.

  • Written by Andrew Whitehouse, Bennett Chair of Autism, Telethon Kids Institute, Univeristy of Western Australia, University of Western Australia
The theory is that if therapies are started early enough, it might be possible to alter the trajectory of autism. Shutterstock

Therapies given to infants before they receive a diagnosis of autism may lead to important improvements in their language abilities, according to our new research published today in the journal Lancet Child and Adolescent Health.

Children with autism typically begin therapy after receiving a diagnosis, which usually doesn’t occur until at least two years of age.

However, our new study suggests that starting therapy with 12-month-old infants who show early behavioural signs of autism may provide additional benefit.

Parents of toddlers who received six months of early therapy reported that their child understood an average of 37 more words, and spoke an average of 15 more words, than those who didn’t receive the therapy.


Read more: What causes autism? What we know, don’t know and suspect


How is autism diagnosed?

Autism is diagnosed on the basis of behavioural differences. These include difficulties in social communication and interaction, and the presence of restricted and repetitive behaviours or interests.

A diagnosis based on behaviour is an inherently subjective task. The dividing line between “typical” and “atypical” is often blurry and can lead to considerable debate.

These challenges led to the development in 2018 of new Australian guidelines for autism assessment and diagnosis, with the hope of addressing inconsistencies in autism diagnosis across Australia.


Read more: New autism guidelines aim to improve diagnostics and access to services


We don’t tend to diagnose autism until two years of age at the very earliest. Two is the earliest age at which a diagnosis is relatively stable. In other words, when a child receives a diagnosis of autism at age two, they’re also very likely to have that diagnosis if they’re reassessed in later childhood. This is not necessarily the case for children younger than two.

In most health systems around the world, including in Australia, therapy for children with autism typically begins after receiving a diagnosis. This is often a straight economic decision for a finite disability funding pool: the limited funding for therapies goes to children who need it most. And we can guarantee that children with a diagnosis of autism need these therapies.

But this model doesn’t allow therapies to take advantage of the first two years of life. These are crucial years for brain development, and early therapies may be more effective in reducing child disability.

The theory is that if therapies are started early enough, particularly when the brain is so young, it might be possible to alter the trajectory of autism, or even prevent the development of the condition in some infants.

The early years are crucial for brain development. Santypan/Shutterstock

Our study

Our study is one of the first rigorous tests of this theory.

We recruited 103 infants from Perth and Melbourne, aged between 9 and 14 months, who were showing early behavioural signs of autism, such as not responding to their names, poor eye contact, and few social smiles.

Half the children were randomly assigned to receive an intervention that helps parents understand their infant’s communication cues, and helps them respond in a way that promotes back-and-forth interactions.

By creating a socially rich environment around the infant that is tailored to their specific needs, we may help support the development of the neural pathways involved in language and social development.

The therapy is considered “low intensity” in the number of contact hours with a therapist (one hour per fortnight). This contrasts with “high intensity” therapies for older children with a diagnosis of autism, which often require at least ten contact hours per week.

The therapy promoted back-and-forth interactions between the infants and their parents. Pavla/Shutterstock

The other half of the group was randomly assigned to receive standard community care. This is often restricted to a parent information session, a few sessions with allied health professionals, or no intervention at all. This group served as the control group.

We then assessed the infants’ development either side of a six-month therapy period.

What did we find?

The intervention group did not show a significant reduction in early autism behaviours compared with the control group. This finding is consistent with a previous study that found it’s not easy to change the symptoms of autism.

However, after treatment, parents in the treatment group rated their infants as having better communication skills than those in the control group.

In the six-month therapy period, the treatment group improved in understanding an average of 37 more words and saying an average of 15 more words compared with the control group. Most children were not saying any words at the start of the therapy period, and so these language gains reported by parents are an important improvement.

This finding has an important caveat: parents could not be “blinded” to the therapy. It’s therefore possible the finding reflects “rater bias”, whereby parents whose children received the intervention hoped there was a developmental improvement, and rated their infants accordingly.

What does this mean for the NDIS?

This study is an important milestone in our understanding of how (and whether) to provide therapy to young infants who show early signs of autism.

Our findings suggest that these therapies do not reduce the core autism symptoms, but may improve language skills. These gains may be especially important for reducing long-term disability and helping each child reach their full potential.

It’s unclear whether the difference will remain when the children are older. Shutterstock

The long-term test will be whether these improvements are still evident when the infants are older.

Few studies have found long-term developmental changes as a result of infant therapies, and we are currently in the process of reassessing the children in our study when they turn three.

If we find that pre-diagnostic therapy leads to longer-term developmental changes, this has important implications for health and disability services.


Read more: Young children with autism can thrive in mainstream childcare


People on the autism spectrum currently represent 29% of all participants enrolling in Australia’s National Disability Insurance Scheme (NDIS).

