Early Autistic Interventions: The Best Methods

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Early autistic interventions are the best way to support your child’s behavioral, cognitive, communication, and social development when they are diagnosed with autism.

Thanks to advances in diagnostic criteria, most children are diagnosed by pediatricians around 2 years old. This means they can get early intervention from applied behavior analysis (ABA) therapists, who use an evidence-based approach to help children manage symptoms of autism so they can be as independent as possible.

Some children with autism may also need physical therapy, occupational therapy, speech therapy, social skills therapy, or other approaches to medical treatment. Some may need prescription medications for conditions that are associated with autism, like being at a higher risk of seizures.

There are some nonmedical treatments that may help, especially dietary and nutritional support. However, these should never be used in place of medical treatment, which is most often focused on behavior therapy.

Early Autistic Interventions: Children Benefit Most From Behavioral Therapy

Since autism is a developmental disorder, there is no cure for the condition.

Diagnostic criteria continue to improve, so pediatricians are able to diagnose children based on behaviors and learning challenges that appear between 6 months to 4 years old. More children are being diagnosed around 2 years old, on average, which means they are able to get behavior therapy and other early autistic interventions.

The goal of early autistic interventions is to help children on the autism spectrum gain the skills that their neurotypical peers often acquire around 2 or 3 years old. These include:

  • Physical strength and coordination.
  • Thinking skills, including planning and problem-solving abilities.
  • Communication skills, both verbal and nonverbal.
  • Social skills.
  • Emotional skills.

There are several options to help children who are diagnosed on the autism spectrum. Behavior therapy, often with an applied behavior analysis (ABA) therapist, is the front line of treatment.

Complementary treatments can support ABA therapy, so you may consider these options to help your child. Generally, there are four approaches to autism treatment, which are

  1. Medical interventions, focused on behavior and communication therapy.
  2. Medication for related conditions.
  3. Dietary and nutritional approaches.
  4. Complementary and alternative medicine approaches.

Since the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), autism has been listed as autism spectrum disorder. This helps clinicians like pediatricians understand that each child has a unique set of behaviors, symptoms, challenges, and strengths, which will determine whether they fall into one of three levels of autism severity.

A treatment plan starting with behavior therapy will be created based on what type of medical interventions your child will need. You can also discuss nonmedical interventions with your child’s pediatrician and ABA therapist once you begin a medical treatment plan.

Medical Treatment to Manage Symptoms of Autism

The best fundamental medical intervention for most people with autism is behavior therapy. ABA therapy is an evidence-based practice that uses a range of techniques to support a child’s improvement in socializing, communicating, and learning. These are skills that can be developed with assistance. If a child receives early ABA therapy, they will have more support in building these skills.

Among the specific early autistic interventions that are part of ABA therapy, your child may benefit from:

  • Early intensive behavioral intervention (EIBI). This type of behavior therapy is designed for children younger than 5 years old, and it is most often part of treatment plans for children younger than 3 years old. EIBI relies on a highly structured approach, teaching positive behaviors like social interaction and communication while reducing unwanted behaviors like emotional tantrums, self-injurious behaviors, and aggression toward others. Therapists work individually with children, so each child receives personal attention from their ABA specialist. Recent studies show that after receiving EIBI therapy, children with autism showed improvements in adaptive behaviors. Secondary effects included improved IQ, along with expressive and receptive language skills. However, one study’s authors reported that evidence in favor of EIBI as the main form of intervention was weak, and more studies on its effectiveness were needed.
  • Early Start Denver Model (ESDM). This is another approach designed for very young children with autism, who are diagnosed between 12 and 48 months old. The program uses playtime and games, with both therapists and parents, to support children in learning better social interactions, more language use, and improved cognition. Joint interactions on a regular basis, which are fun and rewarding for the child, support ongoing growth in these areas. Dozens of studies have been conducted on ESDM’s effectiveness over the years, looking at improvements in both individual children with autism and groups of children in special education classes, finding that ESDM could work for younger children in a variety of settings based on personal need. More current studies using brain scans have found that ESDM changes some brain activity associated with communication and social skills, which means it is one of the more effective and scientifically based approaches to early autistic interventions.

