In most cases autism spectrum disorder is not diagnosed in a child until they are three or four years old. However, new research is adding to the evidence that early detection and intervention are key. A study published today suggests that if treatment begins as early as the first six months of life, it can vastly improve a child's outcome and possibly even eliminate symptoms.
The impact of early interventions can be so great that in some cases an autistic child who received therapy as a baby will no longer exhibit signs of the disorder by age 3, according to a new study published in the Journal of Autism and Developmental Disorders.
The study tested a 12-week treatment plan on seven autistic infants aged 7 to 15 months who were already exhibiting signs of the disorder. After families took part in the program, researchers followed up with the children over a three-year period.
Though the children diagnosed with autism exhibited clear symptoms of the disorder at nine months old compared with the control group, the researchers found that by ages 18 months and 36 months they were less symptomatic. Overall, the children who received the interventions in the first year of their life had fewer language delays, symptoms and general developmental delays.
"Most of the children in the study, six out of seven, caught up in all of their learning skills and their language by the time they were 2 to 3," lead author Sally J. Rogers, professor of psychiatry and developmental sciences at the University of California, Davis, said in a statement. "Most children with ASD [autism spectrum disorder] are barely even getting diagnosed by then."
Dr. Lisa Shulman, director of infant and toddler services at the Children's Evaluation and Rehabilitation Center at the Albert Einstein College of Medicine, told CBS News that while the sample size of this study is small, it indicates what she has seen in her patients: Early interventions can change the course of a child's life.
"This study is groundbreaking in certain regards," said Shulman. "It pulls together various streams of current research in a meaningful way."
Shulman believes that doctors and families often fail to get a diagnosis that early because there's a misconception that children with autism spectrum disorder don't exhibit signs in the first few months of life.
"Many children with autistic tendencies in this age group do become over-focused or their interests lie outside the social interaction," she said "You see their development deviate more and more from peers over time."
Shulman said autistic babies can exhibit a number of signs similar to those of children who a diagnosed later in life. Doctors group them into "positive" and "negative" signs.
"The positive signs of autism are behaviors the child demonstrates that stand out as unusual," said Shulman. "One that's gotten a lot of attention is visual fixation. Rather than looking at faces the child is may be drawn in to look at other objects for long periods of time, often moving objects. Kids who will look at spinning fans for long periods of time or over-fixate on minute details for long periods of time with the exclusion of more typical interests and play."
Additionally she said babies may "demonstrate repetitive interests," such as spinning or tapping objects or opening and closing them. Shulman said that while some of this behavioral is part of healthy normal development, when it's done in excess there may be reason for concern.
Parents should also look out for "negative" signs, when a baby fails to reach developmental milestones that are critical to a child's ability to communicate. There may be a delay in language skills such as inability to make consonant sounds. "They have a lack of gestures," she said. "These kids are not waving bye-bye, they're not raising their hands to their mother to be picked up out of their crib."
In general, there may be a lack of social interest. An autistic baby may not smile at a parent when prompted with typical social cues. Or a baby may fail to respond when their name is called.
The 12-week treatment program used in this study, conducted by researchers at the University of California Davis MIND Institute, addresses many of the deficits found in autistic babies by encouraging parents to become more engaged with their baby. In sessions, infants learn to become more attentive to their parent's face and voice or incorporate toys to support communication. The study also indicates that parents, not therapists, are critical to a an autistic child's development.
"It was the parents - not therapists - who did that," Rogers said. "Parents are there every day with their babies. It's the little moments of diapering, feeding, playing on the floor, going for a walk, being on a swing, that are the critical learning moments for babies. Those moments are what parents can capitalize on in a way that nobody else really can."