Journal of Autism and Developmental Disorders

, Volume 44, Issue 12, pp 2981–2995 | Cite as

Autism Treatment in the First Year of Life: A Pilot Study of Infant Start, a Parent-Implemented Intervention for Symptomatic Infants

  • S. J. Rogers
  • L. Vismara
  • A. L. Wagner
  • C. McCormick
  • G. Young
  • S. Ozonoff
Original Paper

Abstract

The goal of early autism screening is earlier treatment. We pilot-tested a 12-week, low-intensity treatment with seven symptomatic infants ages 7–15 months. Parents mastered the intervention and maintained skills after treatment ended. Four comparison groups were matched from a study of infant siblings. The treated group of infants was significantly more symptomatic than most of the comparison groups at 9 months of age but was significantly less symptomatic than the two most affected groups between 18 and 36 months. At 36 months, the treated group had much lower rates of both ASD and DQs under 70 than a similarly symptomatic group who did not enroll in the treatment study. It appears feasible to identify and enroll symptomatic infants in parent-implemented intervention before 12 months, and the pilot study outcomes are promising, but testing the treatment’s efficacy awaits a randomized trial.

Keywords

ASD Infants Early intervention Parents Early Start Denver Model 

References

  1. American Psychiatric Association (Ed.). (2000). Diagnostic and statistical manual-IV-TR. Washington, DC: American Psychiatric Publishing Incorporated.Google Scholar
  2. Barrera, M. E., Doucet, D. A., & Kitching, K. J. (1990). Early home intervention and socio-emotional development of preterm infants. Infant Mental Health Journal, 11(2), 142–157.CrossRefGoogle Scholar
  3. Brooks-Gunn, J., Liaw, F. R., & Klebanov, P. K. (1992). Effects of early intervention on cognitive function of low birth weight preterm infants. The Journal of Pediatrics, 120(3), 350–359.PubMedCrossRefGoogle Scholar
  4. Bryson, S. E., Zwaigenbaum, L., Brian, J., Roberts, W., Szatmari, P., Rombough, V., et al. (2007). A prospective case series of high-risk infants who developed autism. Journal of Autism and Developmental Disorders, 37(1), 12–24.PubMedCrossRefGoogle Scholar
  5. Bryson, S. E., Zwaigenbaum, L., McDermott, C., Rombough, V., & Brian, J. (2008). The autism observation scale for infants: Scale development and reliability data. Journal of Autism and Developmental Disorders, 38(4), 731–738.PubMedCrossRefGoogle Scholar
  6. Carter, A. S., Messinger, D. S., Stone, W. L., Celimli, S., Nahmias, A. S., & Yoder, P. (2011). A randomized controlled trial of Hanen’s ‘More Than Words’ in toddlers with early autism symptoms. Journal of Child Psychology and Psychiatry, 52(7), 741–752.PubMedCrossRefGoogle Scholar
  7. Chapman, R. S. (2000). Children’s language learning: An interactionist perspective. Journal of Child Psychology and Psychiatry, 41(1), 33–54.PubMedCrossRefGoogle Scholar
  8. Charlop-Christy, M. H., & Carpenter, M. H. (2000). Modified incidental teaching sessions: A procedure for parents to increase spontaneous speech in their children with autism. Journal of Positive Behavior Interventions, 2(2), 98–112.CrossRefGoogle Scholar
  9. Davis, N. O., Kuhn, J. C., & Carter, A. S. (2006). Children’s problem behaviors and self-efficacy among mothers of toddlers with autism. The moderating role of working alliance. Poster presentation, International Meeting of Autism Researchers; Montreal.Google Scholar
  10. Dawson, G., Osterling, J., Rinaldi, J., Carver, L., & McPartland, J. (2001). Brief report: Recognition memory and stimulus-reward associations: Indirect support for the role of ventromedial prefrontal dysfunction in autism. Journal of Autism and Developmental Disorders, 31(3), 337–341.PubMedCrossRefGoogle Scholar
  11. Dawson, G., Rogers, S., Munson, J., et al. (2010). Randomized controlled trial of the Early Start Denver Model: A developmental behavioral intervention for toddlers with autism: Effects on IQ, adaptive behavior, and autism diagnosis. Pediatrics, 125(1), e17–e23.PubMedCrossRefGoogle Scholar
