Autism Speaks issued the following news release about a study appearing
in the journal *Pediatrics*:

Early intervention for toddlers with autism highly effective, study finds
Significant gains seen in IQ, communication and social interaction

(Seattle, Nov. 30, 2009) – A novel early intervention program for very
young children with autism – some as young as 18 months – is effective
for improving IQ, language ability, and social interaction, a
comprehensive new study has found.

“This is the first controlled study of an intensive early intervention
that is appropriate for children with autism who are less than 2 years
of age. Given that the American Academy of Pediatrics recommends that
all 18- and 24-month-old children be screened for autism, it is crucial
that we can offer parents effective therapies for children in this age
range,” said Geraldine Dawson, Ph.D., chief science officer of Autism
Speaks and the study’s lead author. “By starting as soon as the toddler
is diagnosed, we hope to maximize the positive impact of the intervention.”

The study, published online today in the journal Pediatrics, examined an
intervention called the Early Start Denver Model, which combines applied
behavioral analysis (ABA) teaching methods with developmental
‘relationship-based’ approaches.

This approach was novel because it blended the rigor of ABA with play-
based routines that focused on building a relationship with the child.

While the youngest children in the study were 18 months old, the
intervention is designed to be appropriate for children with autism as
young as 12 months of age.

Although previous studies have found that early intervention can be
helpful for preschool-aged children, interventions for children who are
toddlers are just now being tested. Autism is a lifelong
neurodevelopmental disorder characterized by repetitive behaviors and
impairment in verbal communication and social interaction.

It is reported to affect one in 100 children in the United States.

“Infant brains are quite malleable so with this therapy we’re trying to
capitalize on the potential of learning that an infant brain has in
order to limit autism’s deleterious effects, to help children lead
better lives,” said Sally Rogers, a professor of psychiatry and
behavioral sciences, a study co-author and a researcher at the UC Davis
MIND Institute in Sacramento, Calif. Rogers and Dawson developed the

The five-year study took place at the University of Washington (UW) in
Seattle and was led by Dawson, then a professor of psychology and
director of the university’s Autism Center, in partnership with Rogers.
It involved therapy for 48 diverse, 18- to 30-month-old children with
autism and no other health problems. Milani Smith, who oversees the UW
Autism Center’s clinical programs, provided day-to-day oversight.

The children were separated into two groups, one that received 20 hours
a week of the intervention – two two-hour sessions five days a week –
from UW specialists. They also received five hours a week of parent-
delivered therapy. Children in the second group were referred to
community-based programs for therapy. Both groups’ progress was
monitored by UW researchers. At the beginning of the study there was no
substantial difference in functioning between the two groups.

At the conclusion of the study, the IQs of the children in the
intervention group had improved by an average of approximately 18
points, compared to a little more than four points in the comparison
group. The intervention group also had a nearly 18-point improvement in
receptive language (listening and understanding) compared to
approximately 10 points in the comparison group. Seven of the children
in the intervention group had enough improvement in overall skills to
warrant a change in diagnosis from autism to the milder condition known
as ‘pervasive developmental disorder not otherwise specified,’ or PDD-
NOS. Only one child in the community-based intervention group had an
improved diagnosis.

“We believe that the ESDM group made much more progress because it
involved carefully structured teaching and a relationship-based approach
to learning with many, many learning opportunities embedded in the
play,” Rogers said.

“Parental involvement and use of these strategies at home during routine
and daily activities are likely important ingredients of the success of
the outcomes and their child’s progress. The study strongly affirms the
positive outcomes of early intervention and the need for the earliest
possible start,” Dawson said.

In this study, the intervention was provided in a toddler’s natural
environment (their home) and delivered by trained therapists and parents
who received instruction and training as part of the model.

“Parents and therapists both carried out the intervention toward
individualized goals for each child, and worked collaboratively to
improve how the children were responding socially, playing with toys,
and communicating,” said Milani Smith, associate director of the UW
Autism Center and a study co-author. “Parents are taught strategies for
capturing their children’s attention and promoting communication. By
using these strategies throughout the day, the children were offered
many opportunities to learn to interact with others.”

Other study authors include Jeffrey Munson, Jamie Winter, Jessica
Greenson, and Jennifer Varley, all of UW Autism Center or the department
of psychiatry and behavioral sciences, and Amy Donaldson of the
department of speech and hearing science, Portland State University,
Portland, Ore.

The study was funded by a grant from the National Institute of Mental
Health (NIMH). NIMH has also funded a multi-site trial of the Early
Start Denver Model which is currently being conducted at the University
of Washington, the UC Davis MIND Institute and the University of Michigan.