A key plank of the NDIS is the Early Childhood Early Intervention pathway, which provides resources to support intervention for children up to seven years of age.

The pathway is very well conceived, but there are currently long wait lists.

The federal government recently announced a plan to resolve these delays, which indicates a recognition of the importance of early intervention for children with a confirmed diagnosis in reducing long-term disability in these children.

The follow-up of the children in the current study to three years of age will provide a litmus test as to whether very early intervention for infants should be an even higher priority.

Andrew Whitehouse receives funding from the National Health and Medical Research Council, the Australian Research Council, Autism CRC, and the Angela Wright Bennett Foundation.

Kristelle Hudry receives funding from the Autism CRC, Department of Social Services, and La Trobe University Research Focus Areas (Understanding Disease and Building Healthy Communities).

Kandice Varcin does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Authors: Andrew Whitehouse, Bennett Chair of Autism, Telethon Kids Institute, Univeristy of Western Australia, University of Western Australia

Read more http://theconversation.com/treating-suspected-autism-at-12-months-of-age-improves-childrens-language-skills-120331

Become Independent and Install a Solar Power System in your Property

We are certainly living in a very exciting time, and when you consider the technological advances we have witnessed in the last 50 years, it really is amazing. In the 1960s, the Internet emerged and...

News Company - avatar News Company

The Amazon is on fire – here are 5 things you need to know

Huge fires are raging across multiple regions of the Amazon Basin. Guaira Maia/ISARecord fires are raging in Brazil’s Amazon rainforest, with more than 2,500 fires currently burning. They are ...

Danilo Ignacio de Urzedo, PhD candidate, University of Sydney - avatar Danilo Ignacio de Urzedo, PhD candidate, University of Sydney

It's not just athletes who get Achilles tendon pain, but exercising is the answer

Basketball fans around the world were recently sickened by the footage of NBA star Kevin Durant’s Achilles tendon rupturing during a game. But while many think it’s only elite athletes...

Sean Docking, Post-doctoral researcher, La Trobe University - avatar Sean Docking, Post-doctoral researcher, La Trobe University

Australia's energy woes will not be solved by reinforcing a monopoly

Australia's energy market has a logjam, Sean Davis/Flickr, CC BY-NC-SAThe possibility of blackouts affecting half of Victoria has attracted plenty of attention to a document once read only by industry...

Bruce Mountain, Director, Victoria Energy Policy Centre, Victoria University - avatar Bruce Mountain, Director, Victoria Energy Policy Centre, Victoria University

Tim Fischer had his blind spots, but he was an unsung champion of an Asian-facing Australia

Amid the tributes to former deputy prime minister Tim Fischer and the stories of his authenticity, courage and quirky interests – like trains and military history – what has struck me most...

Tim Harcourt, J.W. Nevile Fellow in Economics and host of The Airport Economist, UNSW - avatar Tim Harcourt, J.W. Nevile Fellow in Economics and host of The Airport Economist, UNSW

VIDEO: Michelle Grattan on Tim Fischer's legacy - and Scott Morrison's first year

Michelle Grattan talks about the sad news of the passing of former Deputy Prime Minister Tim Fischer with University of Canberra Vice-Chancellor Professor Deep Saini. They also discuss Scott Morrison&...

Michelle Grattan, Professorial Fellow, University of Canberra - avatar Michelle Grattan, Professorial Fellow, University of Canberra

Catastrophic Queensland floods killed 600,000 cattle and devastated native species

In February, about 600,000 cattle were killed by catastrophic flooding across north Queensland’s Carpentaria Gulf plains. The flood waters rose suddenly, forming a wall of water up to 70km wi...

Gabriel Crowley, Adjunct Principal Research Fellow, James Cook University - avatar Gabriel Crowley, Adjunct Principal Research Fellow, James Cook University

Four home traps that contribute to the gender pay gap

KPMG says Australia's gender pay gap declined from $3.05 an hour in 2014 to $2.43 in 2017. www.shutterstock.comAustralia’s gender pay gap is diminishing, says a new report, but some contributors...

Emma Willamson, Adjunct Senior Research Fellow, Monash University - avatar Emma Willamson, Adjunct Senior Research Fellow, Monash University

Australia wants to install military technology in Antarctica – here's why that's allowed

Technology, such as satellite systems, can be used for both military and scientific purposes. ShutterstockThis week, the ABC revealed that the Australian Defence Force wants to roll out military tech...

Tony Press, Adjunct Professor, Institute for Marine and Antarctic Studies, University of Tasmania - avatar Tony Press, Adjunct Professor, Institute for Marine and Antarctic Studies, University of Tasmania

Why some feminists oppose allowing people to choose their sex on birth certificates

Legislation in Victoria would allow people to change the sex on their birth certificates with just a declaration, not sex reassignment surgery. ShutterstockA bill currently before the Victorian parlia...

