Autism early intervention outcomes study

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Autism Spectrum Disorders (ASDs) are defined in terms of social and communicative impairment co-occurring with repetitive behaviours and restricted interests. The most severely affected individuals fail to develop functional language and show little ability or desire for social interaction. The causes of Autism are not known, although the high concordance rate found in twin studies suggests a strong genetic component. Studies of head circumference and imaging studies of brain morphometry have found evidence of increased brain growth beginning within the first year of life, while functional brain imaging in older children and adults has shown abnormal patterns of interactions between brain regions, possibly related to aberrant connections being laid down during earlier stages of development. One model relating these early abnormalities in brain development to the characteristic socio-communicative impairments has hypothesised that early low-level deficits in recognition and orientation towards social stimuli leads to lack of social engagement with primary caregivers during infancy, resulting in decreased exposure to the reciprocal social interactions critical for healthy development of brain circuits responsible for normal social behaviour (Dawson 2008). This model implies that intervention should occur as early as possible to normalize the developmental trajectory and avoid downstream effects, and that a key component of intervention may be to compensate for early deficits in social attention by providing interventions with emphasis on social interaction. Early intervention may also be important in order to take advantage of the increased plasticity present in the first few years of life (Dawson 2008). One such early intervention program consistent with these aims is the Early Start Denver Model (ESDM), a comprehensive early behavioural intervention for infants to preschool-aged children with Autism that integrates applied behaviour analysis with developmental and relationship-based approaches (Rogers et al 2009). A recent randomised control trial in the United States demonstrated significant improvements in clinical outcomes for children receiving ESDM (Dawson et al 2010). After the first 12 months, 18- to 30-month-olds with Autism who received the program showed significant gains in visual processing and improvements in language abilities with subsequent gains in IQ and adaptive behaviour as well as being more likely to receive a less severe diagnosis upon re-assessment. This study seeks to replicate and extend upon the recent positive international findings regarding the benefits of the ESDM model to children with ASD in an Australian context. References: Dawson, G. (2008). Early behavioural intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20, 775-803. Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., Donaldson, A., & Varley, J. (2010). Randomized, Controlled Trial of an Intervention for Toddlers with Autism: The Early Start Denver Model. Pediatrics, 125(1), e17-e23. Rogers, S.J., Dawson, G., Smith, C.M., Winter, J.M. & Donaldson, A.L. (2009). Early Start Denver Model Intervention for Young Children with Autism Manual. Seattle: University of Washington.