Autism—What is the latest research telling us?
Failure to orient to social stimuli represents one of the earliest and most basic impairments in autism. Early intervention that address the basic social impairments is the most effective tool we have to provide optimum outcomes in children with autism.
What is Autism?
Statistical information from the Centers for Disease Control (CDC) indicates that the rate of autism is 1 in 36 children. ASD is a group of heterogeneous neurodevelopmental disorders that severely compromise the development of social relatedness, reciprocity, social communication, joint attention, and learning.
– Autism is not a disease
– Autism is a disorder affecting the immature developing brain
– Etiology has many Genetic influences
– Etiology has interacting environmental (epigenetic) influences
What we know about autism started with research on older adolescents and young adults. In recent years, more and more autism research has focused on infants and toddlers. Research in the last 10-15 years tells us that autism begins at birth with altered social engagement—a difference in the way a child “tunes in” and interacts with the people around him.
Failure to orient to social stimuli, or lack of “attunement”, represents one of the earliest and most basic social impairments in autism. From birth, typical babies are naturally drawn to people. It is different for our babies with autism. Brain studies have found that while typical infants and young children show increased brain activity when viewing people rather than objects, children with autism show the opposite pattern—they preferred objects. Children with autism do not seem to experience as much natural reward in social interactions as other children.
Attunement...
Attunement describes how reactive a person is to another’s emotional needs and moods. A person who is well attuned will respond with appropriate language and behaviors based on another person’s emotional state. When an infant/toddler is not tuning in to the people in their world—or engaging with the social world attunement does not develop typically.
Infant-caregiver attunement is the sharing of emotional experiences through the matching of expressions during dyadic face-to-face interaction between infants and caregivers. This is a human-unique strategy for social engagement. There is so much that happens in the first 6 months of life. Typically developing children tune into their parents from birth and here begins the back-and-forth communication dance. Toddlers that have or are suspected of autism miss this stage because they are not tuned in to people in the same way. In Pathways we teach the parent to go back and get these very early social communication skills, setting the stage to change the child’s developmental trajectory and help them become active participants in the world.
Diagnosis
In 2019 the American Academy of Pediatrics updated their Autism Guidelines stating: There is no reason to wait for a diagnosis of autism before starting intervention. Interventions work best when they are early, when they are intense, and when they involve the family. Children do not have to have a diagnosis to begin the Pathways program.
Until now people were hesitant about the stability of early diagnosis. A recent study, which made national news, should change that. The large-scale study, conducted at the University of California, San Diego, found evidence that an ASD diagnosis becomes stable starting at 14 months of age and overall is more stable than other diagnostic categories, including language or developmental delay.
It is important to understand how autism might affect a child’s development and how it differs from that of a typically developing child.
For example:
Instead of seeking out interaction with others and actively paying attention to the people in the environment, the child may seem to prefer to play alone and may not even notice some of the people in his world. The child may seem to pay more attention to objects or other unusual things like lights or patterns. Instead of consistently responding or turning when his name is called, the child may seldom or never respond. You may even wonder if the child has a hearing problem.
Instead of making a lot of different speech-like sounds and some words while looking at someone as if in conversation , the child may be very quiet or make a lot of noise but with a limited variety of sounds. Instead of saying words like “Mama” and “Daddy”, the child may label or repeat random words that seem to have no meaning or are not functional.
Instead of pointing, reaching to be picked up, waving bye-bye and shaking the head to say “no”, the child may be using few, if any, gestures to communicate. The child may not respond to gestures either—like looking when you point at something. Instead of showing and sharing things that are interesting or fun, the child may play with things alone or perform a similar routine with them over and over.
Instead of imitating the sounds and actions of others in back and forth social games that seem to bring joy and fun, the child may not copy the actions and sounds of others and may not smile or laugh when you attempt this type of play.
Instead of using eye contact to start a social exchange and looking at the communication partner during social interaction, the child may rarely make eye contact and may even avoid eye contact. Instead of using eye contact to request by looking back and forth between the communication partner and the desired object, the child may cry or tantrum without you even knowing what it is he wants.
Early Intervention
Early intervention that is designed to enhance social attention and engagement can change brain function in toddlers with autism. Research shows that this type of early intervention can make a significant difference in a child’s level of function by school age.
Autism-specific early interventions, like the Pathways Parent Training Program, address the core deficits of autism which will change the way a child tunes in and interacts with the social environment. This change can alter the child’s brain development toward a more typical learning and developmental trajectory and diminish autism symptoms. Because early intervention may activate typical processing mechanisms due to the plasticity of a child’s brain before age three, the capacity for learning and change is great. Autism specific early intervention has been shown to significantly increase social attention and engagement, thereby enhancing the development of cognitive and language skills of children with autism. Early intervention is the most effective tool we have to change the way these children learn—improving both brain and behavioral development.