Other medical treatments may include:

  • Prescription medications. These include options to reduce the risk of seizures, which may be more common in some people with autism.
  • Assistive technology. This may include communication boards or electronic tablets with text-to-speech systems.
  • Speech therapy. This therapy can improve speech impediments or strengthen muscles in the mouth that may struggle to form words otherwise.
  • Occupational therapy. This therapy teaches independent living skills like hygiene, house cleaning, and meal preparation tasks.
  • Physical therapy. This can improve muscle tone and balance, teach exercise habits, and support healthier overall bodies, since many people with autism struggle with strength.
  • Social skills therapy. This can be used with ABA therapy or separate from it, focusing on specifically how to interact with other people, including for problem-solving or conversation.

Behavior therapy is the best first step in treatment. An ABA therapist may recommend that your child receive additional medical approaches, like those listed above.

While nutritional and dietary support for autism are being studied more closely, it is unlikely that your ABA therapist or pediatrician will recommend that your child receive complementary or dietary support in conjunction with medical treatment. If you are interested in these approaches, you can work with your child’s care team to discuss which treatments might work best and how these can support your child’s development. It is important to start with evidence-based medical treatment first, however.

Nonmedical Early Autistic Interventions Can Support Medical Interventions

The most popular approach to nonmedical early autistic interventions is nutritional or dietary support. This approach stems from many children with autism having feeding problems, including food refusal, food avoidance, extremely limited diets, struggles with changes around mealtimes, and a higher rate of gastrointestinal disturbances than their neurotypical peers.

Medical studies show that children with autism often have higher rates of gastrointestinal problems, including constipation, diarrhea, and upset stomach. Some research suggests that wheat protein (gluten) and milk protein (casein) can contribute to these problems.

Some parents are encouraged to put their children on gluten-free, dairy-free diets. Anecdotally, this approach does seem to help some children with autism feel better, get better nutrition, try new foods, and eat a wider range of foods. There is not a consensus on this approach, however, and parents should be wary of changing their child’s diet without first consulting a doctor.

Since many children with autism struggle with food avoidance or rejection, giving them a dietary supplement can support their physical health in the short term. You can then work with a behavior therapist to help your child overcome “picky eating” so they can become healthier adults. Dietary supplements may include important vitamins and minerals like:

  • B12.
  • Vitamin D.
  • Vitamin C.
  • Omega-3 fatty acids.
  • Probiotics and digestive enzymes.
  • Folic acid.

Even if your child benefits from taking a dietary supplement and going gluten-free and dairy-free, it is best to continue with nutritional support. This often includes working with a nutritionist and ABA therapist to reduce your child’s food avoidance and rejection. Adding healthy foods like fruits, vegetables, whole grains, and lean meats to your child’s diet will keep them healthier overall, even if you continue to use additional dietary supports.

Some research suggests that children with autism who receive dietary supplements still end up struggling with nutritional deficiencies because they do not get the care and support they need to expand their diet. Eating whole foods is the best way to get proper nutrition, but children with autism need help to do this.

Other complementary or alternative medicine treatments, like yoga, massage, aromatherapy or essential oils, acupuncture, and other specialty treatments, might work for some, but they should never replace medical treatment. If you are interested in more information on how complementary medicine might work for your child, work with your ABA therapist and pediatrician.

What to Do When Early Intervention Isn’t an Option

Research is still being conducted on how effective interventions are for adolescents and adults who are diagnosed with autism later in their lives. People who are not diagnosed around 2 years old often have a milder form of autism, and they may have developed their own coping mechanisms for communication or learning problems. They may seek treatment on their own for depression or anxiety instead of autism. They may even self-diagnose as autistic before a medical professional can assess and diagnose their symptoms.

While there is no question that early intervention results in the best long-term results, people of any age can benefit from therapy. Teens and adults often participate in ABA therapy, seeing improvements in skills and reductions in negative behaviors. Reach out to a professional to be assessed, so you can get appropriate treatment.

References

Treatment and Intervention Services for Autism Spectrum Disorder. (September 2019). Centers for Disease Control and Prevention (CDC).

Early Intervention for Autism. (January 2017). Eunice Kennedy Shriver National Institute for Child Health and Human Development.

Early Intensive Behavioral Intervention (EIBI) for Young Children With Autism Spectrum Disorders. (May 2018). Cochrane Library.

Early Start Denver Model (ESDM). Autism Speaks.

Gastrointestinal Problems in Children With Autism, Developmental Delays or Typical Development. (May 2015). Journal of Autism and Developmental Disorders.

Dietary Supplement for Core Symptoms of Autism Spectrum Disorder: Where Are We Now and Where Should We Go? (August 2017). Frontiers in Psychiatry.

For Kids With Autism, Supplements Often Result in Nutrient Imbalances. (June 2015). Autism Speaks.