The five-year study is the first multi-site, randomized trial funded by the National Institutes of Health to determine if such efforts can reduce--or circumvent altogether—the language impairments and social deficits associated with the developmental disorder.
Researchers will also determine the behavioral factors that help predict whether a child will respond well to this early treatment.
Catherine Lord, U-M professor of psychology, psychiatry and pediatrics, and director of the U-M Autism and Communication Disorders Center, will collaborate with UC Davis M.I.N.D. Institute researcher Sally J. Rogers and University of Washington Autism Center researchers.
"We very much need to better understand how early intervention works and what interventions work best," Lord said. "Participating in the study allows us to provide high-quality service to families free of charge and to learn more about how to carry out the most effective treatments of autism in young children."
Lord is confident U-M research will make it routine to diagnose autism for children just 18 months old and sometimes even younger.
The intervention to be tested—the Early Start Denver Model—fuses developmental and relationship-based intervention techniques with applied behavior analysis teaching strategies. It focuses on using play and positive reciprocal interactions to teach a developmental curriculum designed for each child based on current abilities and interests. The individualized approach makes the model easy to adapt for younger children.
A combination of the developmental curriculum, teaching techniques based on applied behavior analysis, and warm, engaging social exchanges between an adult and the child is used to achieve measurable treatment goals targeting affective connection, social relatedness and communication skills.
"Development changes over time, and missing a particular marker or having one or more of the 'red flags' does not necessarily mean that a child has autism," said Rogers, professor of psychiatry and behavioral sciences with the UC Davis M.I.N.D. Institute. "However, it is beneficial to any child—whether or not he or she has autism—to receive help in catching up with missed or delayed developmental milestones."
Children enrolled in the study will receive intensive, one-on-one intervention in their homes for more than 25 hours per week over two years, and caregivers will be instructed on how to deliver the intervention themselves.
Results will be compared to children of the same age receiving standard community services to determine the efficacy of the Early Start Denver Model at measurably reducing some or much of the disability associated with autism.
"There is very little published about the effectiveness of any intervention model for children in treatment earlier than age 2. However there are some very promising results from a feasibility study that is being conducted at the University of Washington," said Rogers. "With this new funding, we can broaden that study and truly provide a real test of the effectiveness of this type of interventional approach for very young children with autism."
Together, the three study sites will recruit a total of 108 children approximately 12-24 months old who have symptoms of autism.
Typical red flags in social communication skill development between the ages of 1 and 2 indicating that a child may have an autism spectrum disorder include:
--Lack or loss of typical behaviors, such as pointing, playing with a variety of toys, responses to contextual cues, vocalizations with consonants.
--The presence of atypical behaviors, such as repetitive movements with objects and/or repetitive movements or posturing of the body.
--Unusual prosody (intonation and rhythm in speech).
--Lack of pointing, showing and sharing objects with others.
--Lack of appropriate gaze.
--Lack of sharing interest or enjoyment.
--Lack of response to name.
--Lack of coordinating gestures, eye contact and vocalizations to communicate.
For more on the center, visit: http://www.umich.edu/~umacc/
For more on Lord, visit: http://ipumich.temppublish.com/public/experts/ExpDisplay.php?ExpID=966
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