Parents vital to toddler autism therapy

U. WASHINGTON (US) — Young children show better communication skills after receiving a parent-guided autism treatment than those receiving community-based treatments.

Few autism interventions focus on toddlers—children aged 1 to 3—despite the fact that parents often detect symptoms, including using fewer facial expressions and gestures to communicate, when children reach about 18 months old.

A new study using the autism treatment Hanen’s More Than Words shows that caught early enough and treated with the proper behavior therapy, autism symptoms can improve dramatically.

Details of the research are reported in the Journal of Child Psychology and Psychiatry.

“This report adds to our emerging knowledge about which interventions work for which kids. It will help match children with the right intervention and not waste time enrolling them in treatments that are not well-suited for them,” says co-author Wendy Stone, director of Autism Center at the University of  Washington.

One in 110 children has autism spectrum disorders, which include autistic disorder, Asperger’s syndrome, and pervasive developmental disorder-not otherwise specified. More boys, one in 70, than girls are affected.

For the study, Stone researched the effectiveness of a short-term, relatively low-cost intervention for toddlers showing warning signs of autism.

Sixty-two children (51 boys and 11 girls) younger than age 2 and meeting criteria for autism disorders, participated with their parents. Toddlers’ baseline social and communication skills were measured during a pretest in which parents and children played with toys and read books while a researcher observed.

“Our ultimate goal is to catch the symptoms early and find effective preventive interventions so that these children can attain their full potential,” Stone says.

Youngsters were randomly assigned either to the Hanen’s More Than Words program—intended to stimulate mature communication, language development, and social skills—or to a treatment-as-usual control condition.

Parents in the treatment group learned strategies to help their toddlers communicate, such as practicing

taking turns, encouraging eye contact, and modeling simple sentences from the child’s perspective. For instance, when the child pointed to crackers, the parent wouldn’t just hand over the food. Instead, the parent would get down at eye-level with the child and say, “I want crackers.”

“By age 2, most kids have already learned how to interact and communicate with others,” Stone says.

Children showing early signs of autism spectrum disorders don’t seem to learn basic social interactions without coaching.

To the researchers’ surprise, the intervention did not make a difference in communication skills when they compared the 32 children in the intervention group and the 30 children in the no-treatment group.

But they did find that the intervention helped a subset of the children. Kids who played with fewer toys during the pretest showed more improvement if they received the treatment than if they didn’t. They showed more instances of making eye contact, pointing to or reaching for objects of interest and showing or giving the experimenter a toy.

The effect lasted for at least four months after the intervention ended, Stone says.

“Playing with toys provides great opportunities for teaching social and communication skills. It enables children and caregivers to share a focus of attention.”

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