The importance of early diagnosis for autism spectrum disorder has been highlighted by a recent study demonstrating the value of an educational program for toddlers with ASD.
The study involved 48 toddlers (18-30 months) diagnosed with autism and age-matched normally developing controls. Those with ASD were randomly assigned to participate in a two-year program called the Early Start Denver Model, or a standard community program.
The ESDM program involved two-hour sessions by trained therapists twice a day, five days every week. Parent training also enabled ESDM strategies to be used during daily activities. The program emphasizes interpersonal exchange, social attention, and shared engagement. It also includes training in face recognition, using individualized booklets of color photos of the faces of four familiar people.
The community program involved evaluation and advice, annual follow-up sessions, programs at Birth-to-Three centers and individual speech-language therapy, occupational therapy, and/or applied behavior analysis treatments.
All of those in the ESDM program were still participating at the end of the two years, compared to 88% of the community program participants.
At the end of the program, children were assessed on various cognitive and behavioral measures, as well as brain activity.
Compared with children who participated in the community program, children who received ESDM showed significant improvements in IQ, language, adaptive behavior, and autism diagnosis. Average verbal IQ for the ESDM group was 95 compared to an average 75 for the community group, and 93 vs 80 for nonverbal IQ. These are dramatically large differences, although it must be noted that individual variability was high.
Moreover, for the ESDM group, brain activity in response to faces was similar to that of normally-developing children, while the community group showed the pattern typical of autism (greater activity in response to objects compared to faces). This was associated with improvements in social behavior.
Again, there were significant individual differences. Specifically, 73% of the ESDM group, 53% of the control group, and 29% of the community group, showed a pattern of faster response to faces. (Bear in mind, re the control group, that these children are all still quite young.) It should also be borne in mind that it was difficult to get usable EEG data from many of the children with ASD — these results come from only 60% of the children with ASD.
Nevertheless, the findings are encouraging for parents looking to help their children.
It should also be noted that, although obviously earlier is better, the findings don’t rule out benefits for older children or even adults. Relatively brief targeted training in face recognition has been shown to affect brain activity patterns in adults with ASD.