Autistic children in the ESDM group made more progress than those in the standard group, increasing their IQs by an average of 18 points compared to a seven-point improvement in the standard-treatment group.
For parents of autistic children, non-responsiveness is part of the package. And because autistic kids often don’t respond to parental overtures, many parents stop trying to engage their children. But experts in the field say that in fact, interaction may be just what the doctor ordered. In fact, a new but limited study has found that intensive, controlled play with very young autistic toddlers can have a significant impact on their development.
The study, out of the University of Washington, followed 48 children aged 18 to 36 months. The children were divided into two groups. The first group received the currently endorsed community-based approach where parents received instructions about delivering standard interventions as well as referrals to community providers. The other group followed the Early Start Denver Model (ESDM), a more relationship-based approach. ESDM involves intensive intervention provided by both parents and trained therapists in the child’s home, focused around play, communication, social interaction, and family involvement. The children in both groups received about 20 hours a week of intervention.
All the children improved after two years of treatment. That alone is significant, indicating that intervention started very early can make a difference. But the kids in the ESDM group made more progress than those in the standard group, increasing their IQs by an average of 18 points compared to a seven-point improvement in the standard-treatment group. In fact, seven children (30 percent) from the ESDM group improved enough to move from a diagnosis of autism to a less severe diagnosis. In the standard-treatment group, only one child moved to a lesser diagnosis. And the ESDM kids also improved in communication, motor skills, and daily living skills. Dr. Geraldine Dawson, one of the study authors, made clear that all of the subjects still had at least mild autistic symptoms, but commented, “Many of the children had virtually caught up to the typical kids their age.”
What then made the difference? According to Dr. Sally Rogers, originator of ESDM and study lead, the standard interventions rely on adults attempting to teach skills and behaviors to autistic children. When the child performs well, he or she gets a reward. The reward system has limited effectiveness with these kids. The ESDM approach, in contrast, follows the child, watching to see what interests him or her — what makes him smile. Then, the parents and practitioners sit with the kids and engage them in structured play around that interest, persisting even when the response from the kid isn’t huge. “It’s a very pleasing kind of therapy, kids are happy. It is play, and it can happen everywhere,” says Dr. Rogers.
Dr. Rogers explains, “It’s not simple. Parents require a lot of coaching into how to position themselves so they’ve got children’s attention; how to get children to watch them; how to pull gestures out of the children so the child is communicating; how to choose activities so they have maximal pleasure so the child is motivated. We teach multiple different kinds of skills. Inside one particular play activity, you can get a lot of learning in.
Given the rising numbers of autistic children, finding effective interventions certainly is key. According to the organization Autism Speaks, one out of every 110 children has autism, and one out of every 70 boys. Those are startling figures, but even more startling is the fact that its prevalence is increasing by 10-17 percent annually. The lifetime cost of caring for autistic individuals runs between $3.5 million to $5 million, costing the United States about $90 billion annually.
Again, while interventions such as ESDM may offer hope for those families afflicted with autism, better yet would be to do something about the factors causing it. While the medical community points to heredity, genetics and medical problems as the factors causing autism, certainly heredity and genetics and even medical challenges existed in decades past when autism was extremely rare. And certainly nothing in the medical community’s list of factors would account for the astounding annual increase in prevalence. To account for that, it’s almost mandatory that you look to some environmental change as causing the spike.
I wrote before about a study that linked paternal age with autism in offspring — the older the father, the greater the chance he’ll father an autistic kid — and noted that toxic buildup over time in a father’s body might be responsible for compromised sperm. At that time, I urged adults (and particularly men) who wanted to have children to detox to reduce the chances of having autistic children. Studies have found links between autism and heavy metals (particularly mercury), as well as to numerous chemicals and pollutants. In fact, triclosan and triclocarban, common ingredients in those antibacterial soaps so popular as swine-flu preventives, recently have been implicated. And a study last year found a strong link between autism and a chemical commonly found in pet shampoos and insect sprays.
Once again, the message is clear: live as chemical-free as possible, protect your kids from exposure, and regularly detox to protect yourself and your future children. But if you already do have or know an autistic child, you might want to check out this ESDM link. But keep in mind it was a limited study, and it was conducted under the auspices of the originator of ESDM herself, which may have had an effect on the study’s objectivity…or not.