A Comprehensive, Personalized, Medically Based Care Model Improves Adaptive Behavior Outcomes in Autism vs Standard of Care

OBJECTIVE: This study examined the effects of treatment at Cortica on adaptive behaviors in children with Autism Spectrum Disorder (ASD). Currently, the standard of care for adaptive behavior deficits in ASD is Applied Behavior Analysis (ABA). The Cortica model involves a comprehensive program including ABA in addition to multidisciplinary developmental therapies, overseen by a neurodevelopmental physician. We analyzed longitudinal change in the Vineland Adaptive Behavior Scales over the course of Cortica care compared to standard ASD care received by children included in the National Database of Autism Research (NDAR).

METHODS: Children with an ASD diagnosis (Cortica N=343, NDAR N=103) were assessed up to 7 times between 2-12 years of age. We constructed multilevel models to characterize growth curves within each adaptive behavior domain (composite score, communication, socialization, and daily living skills). We included a time X cohort interaction term to compare relative rates of growth in the Cortica sample versus the NDAR sample.

RESULTS: Multilevel models showed a main effect of time, such that adaptive behaviors demonstrated improvement during treatment for both cohorts (B≥.19, p≤.003; Figure 1). Further, we found a significant cohort X time interaction for the adaptive behavior composite score (B=-0.15, p=.01), communication (B=-0.19, p=.04), socialization (B=-0.18, p=.01) but not daily living skills. All interactions indicated that children in the Cortica cohort showed increased growth in adaptive behaviors relative to children in the NDAR cohort.

CONCLUSIONS: Children with ASD receiving care at Cortica resulted in improved adaptive behavior development compared to a cohort of children receiving typical care.
Keywords: Autism, Adaptive Behavior, Multidisciplinary Therapy