60 Minutes Explores Research on Ultra-Early Intervention for Autism - But at What Cost?
Saturday February 17, 2007
MIND is a research institute focused on autism studies. They've done some groundbreaking work, and are presently involved with a massive study that is attempting to parse out what seem to be several completely different types of autism. Meanwhile, they are working on a project focused on early detection - and it is that research which will be highlighted this Sunday night on CBS's 60 Minutes. Says the CBS Website:
Researchers at the University of California's MIND Institute in Davis believe that if they can accurately diagnose children early, they might actually be able to intervene and change the way a child's brain develops. 60 MINUTES will take a closer look at the subject in this week's show (Sunday, Feb. 18, 7PM ET/PT on CBS)....[according to researcher Dr. Sally Rogers] ""[By using early treatment] we are certainly creating new connections in the brain...We don’t know how to touch the biology of autism. But I do think that the behaviors associated with autism can be reduced to the point where they are not obvious anymore."I'm certainly interested in seeing this program, and learning more about what the MIND Institute is up to. But I'm also concerned about the message this type of research is spreading. IS early intervention more effective than later intervention?
From the point of view of parents, it certainly is preferable to treat a child while he's young. After all, it's a whole lot more practical to provide intensive, 1:1 therapy to a toddler with the hope that he will appear "normal" by age 5 than it is to provide similar therapy to an obviously autistic 12-year-old. But so far, no one seems to know whether early intervention is more effective at treating autism than later intervention.
By pushing earliest-possible intervention with the idea that there is a "window of opportunity" for treatment that closes at some magical age, we are opening the window to some signicant problems.
- First, we're fueling the panic that parents feel when their child is first diagnosed - that panic that leads parents to frantically grab any available therapy at any price.
- Second, we're fueling the anxiety that hits all new parents as they anxiously watch their infant for signs of "normal" development. Children develop at different speeds - but with intensified vigilance, we run the risk of pathologizing normal differences.
- Lastly, we're running the risk of subjecting infants and toddlers who just happen to be developing slowly to therapies which could negatively impact their development. Child development experts are very clear that pretend play, down time, and plenty of peer interaction are important for typical development. Take a typical child with slow-developing speech or eye contact and subject him to 40 hours a week of 1:1 therapy with an adult - and you run the risk of seriously damaging that child.
For more on early intervention, you may want to read:
Comments
The 60 minute program is on CBS not ABC
That isn’t the correct station listed
I do think that there needs to be a sense of urgency when diagnosing and treating autism. I believe the brain is still forming at a young age and that early intervention can make an extreme difference in autism. I have seen children with severe autism with good early intervention over three or more years become higher functioning. I think for too long doctors have been saying to wait and see and it is to the detriment of the child. They did it to me with my son and it is unacceptable.
Parents who didn’t know can’t beat themselves up over it, but if you know your child is autistic, do something about it immediately. So do not allow your toddler to get deeper into their silence, Slowly force them to communicate, encourage eye contact. It will make a huge difference.
thanks so much for your comment! just as an fyi, the brain actually does continue to form and change throughout life. this is why, for example, it’s possible for a stroke victim to recover use of limbs and speech by “rewiring” different parts of the brain to take over for damaged portions.
research shows that the typical brain is MOST plastic during a child’s youngest years. what hasn’t been shown, however, is whether the plasticity of the very young brain translates into better outcomes for autistic children who receive intensive therapy as toddlers or preschoolers.
Certainly, early intervention is more likely than later intervention to result in early improvements - and that translates into more typical school and community settings. And that’s clearly of real importance.
But saying that is not the same thing as saying “if you miss the early intervention window of opportunity you’ve lost the ability to help your child.” And that’s the issue that concerns me: parents being told and/or believing that it’s “now or never!”
Better to be a little rushed than to adapt a “wait and see” attitude and waste important time. And c’mon, if you are a professional in this field you know it’s the most important time.
My son was diagnosed as having PDD/NOS largely due to his lack of communication, weak motor skills and repetitive behaviors when he turned 4.
He qualified for special education in the public schools, but we opted to keep him in a private 2x/week preschool program with mainstream children. We placed him in private speech along with tumbling, piano and I quit my school counseling career to give him the attention he needed at home. We are suffereing financially but I know that early intervention saved his life.
I think it is ABSOLUTELY ridiculous to provide a public school system where all the autistic children are placed and learn in the same classroom. That is the best our government can provide for a free and fair education. Give me a break!!! I know that if I made the decision to throw my son at the public school system that he would not have made the progress that we see today.
With a lot of prayers and a lot of work, my son is talking and he doesn’t seem to have as many tics. He just turned 5, and I am now waiting to see how he is going to survive in school. His receptive and expressive language still needs more work.
I don’t know…that is the scary part. I don’t go a day without worrying about his future. What is happening to our children? I told my husband that I was going to return to college for my doctoral degree so that I could do the research myself.
My opinion may offend some people and I am sorry. I think we are having kids as a convenience in our our materialistic society. Our young kids are not being held enough, read to enough, and are somewhat “institutionilized” way too early. I am guilty of it. I didn’t quit my job until he was 3 years. Could I have helped him more if I gave him the same attention earlier, say 2 or 3…probably?
What concerns me is that all of the attention seems to be focused on early intervention and not much on helping older kids. My child is a teenager and we have over the years done everything that we thought would help. We didn’t get a diagnosis confirmed until she was four, which to listen to some of today’s comments is too late for much early intervention.
The danger to me in putting all the attention on early intervention is that it leaves a large number of older autistic kids out of the picture. My daughter has improved as she has gotten older, but we still have a long way to go and I’m not hearing much about what is going to be done to help the increasing number of teen and young adults with autism.
I don’t think we need to forget that there is always an opportunity for these children to improve if they have the right resources available.
THANK YOU Lisa for your commentary!
I think it is insane to subject ANY toddler/preschooler (Under the age of 5) to 40 hours a week of anything autism or not. This just IS NOT DEVELOPMENTALLY APPROPRIATE!
I also agree we could be subjecting children who just develop a little differently to way too intense interventions that could have a negative impact.
I have kept up with the research and from what I have read it has been proven that children diagnosed with Autism only need 20 to 25 hours a week of one on one. That there is NO DIFFERENCE between the in the gains made in a child in who gets 40 hours week or a child in 25 hours of one on one intervention.
I too worry about parents grasping at ANY intervention.
I work in the field and I tell parents that the most important thing is for them to choose an intervention based on their child’s personality and their OWN parenting philosophy. To do that you must read up on all the available interventions and not just take the word of some professional who has spent a few hours evaluating your child. You don’t need to be an expert in Autism, you only need to be an expert in your own child.
What parent isn’t that?
Yes early intervention is important but let’s wait until we know something is truly wrong.
By the way I have a 21 year old son with Autism who would have been better off with earlier intervention (he didn’t get 25 hours a week until a few months before he turned 5)
But he also would have been better off if he had gotten the RIGHT intervention for him! We just didn’t know any better at the time.
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