Clinical research: Early therapy in autism yields big gains
Children with autism who receive intensive behavioral interventions of various types show the most improvement on tests of social and communicative abilities, according to a study in the January-March 2012 issue of Research in Autism Spectrum Disorders1.
Many studies have investigated factors that predict whether a child with autism will improve, plateau or decline in social and communicative skills over time. This research has shown, for example, that early language ability and intelligence quotients (IQs) correlate with social and communicative improvement2 and with a child's response to behavioral interventions3.
However, most of these reports were small, included only young children, and investigated treatments in a controlled laboratory setting.
In the new study, researchers analyzed various community-based approaches, including speech therapies, occupational therapies and behavioral interventions, in 1,433 children with autism spectrum disorders, aged 6 to 17 years. The participants are part of the Simons Simplex Collection, a study of families that have one child with autism and unaffected parents and siblings, sponsored by SFARI.org's parent organization.
Using the Autism Diagnostic Interview-Revised, the researchers asked parents of participants to rate their child's level of social and communicative function at two time points: at age 4 or 5 years, and at his or her age at the time of the interview. The study found that 95 percent of participants had improved their scores between these time points, although the extent of the gains varied widely.
Some 88 percent of participants had received at least one type of therapy since age 2: 83 percent had speech therapy, 75 percent occupational therapy and 32 percent behavioral therapy.
After controlling for age and initial symptom severity, the researchers reported that children who receive treatment show the largest gains in social and communication scores. For all three types of therapy, the size of response correlates with the initial non-verbal IQs and with how many hours of treatment the child received each year.
This study bolsters a large body of research suggesting that intensive autism intervention should begin as early as possible, the researchers say.
1: Mazurek M.O. et al. Res. Autism Spectrum Dis. 6, 535-545 (2012) Abstract
2: Charman T. et al. J. Child Psychol. Psychiatry 46, 500-513 (2005) PubMed
3: Eldevik S. et al. J. Clin. Child Adolesc. Psychol. 38, 439-450 (2009) PubMed