A small new pilot study has found that parents can help significantly reduce symptoms of autism in babies who haven't even reached their first birthdays simply by changing how they play and interact with them.
By age 3, nearly all of the infants who participated in a 12-week, parent-led treatment and subsequent follow-up had no evidence of an autism spectrum disorder, nor did they appear to have developmental delays of any kind.
"The goal was to see whether it was feasible to locate children who had autism symptoms younger than 12 months, and then provide intervention through their parents," Sally Rogers, a professor of psychiatry and behavioral sciences with the University of California-Davis MIND Institute and an author on the study, told The Huffington Post. "If it was possible, we wanted to see whether the intervention demonstrated benefits for those children."
Seven babies were included in the treatment group, each between 7 and 15 months of age, and all of whom had demonstrated early signs of autism, such as low interest in interactions and abnormal repetitive behaviors. The study also included four comparison groups: Those who were at a higher risk for having an autism spectrum disorder because they had an affected sibling but who did not have autism themselves; those at low risk; those who had developed autism by age 3; and those with early symptoms who received treatment at a later age.
Babies in the treatment group had significantly more autism symptoms at 9 months than those in comparison groups, which was not surprising, Rogers said. Increased developmental delays as babies get older often predict the onset of autism over time, suggesting those babies were truly at risk for developing the disorder, though they were too young for a definitive diagnosis.
But by 18 to 36 months, those same children had substantially lower autism severity scores than those who did not undergo the treatment.
"All of the babies, except one who continued to show high levels of delays throughout, started to show a reversal in those increasing delays ... and six of the seven caught up by the time they were 2 to 3," said Rogers. "Of those six, five did not have a diagnosis of anything related to autism, and one had a mild diagnosis at age 3." The study was published online Tuesday in The Journal of Autism and Developmental Disorders.
The treatment, based on the so-called "Early Denver Start Model," focused on increasing the babies' attention to their parents faces and voices, and worked with parents on how to use toys to engage their children socially, and to optimize engagement in various ways.
"Study after study has demonstrated that parents of children with ASD have excellent parenting skills," said Rogers. "However, their babies may not respond in a way that tells them they're on the right track. For a parent getting feedback from a baby that says, 'I'm not interested,' the parent may change what he or she is doing." At its core, the intervention provides parents with additional strategies to engage their babies, and reassures them they're on the right track and may simply need to persist longer than typically feels right, learning to read their child's subtle cues.
While the new research is a pilot study and as such is highly preliminary, Gerard Costa, director of the Center for Autism and Early Childhood Mental Health at Montclair State University, called the outcomes for this small group of children and their parents "wonderful" and "very encouraging."
"The findings are clearly saying what we've always felt to be the case, which is that early intervention can make an enormous difference," he said. "The infant brain is growing at a rate that is unparalleled in the rest of our lives, from the last trimester of pregnancy through the first two years of life." The study adds to a body of evidence that the most critical interventions must focus on human relationships and engagement, Costa added.
The American Academy of Pediatrics recommends that all children be screened for autism and developmental delays during routine visits starting at 9 months. By age 2, the Centers for Disease Control and Prevention says, a diagnosis by an experienced, trusted professional can be considered very reliable.
Both Costa and Rogers said a key message to emerge from the new study is that parents should trust their instincts. If they suspect their child might have delays based on certain signs, they should bring them in to be screened.
"If you're not seeing good rigorous eye contact by 3 months; if you're not seeing back-and-forth play, reciprocity, making faces by 6 or 7 months; if you're not having vocalizing by 10 or 11 months; if you're not seeing imitation as early as 6 or 7 months, then I really think [screening] is worth their while," Costa said.
On the other hand, many children who develop autism do not demonstrate symptoms so early, and parents should remember that a typical onset is between a child's first and second birthday, Rogers said. She emphasized that the message of the new study is not that parents who do not get treatment for their babies in their first year of life have somehow missed the boat. Instead, the researchers aim to help develop tools for professionals and parents of those infants who do clearly display the earliest signs.
"I am not trying to change the strengths that people with ASD bring to this world. ... My goal is for children and adults with autism to be able to participate in everyday life and in all aspects of the community in which they want to participate," Rogers said in a statement.