Treatment of autism targeting infants may reduce likelihood of later diagnosis | wading

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Doctors have shown for the first time that a new treatment targeting children can reduce autistic behavior and the likelihood that children will continue to be diagnosed with autism before they reach school age.

Children who received treatment after showing early signs of possible autism, such as avoiding eye contact and not responding to their names, were a third more likely to have autism by age three, compared to those who received standard care, the researchers found.

The results suggest that intervention in the first year of life, when autism is suspected but far from certain, can enhance social development in children with autism, with beneficial long-term side effects for their wider lives.

Professor Jonathan Green, from the University of Manchester, said: “This is the first global evidence that a preventive intervention can reduce autistic behaviors and the likelihood of subsequent diagnosis.”

We think this is a landmark finding because it suggests that an intervention at this early time could have such a big impact. It may change the way services provide support to a large number of children around the world.”

The international research team, led by Professor Andrew Whitehouse at the University of Western Australia in Perth, evaluated 104 infants aged nine to 14 months who had come to the attention of community health care services after showing early signs of autism. While half were randomly assigned to receive routine care, the other received 10 sessions of treatment over a five-month period. They were then all reassessed for autistic behaviors at 18, 24 and 36 months of age.

In therapy sessions, parents were videotaped playing with their children. The therapist then reviewed the footage with the parent and helped them understand the different ways their child was trying to communicate, and how they could best engage the child. The goal was to enhance communication and to improve “back and forth” between parent and child, to help the infant develop social communication skills.

Writing in JAMA Pediatrics, the researchers explain how the treatment appears to reduce some symptoms of autism, a change that remained largely until children reached the age of three. At that point, independent doctors evaluated each child. While a fifth of people who received standard care received a diagnosis of autism, only 6.7% of those who received treatment did.

According to the study, the children scored better in social interactions but also in other symptoms, such as repetitive movements and unusual reactions to the senses such as smell and taste. More follow-up is needed to see if treatment only delays or prevents diagnosis in some children.

Researchers stress that the treatment is not a cure for autism. Many children still had significant developmental problems by the time they reached the age of three at the end of the study. But the findings suggest that personalized therapy may help at least some children develop social skills before they reach school age.

“The clinical effect that can be immediate is really quite amazing,” Whitehouse said. “So far, no treatment has shown such positive effects on development that it affected the child’s diagnosis outcome.

For this reason, treatment has real potential to change how we provide support for children who develop differently. At its simplest, this is a change from “wait and see” to “identify and act” – a new clinical paradigm that can transform support for families.”

But the study raises serious questions about how to provide autism services. Some children who improve from treatment may need specialized care but are no longer eligible if they are not formally diagnosed. The findings “highlight the flaws in the system,” Green said, adding that services should be designed based on need, not diagnostic.

Tim Nichols, head of policy at the National Autism Society, said the work had some positives but criticized the researchers for a lack of community involvement.

He said, “It is important that no other study in very early intervention seeks to reduce ‘severity’ – early intervention must be about supporting people with autism their biggest challenge.” For effective research in this area in the future, those with autism must be involved. autism at every stage.

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