - 70)

• 53% enter treatment with baseline IQ scores in the moderately retarded range (IQ scores = 35 - 55)

• 5% enter treatment with baseline IQ scores in the severely retarded range (IQ scores below 35)

IQ Scores After One Year Of Treatment

After one year of intensive treatment, the average IQ score for all children in treatment with Therapeutic PATHWAYS = 75; a gain of 19 points. The gains for some children were of course, smaller; for others, larger. The standard deviation was 19 points. This means that 68% of the children's standard IQ scores were within 56 - 94.

There were also changes in the percentage of children scoring in the severely, moderately, mildly, borderline, and normal ranges of cognitive functioning.

After one year of treatment, none of the children were testing in the severely retarded range of mental functioning. The percentage of children functioning declined while the percentage of children functioning in the borderline and normal ranges increased from 5% to 21% in the borderline range and from 5% to 26% in the normal range of intellectual functioning. None of the children were functioning in the severely retarded range of mental functioning after one year. In addition, the percentage of children who scored in the moderately retarded range of mental functioning declined from 53% to 26%.

BASELINE LANGUAGE SCORES

Language development is measured on standardized tests in a variety of ways. Some measures emphasize vocabulary; others focus on the social or pragmatic use of language. Often separate scores are obtained for receptive and expressive skills.

The average age of children entering treatment with Therapeutic PATHWAYS is 33 months. However, their receptive and expressive language abilities typically measure similar to a child 12 - 14 months of age. Thus, at the start of treatment, both receptive and expressive language development lags considerably. The children are typically averaging a one (1) month gain for every three (3) months that elapse (developmental equivalent/chronological age).

At the end of the first year of treatment, expressive vocabulary is similar to that of a child 37 months of age; receptive skills are similar to a child 40 months of age. This means that children average a 2-month gain in expressive vocabulary for every month they were in treatment with Therapeutic PATHWAYS. Trajectories for receptive skills are slightly higher after children are in treatment for one year. The gains for some children are less; for others greater.

Equally Important Are The Children's Individual Stories

"J" started treatment when he was 3 years old. As is the case with most of the children who enter treatment with Therapeutic PATHWAYS, "J" was not toilet trained and had few other self-help skills. He was also functionally mute and unresponsive to most verbal commands. Aside from some attachment to his mother, he was generally disinterested in social interactions, including those interacting with his siblings. However, he did have a number of dangerous and destructive behaviors. For example, he would use his head to break open the glass cases in his home where his mother kept collectible figurines. But once he "had" the figurines "J" did not play with them in appropriate ways.

After "J" received a year of intensive behavioral treatment, he was able to start on a partial placement in a regular preschool (accompanied by a Therapeutic PATHWAYS Instructional Aide). He completed two years in preschool which were followed by placement in a regular kindergarten class. His Instructional Aide was gradually reduced over the second year of preschool and kindergarten. He entered first grade with age appropriate skills - and no Shadow Aide. He did, however, continue to receive a partial in-home program after school. "J" currently receives approximately 10 hours of after school intervention to help promote acquisition of more complex language and social skills. Consultation is provided at home to help promote good behavior and increase appropriate play with siblings. When last tested, "J's" cognitive skills were well within the normal range. Language and academic skills were comparable. "J" now plays well with others at during recess. He seems virtually indistinguishable from his peers at school. At home he still displays some rigid behaviors and preferences. These appear to be gradually diminishing with appropriate interventions.

His family, friends, and clinical staff were gratified when "J" was selected as the outstanding student of the month for his class at the end of his kindergarten year. In the newspaper article which published the names and stories of all those selected at his elementary school, "J" was described as a "wonderful role model for the other students as he follows classroom rules . . . a kind friend who is well liked by his peers." As important as his selection is the fact that "J" was also very proud with this social recognition for his accomplishments.