We all know that early behavioral interventions for autism help improve a child’s developmental skills. Yet, we’ve always focused on this concept once a child is diagnosed with autism. This typically doesn’t happen until age two or three years, and behavioral therapy doesn’t start until that point. We’ve always thought that getting a child with autism started on ABA and other behavioral therapies by age two or three was considered “early intervention.”
A new study from the University of California at Davis MIND Institute takes the early intervention concept to a whole new level. The Institute has created an Early Start program which is focused on beginning behavioral therapy during infancy, instead of waiting until the preschool years. The program trains parents how to be more therapeutically-interactive with their infants with relationship-and-emotion-building activities such as being more responsive to baby’s verbal cues, engaging more frequently in eye-to-eye contact, being more animated with facial expressions, and interacting with developmental toys.
The MIND Institute published this small study, which demonstrated efficacy in six out of seven infants who demonstrated early signs of autism, as an introduction to the possible benefits of this concept, but the authors caution that this small study doesn’t adequately prove their concept just yet. The abstract quotes: “It appears feasible to identify and enroll symptomatic infants in parent-implemented intervention before 12 months, and the pilot study outcomes are promising, but testing the treatment’s efficacy awaits a randomized trial.”
The study does NOT claim to have prevented autism completely. It just lowered the risk of eventually being diagnosed and improved the severity of some of the symptoms. Also, the seven infants actually continued to show worsening of symptoms and developmental milestones during the first nine months of intervention before they finally turned around and began to improve.
This study raises so many interesting ideas and questions:
First, Early Start and other models of interactive parenting should be most useful for infants in families who already have a child with autism. Such infants are born with a higher risk of autism, and such families are hyper-vigilant, looking out for autism anyway. Starting this program from day one should be useful. Instead of waiting for these kids to show signs, we need to be more proactive in families with risk.
Second, it raises the question of what we should do with first children in a family with no known risk of autism. We should obviously begin intervention at the first sign of delay, but what about the idea of being proactive with this type of program with ALL babies? Would that be preventive? I don’t know. My observation has been that many children who develop autism DO have very interactive parents from day one, and they still develop autism. More research will be needed, as the authors of this study suggest.
Third, this study doesn’t factor in how this applies to infants who DON’T show early signs, but then regress into autism around 15 to 18 months. We can rarely identify these kids earlier, and we certainly should begin intervention at the first sign of regression. This takes us back to the second point – having ALL babies receive this type of early intervention. Is that feasible?
These ideas, I’m afraid, raise the question that if interactive early start programs can help reduce autism, does that make the opposite true? Does a lack of interactive parenting contribute to autism? I would answer this with a HUGE and RESOUNDING NO!!! I haven’t seen any evidence of this in my experience. But I wonder if the researchers are wondering just that. I don’t know. I hope and pray that no one tries to make such a claim.
Bottom line: Early Intervention may now mean infancy, not preschool–the earlier, the better. The study doesn’t prove it yet, but it’s a starting point. Larger studies will soon follow.
You can read the abstract of the study here:
You can read more about the MIND Institute’s program here:
The parent guide to this interactive program is available for $12 on Amazon (paperback).
Dr. Bob Sears
Pediatrician and TACA Medical Advisory Board Member
Pediatrician and author of The Autism Book: What Every Parent Need to Know About Early Detection, Treatment, Recovery, and Prevention and The Vaccine Book.