Investigating potential causes and risk factors of ASD is one important element in ASD research; studying and testing effective treatments is another. Today, scientists and researchers are devoting more resources than ever to exploring the different ways that ASD progresses in people with the condition, and identifying treatments and therapies that have the greatest potential to encourage positive development.
One research area currently of particular interest to scientists and medical professionals is the timing of intervention and treatment commencement in children with ASD. Up until about 10 years ago, research into ASD treatments tended to focus on pre-school age children, typically four years or older. However, thanks to a landmark study published in 2009, present thinking when it comes to intervention is the earlier, the better.
Led by Dr. Geraldine Dawson and conducted over five years at the University of Washington in Seattle, the study examined the effects of the Early Start Denver Model (ESDM), a type of intervention combining play-based routines with applied behavioral analysis techniques, on a group of 48 children with ASD between the ages of 18 and 30 months. For a two-year trial period, half the children received the ESDM intervention for 20 hours per week; the other half participated in community-based therapy programs. At the end of the study, the ESDM group showed marked improvement in IQ levels and receptive language skills over the community therapy group.
Even to non-experts, the results of the study seem logical, even intuitive. The brains of infants and very young children are far more malleable than those of older children, so it makes sense that they have a greater chance of adapting and responding to therapy techniques even when an additional factor like ASD is in play.
The Dawson ESDM study was the first to focus on very young children, and it has since been followed by several others that have further strengthened the case for early intervention. The implications for the future of ASD treatment are considerable. Above all, there is the need for a pre-emptive approach over a reactive one. Previously, as happens with many conditions, parents and caregivers would wait for a diagnosis before deciding how to respond and what treatment options to pursue. But with the average ASD diagnosis taking place at four years of age, well after the “maximum benefit window” has closed, waiting is no longer an effective option. Parents are now encouraged to be pro-active in seeking intervention and treatment for their children, even before a diagnosis takes place. This is all the more important in view of certain studies that suggest that it is the timing of intervention, even more so than the treatment method itself that has the most impact.
In addition, early intervention has practical implications for ASD treatment, particularly in relation to the logistics of treatment delivery and effective use of therapists’ time. Trained therapists can spend up to 40 hours per week working with pre-school age children, but early intervention for infants and very young children is often conducted at least partly by parents. The advantage here is that parents can be trained in intervention techniques in as little as an hour each week, thus exponentially expanding the potential reach and scope of any one therapist.