Holly Lawford-Smith, Senior Lecturer in Political Philosophy, University of Melbourne - avatar Holly Lawford-Smith, Senior Lecturer in Political Philosophy, University of Melbourne

Plants are going extinct up to 350 times faster than the historical norm

Plant extinctions have skyrocketed, driven in large part by land clearing and climate change. Graphic Node/Unsplash, CC BY-SAEarth is seeing an unprecedented loss of species, which some ecologists are...

Jaco Le Roux, Associate Professor, Macquarie University - avatar Jaco Le Roux, Associate Professor, Macquarie University

Vital Signs: economically, Australia is at risk of becoming Germany, and not in a good way

Once, emulating Germany would be something to be proud of. Not at the moment. ShutterstockIt’s four years since then Prime Minister Tony Abbott warned Australia had been heading to “a Gree...

Richard Holden, Professor of Economics, UNSW - avatar Richard Holden, Professor of Economics, UNSW

'What is wrong with me? I'm never happy and I hate school'

Remember, there is always someone to talk to about these things. Wes Mountain Hi, I was just wondering if something’s wrong with me because I’m never happy and never want to do anything a...

Louise Remond, Clinical Psychologist, University of Technology Sydney - avatar Louise Remond, Clinical Psychologist, University of Technology Sydney

Friday essay: how a Bengali book in Broken Hill sheds new light on Australian history

The large book bearing a handwritten English label, 'The Holy Koran', was not a Quran, but a 500-page volume of Bengali Sufi poetry. Samia KhatunSome 1,000 kilometres inland from Sydney, over the Blu...

Samia Khatun, Senior Lecturer, SOAS, University of London - avatar Samia Khatun, Senior Lecturer, SOAS, University of London

Unlawful strip searches are on the rise in NSW and police aren’t being held accountable

Being strip searched by the police can be intrusive, humiliating and harmful. Typically, strip searches involve being required to strip naked in front of police officers, who often give the direction ...

Vicki Sentas, Senior Lecturer, UNSW Law, UNSW - avatar Vicki Sentas, Senior Lecturer, UNSW Law, UNSW

How to make good arguments at school (and everywhere else)

There are more important things than winning an argument – like making everyone feel valued. www.shutterstock.comFrom as early as Grade 3 teachers start teaching children how to put across thei...

Luke Zaphir, Researcher for the University of Queensland Critical Thinking Project; and Online Teacher at Education Queensland's IMPACT Centre, The University of Queensland - avatar Luke Zaphir, Researcher for the University of Queensland Critical Thinking Project; and Online Teacher at Education Queensland's IMPACT Centre, The University of Queensland

GM crops: to ban or not to ban? That's not the question

The South Australian government recently announced its intention to lift the long-standing statewide moratorium on genetically modified (GM) crops, following a statutory six-week consultation period. ...

Rachel A. Ankeny, Professor of History and Philosophy, and Deputy Dean Research (Faculty of Arts), University of Adelaide - avatar Rachel A. Ankeny, Professor of History and Philosophy, and Deputy Dean Research (Faculty of Arts), University of Adelaide

Grattan on Friday: Courting 'quiet Australians' from 'bubble central', it's been a remarkable first year for Scott Morrison

Can Scott Morrison maintain the image of separation from the Canberra elite, given he's its most powerful member? AAP/The ConversationEven Scott Morrison, with his abundant self-belief, couldn’t...

Michelle Grattan, Professorial Fellow, University of Canberra - avatar Michelle Grattan, Professorial Fellow, University of Canberra

Trust Me, I’m An Expert: Why the Hong Kong protesters feel they have nothing to lose

Last weekend, hundreds of thousands of people again took to the streets in Hong Kong to protest against the government – the 11th straight weekend of demonstrations that began in June over a pro...

Sunanda Creagh, Head of Digital Storytelling - avatar Sunanda Creagh, Head of Digital Storytelling

Sick and Tired of Your Dead End Job? Try Teaching!

Tired of the same old grind at the office? Want an opportunity to impact lives both in your community and around the world? Do you love to travel and have new experiences? Teaching English is the perfect job for you! All you need is a willingness to ...

News Company - avatar News Company

The Impact of an Aging Population in Australia

There’s an issue on the horizon that Australia needs to prepare for. The portion of elderly citizens that make up the country’s overall population is increasing, and we might not have the infrastructure in place to support this. Australians h...

News Company - avatar News Company

LifeStyle

A Guide for Tenants

The cost of purchasing a home has been increasing, and the size of deposits needed, make buying pr...

Top ways for men to look after their skin

According to Jack Simmons, from Aboutmen, more and more men are taking pride in their appearance a...

Top 10 Caravan Storage Tips & Tricks

Taking caravan trips is a popular Aussie pastime, but if you have spent more than a few days in ...

5 Meaningful Gifts Your Mother Would Simply Love

Wouldn’t it be wonderful to amaze the person who loves you the most with a thoughtful gift? Why ...