Sustained Autism Outcomes Eight Years After Early Intensive Behavioral Intervention in a Conflict-Affected Low-Resource Setting: A Longitudinal Follow-Up Study

This study examined the long-term outcomes of the Future Centre's Early Intensive Behavioural Intervention (FC-EIBI) for children with autism spectrum disorder (ASD) in a conflict-affected, low-resource setting in Syria. Sixty-six participants were assessed at baseline (2008), post-treatment (2010), early follow-up (2013), and long-term follow-up (2019) using the Childhood Autism Rating Scale (CARS), the Autism Behaviour Checklist-Arabic (ABC), and the Adaptive Behaviour Scale-Arabic (ABS-Arabic). Longitudinal change was examined using nonparametric repeated-measures analyses, with additional analyses of subdomains across six ABS-Arabic domains. Significant improvements were observed across all measures from baseline to post-treatment and early follow-up (all ps < 0.001), indicating substantial reductions in autism symptom severity and marked gains in adaptive functioning. By 2019, small but significant attenuation of earlier gains was detected; however, outcomes remained significantly improved relative to baseline. Improvements in adaptive functioning were most pronounced between 2008 and 2013, particularly in Social Interaction and Communication/Language, whereas later declines were most evident in Communication/Language and Personal-Emotional Adaptation. Overall, FC-EIBI was associated with considerable and durable developmental benefits over more than a decade, despite prolonged sociopolitical instability and service disruptions. These findings underscore the feasibility of sustaining meaningful developmental outcomes for children with ASD in conflict-affected, low-resource contexts.