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An early start. Rogers has gathered some of the promising preliminary data. With Geraldine Dawson, a professor of psychiatry at the University of North Carolina–Chapel Hill and chief science officer of the research and advocacy organization Autism Speaks, she developed a program called the Early Start Denver Model that combines one-on-one Applied Behavior Analysis treatment with a more natural play-based therapy for children just 12 months old. A study the two published in 2009 in Pediatrics found that after two years of the treatment, a group starting at ages 18 to 30 months showed an average IQ jump of more than 17 points, versus 7 points in toddlers who received other services. They also demonstrated higher scores in language, daily living, and motor skills.
An Early Start therapist uses a child's own toys and regular play activities, at home, to work on learning goals, such as passing a ball to the child and throwing it in a bucket so the child follows suit, for example, to work on attention, imitation, motor skills, and social interaction. All the while, the therapist uses gestures and repeats the word "ball" to work on communication. "Everything is a tool that you can use to teach them," says Rashelle Lawson, a property manager in Sacramento, Calif., whose son Preston received 2½ years of Early Start therapy after he was diagnosed with autism at 18 months. Beforehand, Preston, now 6, had stopped speaking and would scream when touched. "Now he's a love bug," says Lawson. Preston is enrolled in a regular kindergarten class with his own aide.
Researchers at the Kennedy Krieger Institute in Baltimore, a hospital that serves children with developmental disabilities and brain disorders, are seeing promise in early classroom-style intervention, too. Their six-month program for small groups of 2-year-olds involves about 10 hours of therapy a week in a preschool format—play time, circle time, snack time—plus practice at home. "It's so much more than a cute little classroom," says Rebecca Landa, director of Kennedy Krieger's autism center. Her research has shown that the children make impressive strides in cognitive skills and social abilities like imitation and shared attention. "They make 11 months' gain in six months in their language development," she says. Kennedy Krieger researchers are now examining programs for 1-year-olds. "It gives you hope," says Kristen Skerry, a former school counselor from Lutherville, Md., whose son Owen, now 3, enrolled in September, when he wasn't talking and simply cried when therapists came to his home. Now he communicates, often through gestures, makes eye contact, and pays attention to tasks.
Nationwide Children's and Kennedy Krieger are two of 17 medical centers in the United States and Canada that make up the Autism Treatment Network (ATN), a group of institutions recognized by Autism Speaks for comprehensive care involving all sorts of specialists. About half of children with an autism spectrum disorder also have at least one of several associated conditions, such as attention deficit hyperactivity disorder, an intellectual disability, or epilepsy; more than 40 percent have sleep problems. Besides helping families live more comfortably with autism, treating these medical problems often helps kids respond better to therapy, experts say. It "has paid off in spades," says Margaret Bauman, a pediatric neurologist at Massachusetts General Hospital for Children in Boston.
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