Early autism interventions show promise
Pediatricians recommend that all toddlers get screened for autism. And for years studies have shown that the disorder can be diagnosed in children as young as 14 months.
Everyone seems to agree that early intervention is key in managing the puzzling neurodevelopmental disorder. But are there effective treatments for children diagnosed as young as their first birthday?
New research appearing in today's Pediatrics suggests there are. A very small five-year study found interventions starting as early as 18 months improved IQ, language ability and social interaction in autistic children.
The study, by researchers with Autism Speaks, the University of Washington and UC Davis Mind Institute, is based on a clinical trial of 48 18-to-30 month old children. Half got intensive two-hour therapy sessions with a specialist five days a week and five hours of parent therapy. The control group received only annual assessments from doctors and referrals to therapies already available in their communities.
The children who received the interventions had an average increase of 18 IQ points over the study period and made gains in language skills and social interaction. Only one child in the control group had an improved diagnosis, the authors found.
"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," said Sally Rogers, of the UC Davis MIND Institute, and a co-author of the study.
Clearly the small study size is a limitation of the research. It's unclear whether children will sustain these gains over the long term, the authors acknowledge. And I wonder how many autistic children have parents have the time and the ability to engage in intense therapy sessions with their children. Many autistic parents I have spoken to for previous articles tell me they are already stretched thin, and understandably so.
Researchers say they hope the findings influence more research, and hopefully, answers to this complex disorder.
Comments
Having an 11 y.o. child who is significantly affected by autism (I don't use the high functioning low functioning tags) these are the kind of studies that drive me crazy. Without long term study, who cares? And once you've been involved in an autism diagnosis, you realize how squishy all these seemingly concrete findings are. Did the IQ go up 18 points or did the child and the researcher figure out a better way of measuring IQ when there are significant communication issues. And Autism Speaks and the Mind Institute are big in the whole anti-vaccine thing which makes me wonder about their "scientific methods".
And then we get to these massively intensive interventions. There is no way that this level of therapy can be sustained over the long term by people who are not independently wealthy or have some really incredible health insurance. And the time commitment doesn't leave time for other kids or a job. And I've got to wonder if this level of therapy might be very stressful for some kids, especially if there is negative reinforcement going on.
Everybody has to figure out their own path in the end. I know that ours has lead to a happy autistic kid with "neurotypical" siblings who generally don't resent him. These kinds of studies make me second guess what might be the outcome if I had a million dollars of disposable income... not the best feeling.
Posted by: a parent | November 30, 2009 10:04 AM
I have a little boy who will be 4 next month. He was diagnosed at 20 months of age and started receiving 40 hours of ABA therapy per week starting at 22 months. It works! He went from being completely Non Verbal, banging his head, rocking in a corner, and chewing on everything even chewing on his crib until his cheeks bled. He didn't know how to play with his toys just threw them on the floor to hear the noise they made. Now 2 years after receiving the one on one therapy he is a happy kid that is always talking, loves to interact with people. No longer rocks, bang his head or chew on things. He can feed and dress himself, knows all his letters, shapes, and colors. Can count to 100. Knows his full address, city and state, phone number, and birth date. Sure we still have some hurdles to overcome but Early intervention does wonders! I am married and have 3 other children but still have been able to balance things out.
Posted by: Another Parent | November 30, 2009 1:49 PM
To the parent of the 4-year-old receiving 40 hours of ABA: Who pays for this therapy, who actually provides the instruction (you or a hired therapist) and what state do live in?
Posted by: Mother of 14-year-old with ASD | November 30, 2009 4:05 PM
Hi we live in California and the regional centers fund the therapy here. I've had a team which consists of a behavior specialist along with 3 different therapists who rotate shifts so they are working one and one with him. Of course I am here and also work with them and implement the same things when they are not here.
Posted by: Another Parent | November 30, 2009 5:09 PM
Congratulations on your son's success ?
Have you looked into Floortime (Stanley Greenspan) as well ?
Posted by: caring therapist | November 30, 2009 7:26 PM
Nonsense, not everyone agress that early intervention with behavioral therapy is the answer. There are thousands of us that agree that bio-medical intervention is more of the answer than anything else for our children. In fact, I recovered one of my grandchildren from PDD/NOS with bio-med treatments. Continuing the dialogue of early intervention is a cop out for seeking the environmental causes of autism. You talk about being able to diagnose a baby at 13 months. Great, but what about the thousands of children that are developing normally and then regress into autism after 13 months of age?
This article is very narrow sighted in helping the autistic community.
Maurine Meleck
Posted by: Maurine Meleck | December 2, 2009 11:28 AM