This study identified developmental pathways of preschool children with autism who completed a 3-month ABA parent training program. Nine pathways emerged based on intellectual and adaptive behavior scores, with 13.5% identified as "Blossomers" who made the most progress. Case studies of 4 Blossomers at follow-up found they were in the average IQ range and showed lasting substantial improvement from early intensive ABA intervention. The study provides examples of children with autism who benefited greatly from parent training and ABA therapy.

1. Who Are Blossomers? Children With Autism Who
Blossomed Through ABA Parent Training
Ruby Jamil, Marcia N. Gragg, & Shawna A. Scott.
The University of Windsor, The Summit Centre for Preschool Children with Autism
Introduction
• Autism is a pervasive developmental disorder that affects
social-communication skills, narrow interests, and repetitive
behaviours (APA, 2013).
• Applied behaviour analysis (ABA) is the first-line treatment
for children with Autism Spectrum Disorders (ASDs).
• Gotham et al. (2012) & Venker et al. (2013) identified four
developmental trajectories based on changes in autism
symptoms over time (improving, worsening, persistent high,
and persistent moderate).
• Fountain et al. (2012) identified six developmental trajectories
based on staff ratings (high functioning, bloomers, medium-
high functioning, medium functioning, low-medium
functioning, and low functioning).
• There remains a need for in-depth description of children
who bloom or improve (Fountain et al., 2012; Gotham et al.,
2012).
Objectives of Present Study:
1. To identify developmental pathways of preschool children
with autism who completed a 3- month ABA parent training
program
2. To identify “Blossomers,” i.e., children who made rapid
progress in intellectual and adaptive skills in the program
3. To provide a rich description of the Blossomers during the
program and at follow-up
This study used archival data for 37 child participants. Children
who “blossomed” during parent training, and their parents
participated in the present follow up study.
Method
Archival Participants: N = 37
• Children, 81% male, mean age 3 years, 5 months.
• Parents, 89% mothers, 75% college/post graduate
education.
• Age; 50% were 35-44, 44% were 18-34, & 5.5% were
45-54.
Follow up Participants: n = 4
• Children, 75% male, mean age 7 years, 8 months.
• Parents, 50% mothers, 100% college/post graduate
education.
• Age; 75% were 35-44, 25% were 45-54.
Senior Staff: N = 2
• 100% female between ages 35-44 with college/post graduate
education
Procedure
• Archival IQ and adaptive behaviour scores were used to
identify developmental pathways.
• Blossomers = those who made most progress in IQ and
adaptive behaviour scores over a 3-month parent training
program.
• Senior staff at the Summit Centre were interviewed about
which children they believe “Blossomed.”
• Blossomer children and parents attended a follow up session
• Interviews and questionnaires for parents.
• Updated IQ and adaptive behaviour assessment for
children.
Results
• Nine developmental pathways emerged based on intellectual
and adaptive behaviour scores (see Figure 1). A cross
tabulation was used.
• 38% were in the Stable pathway.
• The Blossomer group was defined as the 13.5% in the
three pathways with the most progress in IQ, Adaptive
Behaviour, or both (outlined in red; see Figure 1).
• At follow-up, four Blossomers were in the average IQ
range and three were in the average adaptive behaviour
range (see Figure 2).
Case Study 1: Andy, 7 year follow-up
• an affectionate 10 year old boy who loves to learn science
and languages.
• His peers and teachers are fond of him, and he earns A’s
and B’s in most subjects with little support in the
classroom.
• His parents are patient and always willing to advocate on
his behalf.
• Andy received speech and language therapy as a toddler.
• “He actually did so well in the Unity program that he
advanced too far for us to get into [gov’t funded ABA].”
“ABA was very effective for him.” - Parent
• The Chinese letter symbolizes his love of languages. Andy
knows the alphabet in 20 languages and gets up early to
learn languages on Youtube.
Case Study 2: Ben 3 year follow-up
• an easy-going 7-year old boy who enjoys school and
receives little support.
• “He’s the best reader and best at math in his class.” “He’s
constantly improving.” - Parent
• Ben has a close bond with his parents, and his rivalry and
socialization with his siblings contributes to his progress.
• “I’m the primary influence in his life as far as advancing
his autism to a more typical behaviour” - Parent
• At follow up, Ben hesitated to guess on tests for fear of
being wrong. He loved earning “guessing jewel” stickers,
which enticed him to guess.
Case Study 4: Dan 2 year follow up
• an outgoing 5 year old who is doing well in
kindergarten.
• His parent attributes his success to the use of
ABA.
• “Being social has really helped his progress
especially now that he’s in school…he’s more
eager to learn.” – Parent
• Engaging with his sibling “gives him the
opportunity to be more social and show his
brother what to do and how to play”.
• Dan’s pineapple represents his love of being
silly; he often answered “pineapple” to questions
like “what is your name?”
Case Study 3: Cindy 5 year follow up
• an inquisitive 7 year old who does well in school
with minimal support.
• Her family is dedicated, loving, and continued
to do formal ABA programs with her after
Unity.
• “I quit my job, I was with her full time--
completely dedicated to doing whatever had to
be done for her” -Parent
• “When she first came in…I thought she was one
of the lowest kids we’d ever seen.” - Staff
• “She most closely lies with the high functioning
group [now].” - Parent
• Cindy’s beaker represents her love of science.
She watches Nova on TV, and spontaneously
drew a picture of plate tectonics as a gift for her
parent.
0
20
40
60
80
100
120
Pre-Unity Post-Unity Follow-Up
StandardScores
Figure 2. IQ and adaptive behaviour from pre-ABA
training to follow-up.
Andy IQ Andy Adaptive
Ben IQ Ben Adaptive
Cindy IQ Cindy Adaptive
Dan IQ Dan Adaptive
• Nine developmental pathways were identified. Five
children (13.5%) were identified as Blossomers. All
four Blossomers participating in the study were in the
average IQ range, and three were in the average
adaptive behaviour range.
• Previous studies identified four to six developmental
pathways, 7-14% bloomers/ improvers, and a
regression pathway. (Fountain et al., 2012; Gotham et
al., 2012; Venker et al., 2012). Previous studies used
changes in staff rating scales and ADOS scores over
time to identify pathways (Fountain et al., 2012;
Gotham et al., 2012; Venker et al., 2012). The
present study identified 9 pathways and 13.5%
Blossomers, using changes in IQ and adaptive
behaviour scores over 3 months to identify
developmental pathways. The discrepancy between
results is likely a result of the small sample size,
differing statistical analyses, use of different variables
to identify pathways, and
a highly selected parent
sample in this study.
• Case studies suggest that
a subset of children with
autism benefitted greatly
from early intensive
behaviour intervention
with lasting substantial
improvement.
Discussion
Thank you to:
 the parents and children who participated
♥ Research Assistant Gorana Miljevic
 Summit Centre program secretary Jackie Ferriss
♥ Parent advisors
Undergraduate Thesis Conference 2014
Questions?
jamil2@uwindsor.ca