In children with very mild cases
of autism, certain
learning techniques may result in brain changes that make them
“indistinguishable” from unaffected children of the same age — essentially
normalizing them, according to Geraldine Dawson, Ph.D., in the department of
psychiatry at the University of North Carolina at Chapel Hill.
The new study, published in the Journal
of the American Academy of Child & Adolescent Psychiatry, used the
Early Start Denver Model (ESDM). ESDM is a behavioral intervention program that
involves intensive engagement with children diagnosed with autism spectrum
disorders (ASD). In this program, specially trained counselors work with
children twice a day in two-hour sessions, five days a week.
In 2009, Dawson’s group conducted
similar work that showed that children with autism who enrolled in this course
at 18 months and participated for about two years had an average IQ score
improvement of 17.6 points. The children also made significant gains in
adapting typical developmental behaviors, such as brushing their teeth and
engaging with family members during meals.
Dawson and her team wanted to
know what was driving the change. Could alterations in the brains of the Denver
Model toddlers be responsible? It is already well-known that the brain is
remarkably plastic during the first six years of life — meaning it can be
molded and shaped based on the growing child’s experiences. For the study, the
researchers enrolled a group of 48 toddlers aged 18 months to nearly 3 years
old who had been diagnosed with ASD. Half were randomly assigned to receive the
Denver intervention, while the other half were assigned to traditional
community intervention programs including some special-education programs at
schools.
After about two years, the
researchers took electroencephalography (EEG) readings of the electrical
activity of all the children‘s brains while they were looking at pictures of
human faces or toys, and compared the results to those of similarly aged
children without autism. Previous studies have shown that a child’s brain with
autism is more highly activated when the child looks at an inanimate object
like a toy, and less activated when looking at a human face.
In the current study, however,
the Denver program children showed the opposite effect; their brains lit up
more when looking at a woman’s face than when viewing a toy. “We essentially
reversed the pattern so kids with autism are now showing greater normal brain
activity when they saw a woman’s face and less activity when looking at
objects,” said Dawson. “In fact, the brain activity patterns of kids with
autism who received ESDM were no different than a typical four-year-old’s
[pattern] when viewing a woman’s face. They were indistinguishable.”
Dawson notes that the
intervention does not cure autism, but that these results suggest that some
early drivers of ASD may be manipulated and even redirected toward more normal
development. “By providing intervention early on, we can mitigate the severity
of autism symptoms and perhaps really alter the trajectory of the disease at
both the level of behavior and the brain,” she said.
About 1,000 people have been
trained in the technique so far, with 15 specifically trained to teach the
Early Start Denver Model to others. Dawson said the results are encouraging for
not just newly diagnosed toddlers with autism but also those who have been
living with the disorder for years. “Although it’s optimal to start as early as
possible,” she said, “I don’t believe there is any point where the door is shut
and the intervention is not helpful.”
Psych Central
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