The U.S. Centers for Disease Control and Prevention estimate that 1 in every 88 children born today will be diagnosed with **autism spectrum disorder (ASD)**. Distinctive signs of the neurodevelopmental condition include persistent deficits in social communication and repetitive or restrictive patterns of interest that appear in early childhood and impair daily functioning.
A study conducted in California, USA, has determined that intensive early intervention therapy is effective in improving perception and language skills among children with autism from 18 months of age. In addition, it normalizes their brain activity and improves their social skills.
Specifically, this randomized, case-controlled, multi-center study found that children who received the Early Start Denver Model (ESDM) intervention exhibited greater brain activation when viewing faces instead of objects, a response that was typical of children without autism in the study, but contrary in children with autism who received a different intervention (2012).
The Denver Method is an intervention method developed in 2000 by Sally Rogers and Geraldine Dawson. The therapy combines intensive applied behavior analysis teaching methods with “relationship-based” developmental approaches.
The researchers in this study recruited 48 boys and girls diagnosed with autism between 18 and 30 months of age, in Sacramento, California, and Seattle, as well as “control” children. The male-to-female participant ratio was more than 3-to-1, as autism is five times more common among boys than girls. Approximately half of the children with autism were randomly assigned to receive the ESDM (Denver Method) intervention for more than two years. Participants received ESDM therapy for 20 hours a week, and their parents were also trained to provide the treatment, a fundamental characteristic of the intervention. The other participants with autism received a community-based intervention, as well as evaluations, referrals to services, resource manuals, and other reading materials.
At the conclusion of the study, participants’ brain activity was evaluated using electroencephalograms (EEGs) that measured brain activation while viewing social stimuli (faces) and non-social stimuli (toys). Previous studies had determined that infants and young children without autism showed greater brain activity when viewing social stimuli instead of objects, while children with autism showed the opposite pattern.
Twice as many children who received the ESDM (Denver Method) intervention showed greater brain activation when viewing faces than when viewing objects, a demonstration of normalized brain activity. Eleven of the fifteen children who received the ESDM intervention, 73%, showed more brain activation when viewing faces. Twelve of the seventeen typically developing children, or 71%, showed normalized brain activation. The EEGs of five of the fourteen children who received the community intervention, or 36%, showed similar activation.
Furthermore, children who received the ESDM (Denver Method) had greater brain activity while viewing faces and also had fewer social pragmatic problems and better social communication, such as the ability to initiate interactions, make eye contact, and imitate others, said Sally Rogers, a researcher at the MIND Institute. The use of ESDM intervention has been shown to improve perception, language, and daily living skills.
“This is the first case-controlled study of an intensive early intervention that demonstrates both an improvement in social skills and normalized brain activity, resulting from intensive early intervention therapy,” said Dawson, lead author of the study and professor of psychiatry at the University of North Carolina, Chapel Hill. **ASD training for professionals** and research is essential for progress.
For the first time, parents and medical professionals have evidence that early intervention can alter the course of brain and behavioral development in young children. “It is crucial that all children with autism have access to early intervention, which can foster the most positive long-term outcomes” (Dawson, 2012).
“We know that infant brains are very malleable, and this therapy has previously been shown to increase the learning potential of a baby’s brain to limit the harmful effects of autism,” said Sally Rogers, co-author of the study and professor of psychiatry and behavioral sciences at the University of California’s Medical Investigation of Neurodevelopmental Disorders Institute (UC Davis MIND).
“The findings on improved behavioral outcomes and the ability to normalize brain activity associated with social activities mean there is tremendous potential for the brains of children with autism to develop and grow more normally.”
“This may be the first demonstration that a behavioral intervention for autism is associated with changes in brain function, as well as positive changes in behavior,” said Thomas R. Insel, director of the National Institute of Mental Health, which funded the study. By studying changes in neural response to faces, Dawson and her colleagues have identified a new target and a possible biomarker that can guide treatment development.
Studies like these present new horizons for improving the quality of life for children with autism spectrum disorder and their families. ISEP’s **Master in Autism Spectrum Disorder** is an opportunity to better understand ASD and design effective therapeutic approaches.