Children's Health

Targeting child's play to help tackle autism

As efforts expand to diagnose autism earlier and more accurately, researchers also are striving to figure out ways to treat children as young as one year old.

Specialists at the Kennedy Krieger Institute in Baltimore, who focus on disorders of the brain, spinal cord and musculoskeletal system, are testing the use of early intervention groups to improve social and communication skills for one- and two-year-olds who are considered at high risk for autism and related disorders.

The average age of children diagnosed with autism in the US is around four years old, according to the Centers for Disease Control and Prevention. Interventions typically start later than that to treat the spectrum of disorders that leave about one in 88 children struggling to socialize and communicate. Many also exhibit repetitive behaviors.

Early diagnosis and intervention is a mantra in the field: The earlier children can get help, the brighter their long-term prospects, experts say. But it is not certain what, if any, type of intervention is helpful with very young children, so researchers have been testing different approaches.

Kennedy Krieger's programs aim to help children improve basic skills like noticing what other people are noticing; coordinating and imitating behaviors and activities with others; and sharing positive emotions, said Rebecca Landa, a speech pathologist who directs Kennedy Krieger's Center for Autism and Related Disorders and designed the intervention model.

Kids are trained in classroom sessions lasting between 90 minutes and two and a half hours, two to four days a week. They play games, sing songs and do book-sharing exercises -- all standard fare for any small child but done in a simplified manner highlighting the relevant social cues. Parents also are taught how to apply the skills learned in the classroom at home.

The key to the interventions' success is "saturation and routine," Landa said. "We just give every child everything we can at every moment."

Children who develop more typically, beginning early in infancy, gain an understanding of other people's behaviors. Babies, for instance, lift up their arms when they are about to picked up, anticipating the adult's intention, Landa continued.

Kids with autism, however, do not appear to understand what other people are doing or thinking, and therefore what is expected from them.

Landa and other researchers say these skills can be learned and improved with practice. And they think the earlier, the better.

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