A report in the current issue of Pediatrics helps fill in the gap, providing the first randomized, controlled trial — the most rigorous kind of study — of a comprehensive autism treatment that appears to work well for children as young as 18 months. While none of the children in the study were "cured" of autism, those receiving two years of intensive therapy achieved major leaps in IQ score, big improvements in their use of language and significant gains in their ability to handle the kinds of everyday tasks necessary for a child to function at school and at play.
The study, conducted at the University of Washington and funded by the National Institute of Mental Health, involved 48 children ages 18 to 30 months. Half were randomly assigned to receive an intensive intervention called the Early Start Denver Model, which involved 15 hours a week of one-on-one work with trained therapists and another 16 hours a week with parents, who were taught how to continue the treatment during everyday activities such as eating, bathing and getting dressed.
Specifically, the Denver Model uses key elements of Applied Behavior Analysis (ABA), a rigorous system for shaping behavior by parsing desired behaviors into small, measurable — and teachable — units and using rewards to reinforce them. It also incorporates a more naturalistic, relationship-based approach that draws heavily on decades of research on normal child development. "We follow the sequence of normal development in everything we teach," explains psychologist Sally Rogers of the MIND Institute at the University of California, Davis, who developed the Denver Model while at the University of Colorado.
"Whether the Early Start Denver Model will prove to be more effective than other therapies remains to be seen. Leading autism researcher Tristram Smith, an ABA expert at the University of Rochester, who lauds the new study for its methodological rigor, notes that the gains made by children in the intervention group were similar to those reported in studies of ABA models. 'I do think there is a need for head-to-head studies,' says Smith. Also needed is high-quality research on how to match individual children with the therapy that suits them best."
@Time.com
