Doctors have demonstrated for the first-time that an infant therapy can reduce autistic behavior and increase the chance of children being diagnosed with autism.
Researchers found that infants who received therapy when they showed early signs of autism (e.g., not responding to their names or avoiding eye contact) were three times more likely to be diagnosed with autism at age three than those who received standard care.
These findings indicate that intervention in the first year, when autism is suspected but not certain, can increase social development in autistic children. This will have long-term positive knock-on effects on their lives.
Prof Jonathan Green, University of Manchester, stated that this is the first evidence in the world that pre-emptive interventions can reduce autism behavior and increase the chance of a later diagnosis.
This is a significant finding, as it shows that intervention can be made at an early stage to have a substantial impact. This could change how services are provided support for large numbers of children around the world.
An international research team led by Prof Andrew Whitehouse from the University of Western Australia, Perth assessed 104 infants ages nine to fourteen months. They were brought to the attention of community health services because they had shown early signs of autism. One half received routine care while the other was given 10 sessions of therapy for five months. All were reassessed at 18-24 and 36 months for autism behavior.
Parents were videoed with their children during therapy sessions. The footage was then shared with the parent by a therapist who helped them to understand how their child communicated and suggested ways they could engage better. The goal was to strengthen the relationship between the parent and the child and to improve their communication skills.
The researchers wrote in Jama Pediatrics about how therapy seemed to reduce autism symptoms. This effect lasted until the age of three. Each child was evaluated by independent specialists. Only 6.7% of children who received therapy received an autism diagnosis. One-fifth of those who received standard care were diagnosed with autism.
The study found that the children scored higher on social interaction and other symptoms such as repetitive movements and abnormal reactions to sensory senses like smell and taste. To determine if therapy delays or prevents diagnosis in some children, further follow-up is necessary.
Researchers stress that therapy is not an effective treatment for autism. The study found that many of the children had severe developmental issues when they were three years old. The findings indicate that some infants may benefit from a tailored therapy to help them develop social skills before reaching school age.
Whitehouse said that the clinical impact that could be immediately apparent is truly amazing. No therapy has yet shown such positive effects on child development that it has had an impact on diagnostic outcomes for children.
The therapy could change the way we support children who are developing differently. This therapy is fundamentally a shift from waiting and seeing to identify and implement a new clinical model of care that could transform the support for families.
The study raises serious concerns about the provision of autism services. Children who do well with therapy may still require specialist care, but they no longer qualify for services if they have not been officially diagnosed. Green stated that the findings highlighted the weaknesses in the system and suggested that services should be tailored to meet the needs of the patient, not the diagnosis.
Tim Nicholls is the National Autistic Society's head of policy. He said that the work had positive aspects, but criticized the researchers for not engaging the community.
He said that it is important to note that any future research into early intervention doesn't seek to reduce severity. Early intervention should focus on supporting autistic individuals with the most difficult challenges. Autistic people need to be involved at all stages of research in order for this area to be effective in the future.
