Autism Treatment, Best Time To Start?
Among the many questions parents and healthcare providers ponder about autism spectrum disorders(ASD) is when to start treatment. Now a small but important study provides an answer to that question, and names a specific type of autism treatment as well.
When should parents start autism treatment?
Parents of children with ASD face a multitude of challenges as they navigate the complex avenues of the condition, always in search of effective treatments and answers to their many questions. But as the Autism Society explains that "just as there is no one symptom or behavior that identifies individuals with ASD, there is no single treatment that will be effective for all people on the spectrum."
At Yale Child Study Center, a research team has offered some new information. Their study results indicate that a behavioral program called Pivotal Response Treatment could yield good results when started in children as young as less than two years of age. Typically, autism treatment programs have been geared for children around three year or older.
Pivotal Response Treatment (PRT) was developed by Dr. Robert L. Koegel and Dr. Lynn Kern Koegel and, according to the official PRT website, is "one of the few [autism treatments] that is both comprehensive...and empirically supported."
Briefly, PRT focuses on pivotal areas of a child's development, including self-management, response to multiple cues, motivation, and social initiations. The PRT site notes that when these areas are targeted, it "results in widespread, collateral improvements in communication, social, and behavioral domains."
Pivotal Response Treatment stresses parental involvement and educates families so they can integrate the treatment in daily routines. The approach has been shown to lead 85 to 90 percent of children with autism to develop verbal skills as "a primary mode of communication."
In this latest study, researchers were the first to use functional magnetic resonance imaging (fMRI) to examine changes in brain activity after two five-year-olds with ASD had received PRT. The children demonstrated improvement in speaking with other people and in their behavior, and the fMRIs also showed increased activity in areas associated with social perception.
Admittedly this is a small study, but the team has already launched a larger study that includes 60 children. In addition, previous research has indicated PRT can be beneficial for very young children.
For example, results of a pilot study published in the May 2012 issue of the Journal of Autism and Developmental Disorders explained use of PRT in three infants at risk for autism. The authors noted that use of PRT "resulted in increases in the infants' frequency of functional communication," and that their findings "provide preliminary support for the feasibility and utility of PRT for very young children at-risk for autism."
An earlier study from Stanford University School of Medicine reported on the ability of parents to learn PRT in group therapy and how use of treatment affected their children. The authors noted their findings "suggest that parents can learn PRT in a group format, resulting in correlated child language gains."
Based on the results of the latest two case studies, one of the study's authors, Dr. Fred Volkmar, noted that "these findings are exciting because they show that early intervention works in autism." For parents who have a child with ASD, they offer more information about when and how it's best to start treatment for autism.
Minjarez MB et al. Pivotal response group treatment program for parents of children with autism. Journal of Autism and Developmental Disorders 2011 Jan; 41(1): 92-101
Steiner AM et al. Pivotal Response Treatment for infants at-risk for autism spectrum disorders: a pilot study. Journal of Autism and Developmental Disorders 2012 May 10
Voos A et al. Neural mechanisms of improvements in social motivation after pivotal response treatment: two case studies. Journal of Autism and Developmental Disorders 2012; doi:10.1007/s10803-012-1683-9