Study: Early autism intervention in toddlers is effective

http://www.cnn.com/2009/HEALTH/conditions/11/30/autism.study/index.html

By Miriam Falco, CNN
November 30, 2009 1:49 a.m. EST

(CNN) -- Researchers have shown for the first time that if a child is diagnosed with autism as early as 18 months of age, offering the toddler age-appropriate, effective therapy can lead to raised IQ levels and improved language skills and behavior.

"Early intervention can be very effective for toddlers with autism," says Geraldine Dawson, chief science officer of the advocacy group Autism Speaks, and one of the two lead authors of a study published Monday in the journal Pediatrics.

Since 2007, pediatricians have been told to screen 18-month-old children for autism. But what the next step is when such a young child is diagnosed has not been clear.

"It's crucial, if we're going to offer screening at such a young age, that we can offer an intervention, and now we know we have methods that are effective," says Dawson.

She adds, "This is the first controlled trial in children under the age of two-and-a-half."

While Dawson was at the University of Washington, she and co-study author Sally Rogers from the University of California-Davis M.I.N.D. Institute devised the trial involving 48 children with autism.

All the children in the trial were between 1 1/2 and 2 1/2 years old at the beginning of the study. Half of the children were given community-based interventions or therapies and the other half were enrolled in a 20-hour per week intervention program called "Early Start Denver Model" (ESDM), developed by Rogers.

The goal of this research was to determine how much the debilitating effects of autism can be prevented or reduced.

ESDM was designed to address the needs of toddlers with autism as young as 12 months old, and it is delivered by trained therapists and their parents in a very natural setting -- the child's own home -- with children sitting on the floor and playing, rather than having a more adult-directed therapy.

"It's a very pleasing kind of therapy, kids are happy. It is play, and it can happen everywhere," Rogers explains. Dawson adds that this type of intervention builds on a fun, positive relationship with the therapist. This is a contrast to traditional Applied Behavioral Analysis (ABA), which is delivered at a desk, with the child sitting next to the teacher or therapist, who breaks down complex tasks into small components and then gives tangible reinforcements.

At the end of two years, all of the children showed improvements. But children in the ESDM group had increased their IQ by nearly 18 points -- 10 points higher than the children getting the standard autism therapy offered in the community. Scores for listening and understanding as well as motor skills and self-care skills were all higher in the ESDM group.

"Many of the children had virtually caught up to the typical kids their age," says Dawson.

Rogers says parents can pick up the ESDM therapy methods quite easily.

"They can learn this within six hours of working with therapists," she says.

Then parents can use the skills in everyday settings, not just during specific therapy sessions.

The study's authors also noted that the children in the ESDM group required only 15 hours of weekly intervention with a therapist, compared with the usual 40 recommended hours. This can have a significant economic impact on families. In 2006, a Harvard study estimated the lifelong cost of care for person with autism is more than $3 million.

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