Study finds early intervention with infants can help to support neurodiversity

Titled ‘Effect of Preemptive Intervention on Developmental Outcomes Among Infants Showing Early Signs of Autism’, the study is believed to be the first to find that preemptive intervention can have an impact on autism diagnoses.

Most of the time autism is not diagnosed until children reach three years old and supports for the children don’t begin until after diagnosis.

Lead researcher for the study Professor Andrew Whitehouse of the University of Western Australia and the Telethon Kids Institute, says the early intervention doesn’t seek to prevent autism, only to support the development of children from earlier on.

“The aim of the research was to find a safe and effective way to provide support to neurodivergent babies very early in life, when previously they may have received either no support, or support that could potentially lead to harmful outcomes,” Professor Whitehouse says.

“Autism cannot be ‘prevented’, and this is not an aim that the study authors believe in. 

“The babies remain neurodivergent, but they are not showing the same degree of developmental barriers that lead them to meet the ‘deficit focused’ DSM-5 diagnostic criteria of autism.”

The study involved about 100 children between the ages of nine and 14 months who were showing behaviours associated with a later diagnosis of autism.

Half of the children received preemptive intervention as well as their regular family and community care and the other half only received regular care, as a control group.

The preemptive intervention was conducted over five months through teaching parents and caregivers a specific model of positive parenting, based on filming them interacting with their child and feedback being given on how to build the child’s engagement based on their strengths.

“The therapy we tested, iBASIS-VIPP, is not delivered directly to the babies, but instead focuses on guiding parents as they seek to engage and support their child,” Professor Whitehouse says.

“Rather than trying to counter neurodivergence, the therapy seeks to help parents understand the unique skills and abilities of their baby, and how they can best engage in a way that makes their child feel perceived and understood. 

“Contrary to any sense of ‘opposing’ autism, this therapy cherishes neurodiversity by attending to and understanding it, giving equal opportunity to these babies for a social environment that is adapted and responsive to them as individuals.”

Assessments of the children were done at the beginning of the trial, at the end of the intervention sessions and when the children were two and three years old.

The children who had received the intervention showed improved social and communication skills in their final assessments and were less likely to meet the criteria for an autism diagnosis when they reached three years old.

“Rather than waiting until a diagnosis to start therapy – typically at two years of age at the earliest – we need to identify developmental differences as early as possible,” Professor Whitehouse says.

“Then we need to provide developmental supports that nurture each child’s strengths.”

Professor Whitehouse says it’s important to recognise that the study’s approach to early intervention is not the only support a child should receive and that there were system-wide changes which could be made to better support children.

“I want to emphasise that these babies still require support,” he says.

“Systems that provide access to support based on the presence or absence of a diagnosis are flawed, and can lead to children missing out on services that they desperately need. 

“The findings of our study provide clear evidence that we can be more effective in providing support by seeking to understand ‘who’ someone is, that is their strengths and challenges, rather than ‘what’ a child is, that is what diagnostic criteria they may meet. 

“System change requires evidence and advocacy. 

“We hope that the evidence provided in this study will be a powerful catalyst for that change.” 

Professor Whitehouse says a follow up of the children involved in the study later in childhood will help researchers to understand the long term impacts of the intervention, as children might meet different diagnoses as they get older.