  12. Dietz, C., Swinkels, S., van Daalen, E., van Engeland, H., & Buitelaar, J. K. (2006). Screening for autistic spectrum disorder in children aged 14–15 months. II: Population screening with the Early Screening of Autistic Traits Questionnaire (ESAT). Design and general findings. Journal of Autism and Developmental Disorders, 36(6), 713–722.PubMedCrossRefGoogle Scholar
  13. Diggle, T., McConachie, H. R., & Randle, V. R. L. (2002). Parent-mediated early intervention for young children with autism spectrum disorder. The Cochrane Database of Systematic Reviews, 2. doi:10.1002/14651858.CD003496.
  14. Ference, J., & Curtin, S. (2013). Attention to lexical stress and early vocabulary growth in 5-month-olds at risk for autism spectrum disorder. Journal of Experimental Child Psychology, 116(4), 891–903.PubMedCrossRefGoogle Scholar
  15. Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(5), 693–705.PubMedCentralPubMedCrossRefGoogle Scholar
  16. Green, J., Wan, M. W., Guiraud, J., Holsgrove, S., McNally, J., Slonims, V., et al. (2013). Intervention for infants at risk of developing autism: A case series. Journal of Autism and Developmental Disorders, 43(11), 2502–2514.PubMedCrossRefGoogle Scholar
  17. Hanft, B. E., Rush, D. D., & Shelden, M. L. (2003). Coaching families and colleagues in early childhood. Baltimore, MD: Brookes.Google Scholar
  18. Harris, S. L., Wolchik, S. A., & Weitz, S. (1981). The acquisition of language skills by autistic children: Can parents do the job? Journal of Autism and Developmental Disorders, 11(4), 373–384.PubMedCrossRefGoogle Scholar
  19. Johnson-Martin, N. M., Jens, K. G., Attermeier, S. M., & Hacker, B. (1991). The Carolina curriculum for infants and toddlers with special needs (2nd ed.). Baltimore: Brookes.Google Scholar
  20. Kasari, C., Gulsrud, A. C., Wong, C., Kwon, S., & Locke, J. (2010). Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. Journal of Autism and Developmental Disorders, 40(9), 1045–1056.PubMedCentralPubMedCrossRefGoogle Scholar
  21. Koegel, R. L., Bimbela, A., & Schreibman, L. (1996). Collateral effects of parent training on family interactions. Journal of Autism and Developmental Disorders, 26(3), 347–359.PubMedCrossRefGoogle Scholar
  22. Koegel, R. L., Glahn, T. J., & Nieminen, G. S. (1978). Generalization of parent-training results. Journal of Applied Behavior Analysis, 11(1), 95–109.PubMedCentralPubMedCrossRefGoogle Scholar
  23. Landa, R. J., Gross, A. L., Stuart, E. A., & Bauman, M. (2012). Latent class analysis of early developmental trajectory in baby siblings of children with autism. Journal of Child Psychology and Psychiatry, 53(9), 986–996.PubMedCentralPubMedCrossRefGoogle Scholar
  24. Laski, K. E., Charlop, M. H., & Schreibman, L. (1988). Training parents to use the natural language paradigm to increase their autistic children’s speech. Journal of Applied Behavior Analysis, 21(4), 391–400.PubMedCentralPubMedCrossRefGoogle Scholar
  25. Lloyd-Fox, S., Blasi, A., Elwell, C. E., Charman, T., Murphy, D., & Johnson, M. H. (2013). Reduced neural sensitivity to social stimuli in infants at risk for autism. Proceedings of the Royal Society B: Biological Sciences, 280(1758), 20123026.PubMedCentralPubMedCrossRefGoogle Scholar
  26. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Levanthal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic. A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.PubMedCrossRefGoogle Scholar
  27. Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3.PubMedCrossRefGoogle Scholar
  28. McEachin, J. J., Smith, T., & Lovaas, O. I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal of Mental Retardation, 97, 359–372.PubMedGoogle Scholar
  29. Messinger, D., Young, G. S., Ozonoff, S., Dobkins, K., Carter, A., Zwaigenbaum, L., et al. (2013). Beyond autism: A baby siblings research consortium study of high-risk children at three years of age. Journal of the American Academy of Child and Adolescent Psychiatry, 52(3), 300–308.PubMedCentralPubMedCrossRefGoogle Scholar
