Early Intervention Therapy Normalizes Children With Autism

The Centers for Disease Control and Prevention (CDC) states that 1 in 88 children born today will be diagnosed with autism spectrum disorder. This causes persistent deficits in social communication and relatedness, and repetitive or restrictive patterns of interest that appear in early childhood and impair everyday functioning.

However, holding a hope, a new nation-wide study claims that an intensive early intervention therapy is effective and improves cognition and language skills among very young children with autism. The therapy also normalizes their brain activity, decreases their autism symptoms and improves their social skills.

This is the first study to demonstrate that an early intervention program can normalize brain activity.

"We know that infant brains are quite malleable and previously demonstrated that this therapy capitalizes on the potential of learning that an infant brain has in order to limit autism's deleterious effects," said study author Sally Rogers, professor of psychiatry and behavioral sciences and a researcher with the UC Davis MIND Institute.

"The findings on improved behavioral outcomes and the ability to normalize brain activity associated with social activities signify that there is tremendous potential for the brains of children with autism to develop and grow more normally," Rogers said.

The study proposes that the children who received the intervention exhibited greater brain activation when viewing faces rather than objects. This kind of a response was typical of the normal children in the study, and the opposite of the children with autism who received other intervention.

Roger and Geraldine Dawson developed the intervention method known as Early Start Denver Model (ESDM). The therapy fuses a play-based, developmental, relationship-based approach and the teaching methods of applied behavioral analysis.

"This may be the first demonstration that a behavioral intervention for autism is associated with changes in brain function as well as positive changes in behavior," said Thomas R. Insel, director of the National Institute of Mental Health, which funded the study. "By studying changes in the neural response to faces, Dawson and her colleagues have identified a new target and a potential biomarker that can guide treatment development."

For this study the researchers had 48 diverse male and female children diagnosed with autism between 18 and 30 months in Sacramento, Califf and in Seattle. The ratio of male to female participants was more than 3 to 1. Plus Autism is five times more common among boys than girls.

Nearly half of the children with autism were randomly assigned to receive the ESDM intervention for over two years. The participants received ESDM therapy for 20 hours each week, and their parents also were trained to deliver the treatment. The other participants with autism received similar amounts of various community-based interventions as well as evaluations, referrals, resource manuals and other reading materials.

Apart from this the brain activities of the participants were assessed using electroencephalograms (EEGs). It measured brain activation while viewing social stimuli and non social stimuli.

Twice as many of the children who received the ESDM intervention showed greater brain activation when viewing faces rather than when viewing objects. Eleven of the 15 children who received the ESDM intervention, 73 percent, showed more brain activation when viewing faces than toys.

Similarly, 12 of the 17 typically developing children, or 71 percent, showed the same pattern. But the majority 64 percent of the recipients of the community intervention showed the opposite, "autistic" pattern, i.e., greater response to toys than faces. Only 5 percent showed the brain activation of typical children.

According Rogers, the children receiving ESDM and had greater brain activity while viewing faces also had fewer social-pragmatic problems. They had improved social communication, including the ability to initiate interactions, make eye contact and imitate others.

"This is the first case-controlled study of an intensive early intervention that demonstrates both improvement of social skills and normalized brain activity resulting from intensive early intervention therapy," said Dawson, the study's lead author and professor of psychiatry at the University of North Carolina, Chapel Hill.

"Given that the American Academy of Pediatrics recommends that all 18- and 24-month-old children be screened for autism, it is vital that we have effective therapies available for young children as soon as they are diagnosed."

"For the first time," Dawson continued, "parents and practitioners have evidence that early intervention can alter the course of brain and behavioral development in young children. It is crucial that all children with autism have access to early intervention which can promote the most positive long-term outcomes."

This was published online on October 26 in the Journal of the American Academy of Child  & Adolescent Psychiatry.