Therapy beginning as early as age 18 months can greatly improve symptoms of autism, researchers say. The new study included 48 children. Their ages ranged from 18 to 30 months as the study began. Some of the children received specialized therapy. They worked one-on-one with a therapist to improve social and communication skills. The other children received less specialized care. After two years, the group that got the intense therapy improved more than the other group in IQ and language skills. About 30% were given a new diagnosis, with a less severe form of autism. Only 5% of the other group had a new diagnosis. The Associated Press wrote about the study November 30. It was published online by the journal Pediatrics.

By Henry H. Bernstein, D.O.
Harvard Medical School

What Is the Doctor's Reaction?

No parent wants to hear that a child may have autism. This brain development problem starts early in life. It ranges from mild to severe.

Someone with autism has different behavior patterns, trouble with communication and poor social skills. There is still so much we do not know about autism.

Making the right diagnosis is not easy. Plus, if a young child does have a form of autism, what is a good way to treat it?

Research reported this month in the journal Pediatrics shows the importance of specialized treatment early in an autistic child's development.

In the study, this special treatment was done by trained professionals. The children focused on communicating through words, behavior and in other ways. Therapy reinforced:

• Eye contact
• Correct speech
• More parent-child contact

Only 48 toddlers were studied at the University of Washington Autism Center. Children were 18 to 30 months of age and diagnosed with some form of autism. They were divided into two groups:

• Half received 25 hours of therapy per week (20 led by a therapist and 5 led by a parent).
• Half did not receive any special treatment.
• All parents could use the community resources generally available to help autistic children.

After two years, the specialized treatment group showed:

• An average 18-point increase in IQ
• A new diagnosis, with a milder form of autism, in 3 out of 10 children

Those who did not receive special treatment showed:

• Only an average 7-point increase in IQ
• A new diagnosis of milder autism for 1 out of 20 children

In sum, after two years, toddlers who received the special therapy showed fewer symptoms and a milder form of autism.

These early results show so much promise that other study sites across the United States have been added. They will collect more data using the same treatment plan.

What Changes Can I Make Now?

None of the toddlers in this study were "cured" from autism. But there is much hope for autistic children to improve and keep up with their peers.

Research about autism is important.

• About 1 child out of 150 is diagnosed with some form of autism each year.
• Autism costs the United States billions of dollars each year.
• Autism seems to be less severe with early detection and therapy.

Autism is a common disorder of:

• Behavior
• Social skills
• Communication

Symptoms to look out for are:

• Repetitive behaviors (for example, hand flapping or rocking)
• Delayed language skills
• Delayed fine motor skills
• Lack of eye contact
• Anti-social behavior

The causes of autism are not known. Autism symptoms first occur at different times and in different ways during childhood.

There are a lot of myths about the causes and treatment of autism. Autism has been incorrectly linked to vaccines. Parents need to know that:

• The combination measles-mumps-rubella (MMR) vaccine does not cause autism.
• The mercury-containing preservative thimerosal does not cause autism.
• A baby receiving so many vaccines early in life does not cause autism.

Many doctors are screening for autism at younger ages. You can help by observing your child's behavior. If you ever have any concern about autism in your child, make sure you speak with your child's doctor about it.

Autistic children need to receive appropriate care and help with learning as soon as autism is suspected. Diagnosis and management should keep each child's development and personality in mind. There is also support for children diagnosed with a form of autism in schools and communities.

What Can I Expect Looking to the Future?

Autism is complex and involves many areas of the brain. It is a hot area of research.

More studies will look at how early diagnosis and treatment help children, and which specific programs best help them in the long run.

Specialized treatment is expensive. Advocates for children with autism are exploring how to make treatment available for all children.

Researchers also are studying diet changes, herbal medicines and other complementary treatments that some people believe may help autistic children. There is not enough information now to recommend these treatments. Indeed, some can be dangerous or have serious side effects.