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.”