Early intervention for toddlers with autism spectrum disorder helps improve their intellectual ability and reduces autism symptoms years after originally getting treatment, according to a new US study.
The study is the first in more than 20 years to look at long-term outcomes after early intensive autism intervention. The therapy began when children were 18 to 30 months of age and involved therapists and parents working with the toddlers in their homes 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 the study’s 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 therapy, known as the Early Start Denver Model (ESDM), was designed to promote social and communication skills and learning. The research team found 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.
This type of intervention has been shown to help children with autism, but it hadn’t been shown to work with very young children over a longer timescale until now. Estes believes that 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. “This is really important,” she says. “This is the kind of evidence that is needed to support effective intervention policies for children with autism…”
The researchers studied two groups of young children with autism; the first received community intervention, which was a mix of what was available in the community such as speech therapy and developmental pre-school. 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. This 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.
Cognitive improvements
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 those in 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 the study’s co-author Sally J. Rogers, a University of California Davis Professor of Psychiatry and co-creator of the ESDM intervention.
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.
As well as being important for the wellbeing of those with autism, Estes believe this kind of treatment also makes sense economically. “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”, she said.
The research was funded in the USA by the National Institutes of Health, the National Institute of Mental Health, the Autism Center of Excellence and the Autism Speaks foundation. Other co-authors of the project are Jeffrey Munson and Jessica Greenson with the UW Autism Center, Jamie Winter at Weill-Cornell Medical College and Geraldine Dawson at Duke University.
The study will appear in the July issue of the Journal of the American Academy of Child and Adolescent Psychiatry and is available now online.
