UC DAVIS/U. WASHINGTON (US)—A novel early intervention program for very young children with autism—some as young as 18 months—is effective for improving IQ, language ability, and social interaction, a comprehensive new study has found.
“This is the first controlled study of an intensive early intervention that is appropriate for children with autism who are less than 2-1/2 years of age. Given that the American Academy of Pediatrics recommends that all 18- and 24-month-old children be screened for autism, it is crucial that we can offer parents effective therapies for children in this age range,” says Geraldine Dawson, chief science officer of Autism Speaks and the study’s lead author. “By starting as soon as the toddler is diagnosed, we hope to maximize the positive impact of the intervention.”
The study, published online in the journal Pediatrics, examined an intervention called the Early Start Denver Model, which combines applied behavioral analysis (ABA) teaching methods with developmental “relationship-based” approaches. This intervention was novel because it blended the rigor of ABA with play-based routines that focused on building a relationship with the child. While the youngest children in the study were 18 months old, the intervention is designed to be appropriate for children with autism as young as 12 months of age.
Although previous studies have found that early intervention can be helpful for preschool-aged children, interventions for children who are toddlers are just now being tested.
“Infant brains are quite malleable so with this therapy we’re trying to capitalize on the potential of learning that an infant brain has in order to limit autism’s deleterious effects, to help children lead better lives,” says Sally Rogers, professor of psychiatry and behavioral sciences, study coauthor, and a researcher at the UC Davis MIND Institute.
Rogers and Dawson developed the intervention. The five-year study took place at the University of Washington in Seattle and was led by Dawson, then a professor of psychology and director of the university’s Autism Center, in partnership with Rogers.
It involved therapy for 48 diverse, 18- to 30-month-old children with autism and no other health problems. The children were separated into two groups, one that received the intervention and another that was referred to community-based programs for therapy.
At the conclusion of the study, the IQs of the children in the intervention group had improved by an average of approximately 18 points, compared to a little more than four points in the comparison group. The intervention group also had a nearly 18-point improvement in receptive language (listening and understanding) compared to approximately 10 points in the comparison group.
Seven of the children in the intervention group had enough improvement in overall skills to warrant a change in diagnosis from autism to the milder condition known as “pervasive developmental disorder not otherwise specified,” or PDD-NOS. Only one child in the community-based intervention group had an improved diagnosis.
“We believe that the Early Start Denver Model group made much more progress because it involved carefully structured teaching and a relationship-based approach to learning with many, many learning opportunities embedded in the play,” Rogers says.
“Parental involvement and use of these strategies at home during routine and daily activities are likely important ingredients of the success of the outcomes and their child’s progress,” Dawson notes. “The study strongly affirms the positive outcomes of early intervention and the need for the earliest possible start.”
The study was funded by a grant from the National Institute of Mental Health, which has also funded a multisite trial of the Early Start Denver Model currently being conducted at the University of Washington, the UC Davis MIND Institute, and the University of Michigan.
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