  30. Mullen, E. (1995). The mullen scales of early learning. Circle Pines, MN: American Guidance.Google Scholar
  31. Mundy, P., & Crowson, M. (1997). Joint attention and early social communication: Implications for research on intervention with autism. Journal of Autism and Developmental Disorders, 27(6), 653–676.PubMedCrossRefGoogle Scholar
  32. Ozonoff, S., Iosif, A. M., Baguio, F., Cook, I. C., Hill, M. M., Hutman, T., et al. (2010). A prospective study of the emergence of early behavioral signs of autism. Journal of the American Academy of Child and Adolescent Psychiatry, 49(3), 256–266.PubMedCentralPubMedGoogle Scholar
  33. Ozonoff, S., Young, G. S., Belding, A., Hill, M., Hill, A., Hutman, T., et al. (2014). The broader autism phenotype in infancy: When does it emerge? Journal of the American Academy of Child and Adolescent Psychiatry, 53, 398–407. PMCID: in progress.Google Scholar
  34. Ozonoff, S., Young, G. S., Goldring, S., Greiss-Hess, L., Herrera, A. M., Steele, J., et al. (2008). Gross motor development, movement abnormalities, and early identification of autism. Journal of Autism and Developmental Disorders, 38(4), 644–656.PubMedCrossRefGoogle Scholar
  35. Pan, B. A., Rowe, M. L., Singer, J. D., & Snow, C. E. (2005). Maternal correlates of growth in toddler vocabulary production in low-income families. Child Development, 76(4), 763–782.PubMedGoogle Scholar
  36. Resnick, M. B., Armstrong, S., & Carter, R. L. (1988). Developmental intervention program for high-risk premature infants: Effects on development and parent-infant interactions. Journal of Developmental and Behavioral Pediatrics, 9(2), 73–78.PubMedCrossRefGoogle Scholar
  37. Rogers, S. J., & Dawson, G. (2010). The Early Start Denver Model for young children with autism: Promoting language, learning, and engagement. NY: Guilford.Google Scholar
  38. Rogers, S. J., Dawson, G., & Vismara, L. (2012a). An early start for your child with autism: Using everyday activities to help kids connect, communicate and learn. NY: Guilford.Google Scholar
  39. Rogers, S. J., Estes, A., Lord, C., Vismara, L., Winter, J., Fitzpatrick, A., et al. (2012b). Effects of a brief Early Start Denver model (ESDM)-based parent intervention on toddlers at risk for autism spectrum disorders: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 51(10), 1052–1065.PubMedCentralPubMedCrossRefGoogle Scholar
  40. Rogers, S. J., & Vismara, L. (2014). Interventions for infants and toddlers at risk for autism spectrum disorder. In F. Volkmar, S. J. Rogers, R. Pelphry, & K. Paul (Eds.), Handbook of autism and developmental disorders (4th ed., pp. 739–769). Hoboken, NJ: Wiley.Google Scholar
  41. Rogers, S. J., Vismara, L., & Wagner, A. (2012). Infant start fidelity. University of California, Davis. Unpublished material.Google Scholar
  42. Ross, G. S. (1984). Home intervention for premature infants of low-income families. American Journal of Orthopsychiatry, 54(2), 263–270.PubMedCrossRefGoogle Scholar
  43. Sacrey, L. A. R., Bryson, S. E., & Zwaigenbaum, L. (2013). Prospective examination of visual attention during play in infants at high-risk for autism spectrum disorder: A longitudinal study from 6 to 36 months of age. Behavioural Brain Research, 256, 441–450.PubMedCrossRefGoogle Scholar
  44. Sanz, M. T., & Menendez, J. (1996). A study of the effect of age of onset of treatment on the observed development of Down’s syndrome babies. Early Child Development and Care, 118(1), 93–101.CrossRefGoogle Scholar
  45. Sanz-Aparicio, M. T., & Balaña, J. M. (2002). Early language stimulation of Down’s Syndrome babies: A study on the optimum age to begin. Early Child Development and Care, 172(6), 651–656.CrossRefGoogle Scholar
  46. Sanz-Aparicio, M. T., & Balaña, J. M. (2003). Early learning in psychomotor training of Down’s syndrome. Early Child Development and Care, 173(2–3), 317–321.CrossRefGoogle Scholar
