How early intervention can support children with autism

Although autism is usually diagnosed when a child is two or older, some youngsters exhibit signs of this condition well before their official diagnosis.

Now, a new Australian study suggests that early therapy for autism, from the age of 12 months, can have a positive impact on an infant's developing brain and, in particular, on their language skills.

Here we look at some of the signs of autism, and see how this study offers hope for children exhibiting early autism behaviours.

What is autism?

Autism – or autism spectrum disorder (ASD) – is a neurodevelopmental condition that affects how people interact with others and understand the world around them.

It presents differently in every person, and can be mild, moderate, or severe. That said, people with autism often have:

• Difficulties with communication, e.g. being unable to maintain two-way conversations or read body language;
• Difficulties with social interaction, e.g. finding it hard to make friends
• Restricted/repetitive interests and behaviours, e.g. having intense interests and a strong need for routine/predictability

Autism Awareness says these difficulties are, 'Often accompanied by sensory issues, such as over-sensitivity or under-sensitivity to sounds, smells or touch' which can lead to behavioural challenges too.

The condition occurs in all races, ethnicities, and socioeconomic groups, however, boys are four times more likely to have autism than girls and while some people with autism have an intellectual disability, others are highly intelligent or of normal mental ability.

Autism is a life-long condition that can't be cured or 'out-grown', but the good news is that quality early intervention can help children develop the learning, communication and social skills that will enable them to lead productive and happy lives.

What are some early signs of autism in children?

Parents often notice signs of autism when their child is around two years old, however, autism behaviours can be noticed earlier or later in life.

Developmental gaps may become more obvious when a child starts preschool or big school, but when it comes to babies and toddlers, Autism Awareness recommends that you seek medical advice if your child is showing some of these 'common red flags for autism':

By the age of 12 months, your child:

• Doesn't pay attention to new faces, or is scared of them
• Doesn't smile or follow a moving object with their eyes
• Doesn't laugh or babble, has trouble bringing objects to their mouth
• Has no words
• Doesn't turn their head to locate sounds, doesn't seem to respond to loud noises
• Doesn't push down on their legs when their feet are put on a firm surface
• Doesn't show affection to a primary care-giver, doesn't like being cuddled
• Doesn't crawl or stand when supported
• Doesn't use gestures, like pointing or waving

By the age of 24 months, your child:

• Doesn't speak
• Doesn't copy actions
• Can't follow simple instructions
• Can't walk by the time they're 18-months-old or walks only on their toes
• Can't push a wheeled toy
• Doesn't seem to know what common household objects do, e.g. a telephone by 15 months

By the age of 36 months, your child:

• Has very limited speech, doesn't use short phrases
• Has little interest in other kids or in 'make-believe' play
• Has difficulties separating from you or another primary care-giver
• Finds it hard to manipulate small objects
• Falls over often, struggles with stairs

If you do have concerns about your child, then ASDetect is a free app that can analyse your young child's behaviours (between the age of 11 and 30 months) to predict a 'low' or 'high' likelihood of autism. Keep in mind, though, that it is only a screening tool, not a formal assessment.

In Australia, there are National Guidelines for the assessment and diagnosis of autism, so if your child exhibits signs of the condition, it's important that you see a doctor and request an assessment referral if necessary.

When can autism therapy begin?

The experts say they, 'Don't tend to diagnose autism until two years of age at the very earliest [when the] diagnosis is relatively stable,' and it's typical for behavioural and developmental therapy to begin after that time.

However, as mentioned above, while most children won't be formally diagnosed before they turn two, children as young as 12-months-old may show early signs of autism and can benefit from therapy at that time.

Specifically, the new Australian study indicates that early, pre-diagnostic therapy can bring about important improvements in infants’ language abilities and take advantage of the crucial brain development that's happening before they turn two or older.

What did the early therapy study involve?

For this study, autism experts recruited 103 infants aged between nine- and 14-months-old who were showing early behavioural signs of autism (e.g. not responding to their names, not smiling much and having poor eye contact).

Through random selection, half of the infants (the control group) were given standard community care for six months. This could have meant a few sessions with health professionals, a parent information session or no intervention at all.

The other half (the intervention group) were given 'low intensity' therapy for six months, which involved one hour per fortnight with a therapist. Parents got help understanding their child's 'communication cues' and learning how to promote back-and-forth interactions.

After six months, the researchers assessed all the infants' development and found that although the early therapy hadn't greatly reduced the intervention group's early autism behaviours, it had improved their language skills.

In the intervention group, parents 'rated their infants as having better communication skills than those in the control group.' And in number terms, the toddlers who received early therapy understood an average of 37 more words and spoke an average of 15 more words than those with little or no intervention – which is particularly impressive, given that most of the infants weren’t saying any words at the beginning of the six month therapy period.

The researchers admit that some parents could have been positively biased when rating their child's improvement, and that a long-term test is needed to see if the language improvements remain once the children turn three.

However, this study does provide hope that early therapy can help children reach their full potential and possibly reduce long-term disability. With autism currently affecting about 1 in 70 Australians, this kind of research is important and we look forward to the researchers' future findings.

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References

The Conversation
Autism Awareness
Autism NZ
Autism Association of WA
Autism Spectrum