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Early Autism Intervention Can 'Normalize' Brain Activity

A new national study has found that intensive early intervention therapy effective at improving young children's cognition and language skills can normalize the brain activity of those with autism.

The Early Start Denver Model also has been shown to decrease autism symptoms and improve social skills, researchers found in the study published Friday in the Journal of the American Academy of Child & Adolescent Psychiatry.

The randomized, case-controlled, multi-centered study found that children who received the intervention showed greater brain activation when viewing faces rather than objects, a response typical of the normal children in the study, and the opposite of the children with autism who received other interventions.

The Early Start Denver Model was developed by Sally Rogers, professor of psychiatry and behavioral sciences and a researcher with the University of California Davis' MIND Institute, and Geraldine Dawson, the chief science officer of the research and advocacy organization Autism Speaks. The therapy combines play-based, developmental, relationship-based approaches and the teaching methods of applied behavioral analysis.

"This may be the first demonstration that a behavioral intervention for autism is associated with changes in brain function as well as positive changes in behavior," said Thomas R. Insel, director of the National Institute of Mental Health, which funded the study, in a written statement. "By studying changes in the neural response to faces, Dawson and her colleagues have identified a new target and a potential biomarker that can guide treatment development."

The researchers recruited 48 diverse male and female children diagnosed with autism who were between 18 and 30 months old in Sacramento, Calif., and in Seattle, as well as typically developing children. The ratio of male-to-female participants was more than 3-to-1, reflecting the prevalence of autism among boys—five times that of girls.

Half the children with autism were randomly assigned to receive the Early Start Denver Model for 20 hours a week over the course of two years. Their parents also were trained to deliver the treatment, which is a core feature of the intervention. The other half of children with autism in the study received similar amounts of various community-based interventions as well as evaluations, referrals, resource manuals, and other reading materials.

Then the children's brain activity was measured while they watched faces and toys. Earlier studies have found that typical infants and young children show increased brain activity when viewing faces and other social stimuli versus objects, while children with autism show the opposite.

But in the study, twice as many children who received the Early Start Denver Model intervention showed greater brain activation when viewing faces rather than when viewing objects, demonstrating normalized brain activity, the researchers said. Eleven of the 15 children who received the ESDM intervention showed more brain activation when viewing faces than toys, compared to 12 of the 17 typically developing children. Meanwhile, the majority of children with autism receiving a different intervention showed the typical autism pattern: a greater response to toys than faces.

In addition, the children receiving the ESDM who had greater brain activity while viewing faces also had fewer social-pragmatic problems and improved social communication, including the ability to initiate interactions, make eye contact and imitate others, said MIND Institute researcher Rogers.

A study published in 2009 found that Early Start Denver Model recipients showed more than three times as much gain in IQ and language than the recipients of community interventions.

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