Could early intervention erase signs of autism?

A child isn't typically diagnosed with autism until age 3 or later. While the signs for autism spectrum disorder, or ASD, may be hard to detect in infants, researchers suggest there may be some early indications if you know what to watch for.

Children with autism often don't produce many sounds or use their voices to communicate. They may engage in frequent repetitive behavior. They stare at their hands or at objects for long periods of time.

Sally Rogers, a professor of psychiatry and behavioral studies at UC Davis MIND Institute, wondered what would happen if a parent could intervene before a child is officially diagnosed with autism. Other research on early intervention has shown some promise.

Rogers asked Hinson if she would be interested in becoming part of a study. Since the study involved behavioral modification therapy, if Noah wasn't diagnosed with autism there would be no harm. Hinson said yes, as did six other parents with children between the ages of 7 months and 15 months who showed some signs of autism.

"As a parent, I'll take anything that can help my child," Hinson said.

For the study, she and the other parents visited Rogers' clinic once a week for 12 weeks. There the researchers taught the parents behavioral modification techniques they could use on their children.

The techniques were simple exercises: Hinson would play "piggies" with Noah, reciting the classic poem about pigs going to market and touching Noah's feet. Often children with autism become distressed when they are touched. Other times she would play "airplane" with Noah's food as she fed him. Or they'd focus on songs and rhymes.

"Basic things you do as a mom, but really are cuing into the responses he is making and really reinforcing the responses to get him to engage with me," Hinson said. "The wonderful thing about it was that most of what they taught me, they taught me how to use in my general day-to-day routines with Noah."

Scientists thought parents would be more apt to do exercises that could be woven into daily life.

At about 15 months in, there were still concerns, but Hinson had noticed improvement in Noah's interactions with her. At 18 months, he seemed to be back on track developmentally.

"It was like this beautiful thing happened."

Noah didn't just catch up to the developmental goals of other children his age, he surpassed them. He remained talkative and engaged.

"This completely helped him," she said. "I don't know what would have happened (otherwise)."

She was not alone. At 36 months, the group that had used the behavioral intervention techniques with their children had much lower rates for autism spectrum disorder. Five children no longer showed symptoms of autism, one had mild autism but no developmental delays, and one had severe autism.

Today Noah is a 4-year-old boy with extensive language skills.

The scientists behind the study caution that this is only a pilot study; the findings cannot be applied to a larger population yet.

"With seven (children) you can't draw a conclusion," Rogers said.

But other researchers in the field see real promise in the results.

"It is exciting to think about an intervention that could change the developmental outcome for babies at risk of autism spectrum disorder," said Dr. Jeremy Veenstra-VanderWeele, an associate professor of psychiatry at Columbia University. "This pilot study ... suggests that parents can be trained to interact with their at-risk infants using many of the same principles that are used for toddlers and preschoolers with ASD."

"It begins to set the scene for future randomized, controlled studies to evaluate whether this type of intervention could actually prevent babies from developing full symptoms of autism spectrum disorder," Veenstra-VanderWeele said. If it proves to work on a larger group, this "would be a truly transformative finding."