The Importance of Early Diagnosis and Intensive Therapy for Children with Autism
It’s a fact: Autism Spectrum Disorder (ASD) is becoming more widespread across the United States. There is no consensus on why the prevalence of the condition is continuing to rise. Theories range from more awareness, to better diagnosis, to genetic mutations… even to environmental factors. Regardless of the reason or reasons for the rise in diagnosis of children with autism, experts stress that it is important for parents to have early screenings for ASD and, if their child shows any symptoms, to take immediate action.
A complex developmental disability related to brain development, ASD typically appears during early childhood and affects the child’s ability to communicate and interact with others. This not only causes communication issues but problems with every day social interaction. Because individuals have a wide range of symptoms and severity—varying from mild to severe or somewhere in between—it is considered a “spectrum” condition.
Every child on the autism spectrum has a range of problems and issues to overcome. Among the more common symptoms and signs of ASD are problems with social communication and interaction, delayed language skills and learning, difficulty making eye contact, narrow or intense interests, repetitive patterns of behaviors and sensory sensitivities.
Not all of these symptoms are necessarily manifested. Children may have just a few of these or even unique symptoms that are either separate from these or in combination with them. Some children may only have mild impairments while others face greater obstacles. Additionally, many of these symptoms can persist throughout the child’s life.
The Benefits of Early Intervention
There is no cure for ASD and there’s no consensus on what causes it. Nor is there agreement on whether there is a “standard” treatment course for it. However, everyone agrees that the earlier intervention begins for children with ASD, the more dramatic of a difference it can make in their lives.
That makes it vitally important to diagnose autism at the earliest possible age in order to optimize outcomes for children with ASD. Diagnosis is ideal when made by the age of 2, which is currently the earliest age that is reliable[i]—although symptoms can appear as early as 12 to 18 months.
Unfortunately, most children with ASD are not diagnosed until after they are 4 years old, which means they are missing the most opportune time to be getting treatment. There are a variety of reasons for this, including parents’ reluctance to identify and recognize the severity of the symptoms displayed, as well as a lack of trained professionals.
Once diagnosed, treatment should begin as soon as possible. There is ample evidence that early intervention can improve social and communication skills during infancy and this has the potential to significantly help improve the child’s later development. Additionally, early intervention stops problematic behavior from becoming a habit.
Proper early treatment can reduce children’s symptoms and can improve their overall development by helping them learn new skills that will allow them to be more independent throughout their life. Because they are receiving appropriate treatment at key developmental stages, children with autism are more apt to gain essential social skills and the ability to act better in social situations. These are valuable tools that will help the children to be more independent require fewer services as they age. In short, early detection can help the children make the most of their strengths and provide them with the potential for a better, more independent life throughout childhood and well beyond.
Early diagnosis can also benefit parents. Instead of noticing symptoms and worrying that something is wrong with their child, an early diagnosis enables parents to take action and begin helping him or her. Under the guidance of specialists and organizations such as Alternative Behavior Strategies (ABS), parents can begin following the prescribed treatment to help their child improve throughout his or her developmental stages—setting the stage for significantly improved outcomes.
The “Gold Standard” of Treatment for Greater Progress
Now that we know how early diagnosis and intervention has been proven to be most helpful to maximize the child’s ability to function, the important question is which treatment will prove to be most effective. As stated before, ASD cannot be prevented, but there are effective treatment options that can help improve behavior, skills and language development—and emerging treatments continue to evolve.
Applied Behavior Analysis (ABA) therapy is the recognized “gold standard” for treating ASD. The most successful evidence-based treatment for ASD, ABA is a data-driven therapy that uses systematic, evidence-based assessments to measure outcomes in real-time measurement of behavior. This guides intervention decisions and any necessary adjustments can be made on the basis of solid data. In fact, it is the only treatment for ASD that has been designated as medically necessary and recognized by the U.S. Surgeon General.[ii]
A behavioral learning program, ABA reinforces and encourages positive behavior while discouraging negative ones. Additionally, ABA teaches children with ASD new skills and how to apply them in real life situations.
Unlike other service models, ABA is an intense treatment, with up to 40 hours per week prescribed. Dramatic improvements have been seen when children receive early and intense ABA therapy to build their functional skills. Treatment can effectively help with challenging behaviors, such as repetitive behavior, self-injury and tantrums and also help children in areas such as language and social skills.
Decades of research has established that ABA’s intensity of treatment is a critical part of helping a child with ASD to learn new skills, reduce problem behavior and make lasting gains. In a groundbreaking study conducted by Ivar Lovaas in the late 1980’s, children received 40 hours per week of intensive treatment for two to six years. The results were remarkable: more than 90% of the children showed significant improvements in symptoms, including socialization. Since that time, other researchers have replicated Lovaas’ original findings, with similar results. A 2016 study added to the existing support for higher intensity treatment for children with ASD.
Additionally, a number of studies have proven that the best outcomes are achieved when treatment intervention is started as early as possible and with a high intensity (or hours) per week. One study[iii] demonstrated that children who have both greater treatment intensity and longer treatment duration gain positive effects in their intellectual functioning, language and adaptive behavior. In another later study,[iv] the same researchers found that a combination of intensity and duration was the single predictor of and the highest contributor to treatment outcomes.
Conclusion
The strain of caring for a child with autism can be challenging for parents and families. But with the right strategies and support for their child, treatment can reduce the effects of ASD and help the child thrive. With earlier diagnosis, treatment intensity and longer treatment duration, children with ASD can achieve statistically significant gains and optimal therapeutic results.
[1] Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/autism/data.html
[1] Profiles in Science, US National Library of Medicine. “The Reports of the Surgeon General.” Chapter 3, Section 6. http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec6.html#autism
[1] ScienceDirect. “The Effects of Age and Treatment Intensity on Behavioral Intervention Outcomes for Children with Autism Spectrum Disorders,” D. Granpeesheh, et al. Research in Autism Spectrum Disorders. Volume 3, Issue 4, October–December 2009, Pages 1014-1022. https://www.sciencedirect.com/science/article/pii/S1750946709000658
[1] ScienceDirect. “Prediction of Treatment Outcomes and Longitudinal Analysis in Children with Autism Undergoing Intensive Behavioral Intervention.” J. Virués-Ortega, et al. International Journal of Clinical and Health Psychology. Volume 13, Issue 2, May 2013, Pages 91-100. https://www.sciencedirect.com/science/article/pii/S1697260013700127?via%3Dihub
