Early Intervention for Autism
According to the Centers for Disease Control (CDC), approximately 1 in every 68 school children in the United States are on the autism spectrum. Autism presents unique challenges for every person on the spectrum, including misunderstanding nonverbal cues, a lack of social skills, and varied levels of academic ability. Many of these obstacles can be difficult to overcome, especially since most children do not receive an autism diagnosis until they are age three or older.
Studies indicate that early intervention can make a significant positive impact in a child’s life. Detecting autism and beginning therapies from age 0-3 can help children gain better social skills and cope with difficulties.
Detecting early signs of autism in babies and toddlers
Detecting signs of autism in very young children lies more on parents or caregivers noticing the absence of normal behaviors rather than the presence of abnormal ones. In other words, you are not looking for odd things your child does; you are looking for what they do not do.
Babies and toddlers who have autism may not
- Make eye contact during feeding or return smiles
- Play games like peek-a-boo
- Hold out their arms to be picked up or cuddled
- Look at an object when someone points to it
- Mimic or repeat facial expressions or noises
- Babble or try to speak
- Notice that another person is upset or hurt
- Play “pretend” or other imagination games like caring for dolls or cooking play food
Red flags for development
All children develop at slightly different rates. Some are simply late bloomers. However, if your child misses certain developmental milestones, you should request a pediatric evaluation as soon as possible.
By six months, your baby should be giving you big smiles or showing other signs of joyful recognition with close family members. By nine months, they should repeat or mimic sounds, smiles, and facial expressions. By 12 months, your child should respond to their name, babble or engage in baby talk, and be able to point, show, reach or wave at an object. At 16 months, he or she should be using spoken words. A 24-month-old should be using two-word phrases and understand their meaning.
If your child does not meet these milestones, it does not automatically mean something is wrong. However, it is important to have an evaluation done. If autism or another developmental issue is present, early intervention can significantly improve their progress.
Regression is another significant warning sign of autism. Children may develop normally until 12-24 months, then suddenly stop using acquired skills. For example, a child who has been saying “Mama” or asking for a bottle may stop using language. Any loss of social skills, gestures, language or babbling is grounds for a pediatric evaluation as soon as possible.
Understanding your child’s rights
In 1975, Congress enacted the first version of the Individuals with Disabilities Education Act (IDEA). The law requires states to make accommodations in the learning environment and curriculum for children with physical or mental disabilities. Local school districts comply with this mandate by working with parents to create an Individualized Education Plan (IEP) for children with disabilities. Autism is one of the thirteen disability categories protected under IDEA.
Free and Appropriate Public Education (FAPE)
Under IDEA, the state must provide every child with a free and appropriate public education. For children with autism and other disabilities, the key word in this phrase is “appropriate.” Your local school district must offer necessary therapy, accommodations, and a learning environment tailored to your child’s level of ability. The school cannot charge you for these adjustments, even if it requires assistance from speech, occupational or physical therapists, or an assistive device.
Least Restrictive Environment (LRE)
Your child also has the right to learn in the least restrictive environment. In other words, disabled students must be educated with their non-disabled peers whenever possible. The law does not require students to be in a general classroom. However, it does focus on providing a natural learning environment within the student’s home community.
Extended School Year (ESY) services
Some children experience a significant regression in skills or knowledge over extended school breaks. These children may be eligible for ESY services. These services focus on reviewing and retaining what has already been learned rather than trying to teach the child something new.
Exploring Early Intervention (EI) Services
IDEA also provides states with federal grant monies for childhood EI programs. Targeted at children age 0-3, these programs give children with developmental delays much needed support. The primary goal of EI services is to minimize the impact your child’s disability has on their development. Although services can vary by region, available assistance should be based on your child’s needs and not limited to what is currently available.
If you see signs of autism or notice developmental delays in your child, it is a good idea to reach out to the EI program in your state. Your child’s current pediatrician, the local school district, and your state Division of Family Services are good places to start. Your child will undergo a comprehensive evaluation to determine what services they need.
A caseworker will work with you to create an Individual Family Service Plan (IFSP). The IFSP is a little like an IEP, but it is geared toward younger children. The plan describes your child’s current ability level, defines goals, and lists specific services available to the child and your family. These services may include
- Occupational therapy – developing age-appropriate skills like feeding or dressing themselves
- Physical therapy – strengthening weakened muscles
- Psychological evaluation – determining whether there is a mental or emotional component to the child’s disability
- Applied Behavior Analysis (ABA) – developing and applying positive reinforcements to aid in learning
- Speech and language instruction – helping the child learn to communicate
If your child is eligible, your IFSP will remain in place until he or she reaches age three. At that point, your preschool-aged child will transition to an IEP through your local school district.
Treatments and therapy for autism
There are several therapies available for children with autism. No single approach that will work for every child. Finding the method that works best for your child is the key to success.
Applied Behavioral Analysis (ABA)
ABA treatments focus on data, routine, repetition, and feedback to provide structure and positive reinforcement. Although tracking progress and providing structure are helpful, members of the autism community raise valid concerns about this type of therapy. The end goal of ABA is to produce a child or adult who appears neurotypical, with no autistic symptoms. Autism advocates, including people diagnosed with autism spectrum disorder, say that goal of therapy should be a happy, healthy, autistic adult who can make decisions for themselves.
Floortime and Pivotal Response Training (PRT)
This therapy uses elements of ABA but focuses more on child-led interaction. Much of the therapy may take place on the floor, at the child’s level. For example, if a toddler is spinning the wheel on a toy car, their parent or therapist might mimic that behavior. It can be used with children as young as nine months old. Rather than focusing on repetitive tasks, therapists and caregivers share an interest in what the child is already doing to build trust and relationship.
Researchers are learning that a relationship-based approach to autism therapy can lead to significant improvements. The Early Start Denver Model uses some of the goal setting and record keeping of ABA but integrates the play-based angle of PRT. In a 2009 study conducted by the University of Washington in Seattle, researchers learned that this method improved measurable intelligence, social interaction, and language ability, even in toddlers as young as 18 months.
Accessing early intervention services can make a significant difference in the life of an autistic child. If you suspect your child may have autism, do not wait to have them evaluated. Getting your child the help they need can make a significant difference in the years to come.