Early intervention lasts for kids with autism

Children with autism who received early one-on-one therapy that included songs and fun activities, were still showing improvements years later. "This is the kind of evidence that is needed to support effective intervention policies for children with autism, whether it's insurance coverage or state support for early autism intervention," says Annette Estes. (Credit: iStockphoto)

Early intervention for toddlers with autism spectrum disorder helps improve intellectual ability and reduces symptoms even years after the treatment ends.

A new study is the first in more than 20 years to look at long-term outcomes after early intensive autism intervention. Therapy began when children were 18 to 30 months old and involved therapists and parents working with children at home for more than 15 hours each week for two years.

“When you intervene early in a child’s life, you can make a big difference,” says lead author Annette Estes, director of the University of Washington Autism Center. “We hope this translates to a higher quality of life for people with autism spectrum disorder.”

The earlier the  better

The therapy, known as the Early Start Denver Model (ESDM), was designed to promote social and communication skills and learning.

Published online in the Journal of the American Academy of Child and Adolescent Psychiatry, the study shows that two years after completing the intervention, children maintained gains in overall intellectual ability and language and showed new areas of progress in reduced autism symptoms.

The intervention has been shown to help children with autism, but it has not been shown to work with very young children over a longer time period until now.

These results make the case for autism-specific, one-on-one intervention to begin as soon as autism symptoms emerge, which for many children is before 30 months of age, Estes says.

“This is really important. This is the kind of evidence that is needed to support effective intervention policies for children with autism, whether it’s insurance coverage or state support for early autism intervention.”

Songs and toys

The researchers studied two groups of young children with autism—the first received community intervention as usual for two years, which was a mix of what was available in the community such as speech therapy and developmental preschool.

The second group received ESDM, which addresses a comprehensive set of goals, is delivered one-on-one in the home, and incorporates parent coaching and parent-delivered intervention with the child. The approach is designed to enhance a child’s motivation and follows each child’s interests in playing with toys and engaging in fun activities, songs, and basic daily routines.

After two years of intensive intervention, children in the ESDM group showed a significantly greater increase in IQ, adaptive functioning, communication, and other measures than did the comparison group.

“These findings indicate that children who had received the ESDM earlier in their lives continued to progress well with significantly less treatment than the comparison children received,” says coauthor Sally J. Rogers, professor of psychiatry at University of California, Davis, and co-creator of the Early Start Denver Model intervention.

Good for society, too

It was surprising to researchers that two years after the early intervention ended, children who received the one-on-one care saw their autism symptoms reduce further, while children who had participated in community intervention had no overall reduction.


This kind of treatment is important for the well-being of children with autism, but it’s also a good idea economically, Estes says.

“People who are better able to communicate, care for themselves, and participate in the workforce at greater levels will need less financial support in their lives.

Other researchers from University of Washington and from Weill-Cornell Medical College and Duke University are study coauthors. The National Institutes of Health, the National Institute of Mental Health, the Autism Center of Excellence, and the Autism Speaks foundation funded the work.

Source: University of Washington