Early Intervention for Young Children with Autism
Which interventions work best?
Now that an estimated one out of 68 children in the United States has been diagnosed with an autism spectrum disorder (ASD) (Baio, 2014), it is essential that researchers and speech language pathologists pay close attention to the needs of these children and their families. The recent emphasis on identifying young children with ASD early in their lives has meant that more and more children are being diagnosed before the age of four (Baio, 2014). Although we now know that beginning speech and language therapy as early as possible leads to better outcomes for children with ASD, there hasn’t been much research focusing on very young children with autism until recently. A recently published article in Pediatrics reviewed many different types of interventions that may help children under the age of three improve their social communication. The authors came up with the following list of statements that summarize what the best interventions have in common:
Intervention services for young children with autism (suspected or confirmed) should include a combination of developmental and behavioral approaches and begin as early as possible.
This means that interventions should focus on teaching and changing behavior in an appropriate way, based on where children are in their development. In the past, most research focused on what interventions could best help preschool or school-aged children with autism (Zwaigenbaum et al., 2015). When working with very young children, clinicians like psychologists, speech pathologists, or early interventionists would change these strategies a little bit based on what they knew about how toddlers learn. However, what works for preschool-aged children may not work as well as for toddlers. This means researchers should tailor interventions to young children from the beginning and test how well these new, toddler-specific interventions work. That way, we know exactly what helps children learn to communicate their thoughts and feelings.
Intervention services should begin as early as possible. We know that around the age of two, children go through a stage of development in which their brains develop very quickly. Some research suggests that we can prevent or lessen autism-related impairments (such as not using language to communicate wants and needs or not interacting with family members) by taking advantage of this period of brain growth (Zwaigenbaum et al., 2015). In other words, parents and clinicians may be able to change the way their child’s brain is wired within this critical period by using strategies that help their children learn language, social, and play skills.
Families should be actively involved in the intervention process.
For young children especially, it is important that parents are involved in every step of the learning process. Often, this means that the early interventionist, speech pathologist, or therapist teach parents strategies that they can use even when the therapist isn’t there. That way, parents can take advantage of the “teachable moments” that naturally happen over the course of the day. Children are more likely to learn in these moments, rather than in an environment where what is being taught is not related to what the child is doing.
Interventions should improve a child’s abilities in all aspects of development.
Children with autism have difficulty using language to communicate their wants and needs, interacting socially, and sometimes have intense interests that take away from other activities. However, it is also common for children with autism to have difficulties in areas other than language and social skills. These difficulties may include sleeping or behavioral problems, difficulty eating or swallowing, seeking out or avoiding certain sensations, or self-harming behaviors. All of these issues can affect how a child feels throughout the day and how well a child is able to concentrate and learn. Often, addressing these other behaviors will not only improve how well language or social communication therapy works for the child, but also improve the quality of life for the child and his or her family.
Interventionists should take into account the beliefs and culture of the family.
All families are different. Good therapy practices take into account families’ abilities and strengths when choosing intervention strategies to use with their child at home. Different cultural values can affect the goals and priorities of families, and if therapists aren’t careful, these beliefs can sometimes lead to misunderstandings between parents and therapists. Therapists should try to understand the unique goals and beliefs of each family and tailor a child’s therapy based on these characteristics. The ultimate goal of all therapists and professionals is to help children and their families – and the best thing we can do is to make sure families are comfortable and confident in their ability to help their child.
For parents of children with autism, take the time to talk to your therapist about what goals are important for you and for your family. Working as a team, you and your therapist can help your child develop the skills that will allow your child to participate fully in your unique culture and family.
This article contains great suggestions for creating well-rounded, effective interventions for young children with autism. Keeping these best practices in mind will help both clinicians and researchers, understand what kinds of therapy best help families and young children.
Baio, J. (2014). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2010. Surveillance Summaries, 63(2), 1-21. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm?s_cid=ss6302a1_w
Zwaigenbaum, L., Bauman, M.L., Choueiri, R., Kasari, A., Granpeesheh, D., Mailloux, Z., … Natowicz, M.R. (2015). Early intervention for children with autism spectrum disorder under 3 years of age: recommendations for practice and research. Pediatrics, 136, S60-81. doi:10.1542/peds.2014-3667E.