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

## TL;DR

This study shows that early behavioral intervention for autism in Syria led to long-term improvements, even amid conflict and resource limitations.

## Contribution

The study demonstrates the durability of autism intervention outcomes in a conflict-affected, low-resource setting over more than a decade.

## Key findings

- Significant improvements in autism symptoms and adaptive functioning were observed from baseline to post-treatment and early follow-up.
- By 2019, some gains declined, but outcomes remained significantly better than baseline.
- Improvements were most notable in social interaction and communication, with later declines in communication and emotional adaptation.

## Abstract

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.

The online version contains supplementary material available at 10.1007/s10802-026-01438-x.