  47. Schreibman, L., & Koegel, R. L. (1997). Fostering self-management: Parent-delivered pivotal response training for children with autistic disorder. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice. Washington, DC: American Psychological Association.Google Scholar
  48. Seifer, R., Clark, G. N., & Sameroff, A. J. (1991). Positive effects of interaction coaching on infants with developmental disabilities and their mothers. American Journal on Mental Retardation, 96, 1–11.PubMedGoogle Scholar
  49. Short, A. B. (1984). Short-term treatment outcome using parents as co-therapists for their own autistic children. Journal of Child Psychology and Psychiatry, 25(3), 443–458.PubMedCrossRefGoogle Scholar
  50. Simpson, J. A., Collins, W. A., Tran, S., & Haydon, K. C. (2007). Attachment and the experience and expression of emotions in romantic relationships: A developmental perspective. Journal of Personality and Social Psychology, 92(2), 355.PubMedCrossRefGoogle Scholar
  51. Sloper, P., Glenn, S. M., & Cunningham, C. C. (1986). The effect of intensity of training on sensori-motor development in infants with Down’s syndrome. Journal of Mental Deficiency Research, 30(2), 149–162.PubMedGoogle Scholar
  52. Smith, T., Groen, A. D., & Wynn, J. W. (2000). Randomized trial of intensive early intervention for children with pervasive developmental disorder. American Journal on Mental Retardation, 105, 269–285.PubMedCrossRefGoogle Scholar
  53. Smith, T., Scahill, L., Dawson, G., Guthrie, D., Lord, C., Odom, S., et al. (2007). Designing research studies on psychosocial interventions in autism. Journal of Autism and Developmental Disorders, 37(2), 354–366.PubMedCrossRefGoogle Scholar
  54. Steiner, A. M., Gengoux, G. W., Klin, A., & Chawarska, K. (2013). Pivotal response treatment for infants at-risk for autism spectrum disorders: A pilot study. Journal of Autism and Developmental Disorders, 43(1), 91–102.PubMedCentralPubMedCrossRefGoogle Scholar
  55. Tamis-LeMonda, C. S., & Bornstein, M. H. (1994). Specificity in mother-toddler language-play relations across the second year. Developmental Psychology, 30(2), 283.CrossRefGoogle Scholar
  56. Tomasello, M. (1992). The social bases of language acquisition. Social Development, 1(1), 67–87.CrossRefGoogle Scholar
  57. Vismara, L. A., Colombi, C., & Rogers, S. J. (2009). Can 1 hour per week of therapy lead to lasting changes in young children with autism? Autism: An International Journal, 13(1), 93–115.CrossRefGoogle Scholar
  58. Vismara, L. A., Young, G. S., & Rogers, S. J. (2012). Telehealth for expanding the reach of early autism training to parents. Autism Research and Treatment,. doi:10.1155/2012/121878.PubMedCentralPubMedGoogle Scholar
  59. Wallace, K. S., & Rogers, S. J. (2010). Intervening in infancy: Implications for autism spectrum disorders. Journal of Child Psychology and Psychiatry, 51(12), 1300–1320.PubMedCrossRefGoogle Scholar
  60. Wan, M. W., Green, J., Elsabbagh, M., Johnson, M., Charman, T., & Plummer, F. (2013). Quality of interaction between at-risk infants and caregiver at 12–15 months is associated with 3-year autism outcome. Journal of Child Psychology and Psychiatry, 54(7), 763–771.PubMedCrossRefGoogle Scholar
  61. Wetherby, A., & Prizant, B. (2002). Communication and symbolic behavior scales developmental profile (1st ed.). Baltimore, MD: Paul H. Brookes.Google Scholar
  62. Zwaigenbaum, L., Bryson, S., Rogers, T., Roberts, W., Brian, J., & Szatmari, P. (2005). Behavioral manifestations of autism in the first year of life. International Journal of Developmental Neuroscience, 23(2), 143–152.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • S. J. Rogers
    • 1
  • L. Vismara
    • 2
  • A. L. Wagner
    • 3
  • C. McCormick
    • 1
  • G. Young
    • 1
  • S. Ozonoff
    • 1
  1. 1.MIND InstituteUniversity of California, DavisSacramentoUSA
  2. 2.York UniversityTorontoCanada
  3. 3.University of CaliforniaDavisUSA

Personalised recommendations