Growing awareness about autism is fueling a push for earlier intervention aimed at shoring up deficits in a child’s brain development giving them a better chance to catch up. Children often aren’t officially diagnosed with autism until around age two, but mounting research shows that work on a child’s social and communication skills before then can be crucial to future development.
“Early intervention is important because the earlier you start working on any deficits, the more impact you’re going to have in the future,” says Vince LaMarca, a board certified behavior analyst and Clinical Director for Little Star Center, a nonprofit network of Applied Behavior Analysis centers and in-home programs. “Once they have learned a set of skills, it snowballs.”
Don’t wait for a diagnosis
Where can parents start if they suspect a problem? In Indiana, First Steps – a federally mandated early intervention program for children from birth to three years old with developmental delays or other disabilities – does not require a medical diagnosis.
Instead, a child is evaluated in several areas of childhood development, including cognitive, physical, communication, social and emotional capacities. A child is typically eligible for services if he or she shows delays of 25 percent or more in one area or delays of 20 percent in two or more areas, or if he or she has a diagnosed condition that has a high probability of resulting in a developmental delay.
The initial evaluation is performed at no cost to the family.
“We encourage parents not to wait for a diagnosis to seek out services,” says First Steps Director Cathy Robinson. “The 0 to 3 year old age period is a critical time for intervention.”
Repetition and intensity
Early intervention, especially for very young children, may seem more like play than traditional therapy, but ABA strategies that include repetition and intensity are key to making real progress, LaMarca says.
At Little Star Center’s facilities, therapists follow a learner’s lead to see what he or she is interested in, and then use that to reinforce developing skills such as imitation, learning to request and joint attention.
“It’s not like you can do a tiny bit of training and have it generalize throughout the day,” LaMarca stresses. “It’s the time that you’re teaching that increases the skills. It’s the time you’re not teaching that doesn’t increase skills.”
Similarly, Robinson emphasizes the family focus of First Steps, which not only coordinates services for children but also provides parents with guidance on how to assist their child. “We’re a little different from clinical programs in that First Steps trains parents on what they can do for their child in the course of their day,” she says. “What we’re doing in the home on a daily, weekly or monthly basis is important, but it’s what parents do on a daily basis that is really critical.”
For parents who believe their child may have a developmental delay, experts stress there is not any age that’s too young to seek support.
Robinson, whose own child went through the First Steps program, encourages parents to visit the program’s web site or call their local office at 317-257-BABY for preliminary information.
LaMarca also recommends the resources at AutismSpeaks.org and the treatment comparison information at ASATOnline.org, the website for the Association for Science in Autism Treatment.
He stresses that the earlier intervention can begin the better. “Prior to early intervention, children are learning to cope with the world any way they can, and the longer they do that, the longer they may be learning bad habits – coping versus thriving,” LaMarca says. “The earlier the intervention can get started, the less there is that has to be unlearned.”