The earlier you can start evidence-based interventions, such as occupational therapy, with a child with autism spectrum disorder, the more effective that treatment will be.
Most experts in the field agree on that.
However, one barrier to early treatment has been the reliability of autism diagnoses of young children.
Previously, a diagnosis wasn’t considered reliableTrusted Source until the age of 2.
That may soon start to change.
A new study published in JAMA PediatricsTrusted Source concludes that autism spectrum disorder (ASD) diagnoses made at the age of 14 months generally don’t change as a child gets older.
Researchers tracked 1,269 toddlers while examining the children at multiple times, beginning at 12 months of age.
The researchers said they noticed an autism diagnosis at 14 months was generally “stable.”
They also noted that 24 percent of the children eventually diagnosed with ASD were “missed” on initial evaluations by licensed psychologists who attributed behavioral patterns to other aspects such as language delay.
The new findings could support health professionals who want to make earlier diagnoses and begin implementing interventions sooner.
For families and children with ASD, this could have life-changing outcomes.
“Now that we understand the early nature of ASD and the very early age of diagnostic stability, it opens doors for researchers to begin examining the impact of very early delivered treatment,” Karen Pierce, PhD, a study co-author and a professor in the neurosciences department at the University of California San Diego, told Healthline. “Our understanding of early brain plasticity suggests that very early treatment should result in excellent outcomes, but we will only know for sure once the studies have been conducted. Our findings open the door for such studies.”
Two autism experts also interviewed by Healthline agreed a diagnosis earlier than 2 years of age is certainly possible, but they had a few cautions.
Rebecca Sachs, PhD, a licensed clinical psychologist at CBT Spectrum in New York, said indicators for autism such as language delay and social interaction are present as early as 14 months.
However, she noted that girls with autism sometimes aren’t diagnosed until a later age or are often misdiagnosed due to the structure and measures used in ASD evaluations.
Kate Cody, PsyD, a licensed psychologist with Spectrum Psychological Services, said the accuracy of such early diagnoses can be determined by what experts are focusing on.
She also noted most early diagnoses are based on how a child interacts with an adult. Other signs might appear when the child is older and starts interacting with peers.
“There is a lot of variability,” said Sachs.
ASD encompasses a wide range of conditions characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication.
It affects about 1 in 59 childrenTrusted Source, with boys being four times more likely to be diagnosed than girls.
How autism presents itself can differ greatly from one child to the next, making individualized intervention plans vital.
Timing is also an important factor in maximizing the potential benefits of treatment.
Pierce notes that the mean age for autism diagnosis in children is 52 months.
“Given the plasticity of the human brain to be shaped by early environmental experience, particularly within the first years of life, this late age of diagnosis is unfortunate because children are not receiving treatment at an age that might be most beneficial to them,” she said.
Sachs and Cody agree.
“The earlier the intervention, the better prognosis we see,” said Sachs.
Cody added that earlier treatments have a better chance of rewiring a child’s brain and adjusting behaviors.
“Early intervention tends to be more effective,” she said.
Sachs noted that these therapies tend to develop better communication skills in children, which in turn can relieve frustration and stress.
“When a kid throws something across the room, they’re communicating,” she said.
Both Sachs and Cody said there appears to be little harm in using early intervention treatments on children who may not be on the spectrum.
The therapies will still help with language delays or any other developmental problems the child may be having.
“It’s only going to benefit the child,” said Cody.
There are three main approaches to intervention and treatment: medical, non-medical, and additional or alternative.
According to officials at Autism Canada, the medical approaches include:
- specialized diets, such as gluten-free
- pharmaceuticals, such as antibiotics
- nutraceuticals, such as digestive enzymes
Non-medical approaches, according to the Texas Autism Resource Guide for Effective Teaching (TARGET), are vast and include:
- Cognitive behavioral intervention that teaches individuals to understand and change thoughts and behaviors.
- Exercise that uses physical exertion to reduce problem behaviors or increase appropriate behaviors while increasing physical fitness and motor skills.
- Parent-implemented intervention that increases positive learning opportunities and acquisition of important skills.
- Prompting that assists individuals when they are using a specific skill.
- Reinforcement that establishes the relationship between the individual’s behavior/use of skill and the consequence of that behavior/skill.
- Self-management that teaches individuals to regulate behaviors and act appropriately.
- Social skills training that aids individuals with peer, adult, and other individual social interactions.
In addition to the above interventions and therapy options, many families and children with ASD find support from other approaches.
According to Autism Canada, these other therapies include:
- occupational therapy
- sensory integration
- therapeutic recreation
Animal therapy has also been highlighted by the Autism Society as an effective form of therapy in appropriate cases. Animal therapy can include working with dogs, horseback riding, or swimming with dolphins.
“These animals can provide soothing sensory stimulation, a point of focus and opportunities to learn about behavior and communication,” states the Autism Society.
Cody and Sachs noted therapies can benefit a child even into adulthood, especially if treatments are ongoing.
“Intervention is so important for the development of skills that will last a person a lifetime,” said Cody.
Sachs added that the therapies can also help with issues such as anxiety, depression, and obsessive behavior that sometimes co-exist with autism.
So what should you do if you notice developmental delays?
Contact a medical professional who can evaluate ASD as soon as possible.
“If a child is showing signs of ASD, it is important to take them for an evaluation by a qualified professional right away,” said Pierce. “The high stability of an ASD diagnosis during early development implies that the symptoms of ASD will not resolve on their own. A ‘wait and see’ approach is probably not in the best interest of the child.”
Sachs and Cody add that treatments can also benefit parents.
They said a parent can understand a child’s behavior better once they have a diagnosis and are educated about the therapies being administered.
It can also lead parents to join a support group.
“The interventions can provide parents with access to a community and access to a roadmap,” said Cody.