Psychosocial EIBI
Early Intensive Behavioral
Early Intensive Behavioral Interventions (EIBI) are behavioral interventions that are widely used in the management of individuals with ASD.
They are based on the Applied Behavior Analysis (ABA) model and, historically, they have relied on the Lovaas model (1981, 1987).
They are based on the Applied Behavior Analysis (ABA) model and, historically, they have relied on the Lovaas model (1981, 1987).
The foundation of the program developed by Ivar Lovaas is that a behavioral intervention can build positive behaviors and suppress unwanted ones. According to Lovaas, the younger the child, the more effective the generalized learning opportunity will be. This program uses the principles of operant conditioning: positive behaviors are reinforced while negative or aggressive behaviors are ignored (historically, these negative behaviours could have been punished using aversives but this has been criticized and is no longer used, Dixon et al., 2012). The reinforcers are external to the tasks being taught and pre-selected by the adult.
The main behavioral technique used in the Lovaas program is Discrete Trial Training (DTT), which consists of (Doehring, 2001) :3
- presenting a stimulus in repeated sequences
- then observing the child response to these presentations
- rewarding expected responses of the child (reinforcement)
Progressively, the therapeutic team makes the tasks more complex. The goal of the program is to allow the child to progressively develop skills related to autonomy, receptive language, verbal and non-verbal imitation and to establish the basis for play. A key aspect of this program is teaching the child imitation skills. Once taught, imitation is used as a learning tool. As soon as the child has acquired certain skills, the goal is to help the child generalize these skills at home and then in a school setting.
Because many researchers were concerned that the highly-structured and adult-led environment proposed in the Lovaas program could result in an over-reliance on adults prompts and limit children ability to generalize learned skills to news contexts, both researchers and clinicians have worked to improve and expand the Lovaas program (Schreibman et al., 2015).
Influenced by the work of developmental psychologists, new EIBIs have placed more emphasis on child motivation. In these new approaches, the adult gives the child more control over the choice of materials and the initiative for interactions. Reinforcers are natural, that is, they are directly related to the success of the task. A wider range of responses is accepted and attempts, not only successes, are rewarded.
As in the Lovaas program, these new approaches encompass the fundamentals of ABA methodology (such as DTT), take a comprehensive approach to skills development, and maintain a quite structured environment to facilitate initiative. A prominent example of EIBI inspired by these new approaches is the early start Denver model (ESDM).
Currently, the critical components of EIBI involve the use of:3
- a specific ABA-based teaching procedure (such as DTT)
- a very intensive format for an extended period of time (e.g., 15 hours per week for at least one year)
- a one-to-one adult to child ratio or in very small groups
Number of meta-analyses
- Preschool (0-5): 12 meta-analyses
- School-age (6-12): no meta-analysis
- Adolescents (13-17): no meta-analysis
- Adults (18+): no meta-analysis
One meta-analysis per outcome and age group, shown in the Intervention explorer.
See its evidenceReferences 2
- ScKlintwall L, Eikeseth S. Early and Intensive Behavioral Intervention (EIBI) in Autism. 2014; In: Patel V, Preedy V, Martin C. (Eds) Comprehensive Guide to Autism. Springer, New York, NY.
- Healy O, Lydon S. Early Intensive Behavioural Intervention in Autism Spectrum Disorders. 2013; In Recent Advances in Autism Spectrum Disorders - Volume I. IntechOpen
Early Intensive Behavioral
- DTT Discrete Trial Training Structured behavioral teaching in clear, repeated learning trials. Delivered by A professional Teaching style Massed adult-led trials
- Other programmes may be studied under the same label.
Discrete Trial Training
Structured behavioral teaching in clear, repeated learning trials.
Delivered by A professional Teaching style Massed adult-led trials
Techniques identified in published trial reports and programme documents
9A name opens its description
A Setting up the moment
Antecedent - arranging things before
B Teaching & helping the child
Teaching - what the adult does in the moment
C What happens afterwards
Consequence - the response to what the child did