A simple treatment that helps parents interact better with very young children with autism pays off years later, British researchers reported Tuesday.
The therapy, which involves using videos to give specific feedback to the parents, reduced symptoms in children with severe autism for years — until some of the children were 11.
It’s one of the first such approaches to be shown to actually work, the team at University of Manchester, King’s College London and Newcastle University reported in the Lancet Medical Journal. And it’s the first to show long-term benefits.
“To our knowledge, this study is the first study to report long-term symptom outcomes to middle childhood (7–11 years) following a randomized controlled trial of early intervention in young children,” the team wrote.
“This type of early intervention is distinctive in being designed to work with parents to help improve parent-child communication at home,” said Jonathan Green of the University of Manchester, who led the study.
“This is not a ‘cure’, in the sense that the children who demonstrated improvements will still show remaining symptoms to a variable extent, but it does suggests that working with parents to interact with their children in this way can lead to improvements in symptoms over the long-term,” Green added in a statement.
The team tested 152 children aged 2 to 4 in a study called the Preschool Autism Communication Trial (PACT), which began six years ago.
Some got the treatment – a home-based approach in which parents were trained to watch for a child’s cues.
“The parent studies these videos alongside the therapist and learns how to be able to better interpret the child’s often indirect and unusual communications - to see that, behind the unusualness, what the child is actually intending to communicate is often just like any other child,” Green writes in a separate description of the approach.
Parents got 12 therapy sessions for six months, monthly support sessions for the next six months and are asked to spend at least 20 to 30 minutes playing and communicating with their children.
“The parent learns how to respond to these child communications in a way that we believe will encourage in turn children's social understanding,” Green said.
"Also of course, like anyone, if the child feels they are understood and can make themselves understood, they are likely to feel happier and less stressed."
It was shown to work early on, and the effects have lasted for years. Kids whose parents got the training showed better social communication and reduced repetitive behaviors compared to children in the study who got usual care for autism.
"The advantage of this approach over a direct therapist-child intervention is that it has potential to affect the everyday life of the child," Green said.
The therapy didn’t help every aspect of the kids’ lives, said Tony Charman, who led the King's College London arm of the trial. “We found no evidence of any effect on child mental health, such as anxiety or challenging behaviors, suggesting that additional interventions may be needed to address these difficulties at later ages."
Autism spectrum disorder refers to a large range of conditions, from the relatively mild symptoms of Asperger's to severe and profound intellectual deficits and an inability to communicate with others. Symptoms often overlap with other disorders such as attention deficit/hyperactivity disorder, cerebral palsy or various learning disorders.
And it’s becoming more commonly diagnosed.
A 2015 government survey found that more than 2 percent of U.S. kids have been diagnosed with autism — or 1 in 45 children aged 3 and older.
The causes appear to be both genetic and environmental, and while there is no cure, researchers are beginning to find some bits of evidence that therapy can help.
In 2014 Sally Rogers of the University of California found training parents to watch for their kids’ cues while playing gently could make a difference.
The idea is that delicate but insistent therapy early in life can help children rewire their brains and possibly reverse the symptoms.
And in 2009 a team at the University of Washington also found behavioral therapy in very young children could help.
But experts say much more research is desperately needed.
"Parents commonly tell us that they fight for a diagnosis, but when they finally get it, the cupboard is bare, with little information or tailored support available to them" said Dr. James Cusack of the British charity Autistica, who was not involved in the study.
"Too often, parents fall victim to the false claims of charlatans who prey on desperate families. These results look promising for the many thousands of parents who want to find early interventions for their children based on solid science."