Lasting outcomes of early intervention for ASD

Yet another study has shown that early interventions may make a positive difference for the autistic child.

The study by Annette Estes and others was recently reported in the Journal of the American Academy of Child and Adolescent Psychiatry. This was a randomized clinical trial that looked at the effectiveness of the Early Start Denver Model (ESDM). The study recruited 39 children under the age of 30 months who had received a diagnosis of an Autistic Spectrum Disorder. Some of these children were allocated to an ESDM intervention for two years and some received community-intervention-as-usual (COM).

The ESDM approach to treatment emphasises early and intensive interventions, with strong parental involvement and which take place within positive, affect-based relationships.

At the end of the treatment no differences in core autism symptoms were found between the two groups, however the group receiving the ESDM intervention showed improvements in several areas, including overall intellectual ability, adaptive behaviour, symptom severity and challenging behaviour. Significantly, though, when tested two years later the ESDM group did show an improvement in core autism symptoms as compared to the COM group. Children from the ESDM group had also maintained many of the benefits that were evident at the end of the treatment.

The two groups had received equivalent hours of intervention during the original study and the clinicians undertaking the follow up did not know to which group each child had originally been allocated.

There are at least two significant take away messages from this study. The first is that early intensive interventions do produce significant benefits for children with ASD, in this case these benefits were in intellectual ability and improved behaviour. The second is that the ESDM treatment seemed to set the two groups of children on to different developmental paths, with children from the ESDM group showing a decrease in core autism symptoms two years after the treatment had ceased. This latter effect was especially significant in that children from the ESDM group tended to have a lower level of support during this later period.

This study provides yet more evidence for the effectiveness of early interventions for autism. For a recent overview of one type of early intervention – the Naturalistic Developmental Behavioral Intervention approach – please see our earlier post.

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