Very Early Intervention therapy said to be “breakthrough”

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carlos55
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21 Sep 2021, 2:06 am

Just when you think you’ve seen the back of something it comes back swinging. Latest research claims autism can be prevented by parents interacting with their babies.

Not sure how these findings add up they are all over the UK news this morning in every paper.

Many autistic kids have complex mitochondrial and auto immune problems that I don’t see fixed by interaction.

Besides most babies aren’t dumped in a cot like in a Romanian orphanage.

Either way looks like a return of mom blaming and will be a huge boost to the ABA industry around the world.

https://www.theguardian.com/society/202 ... evelopment

Quote:
Autism therapy aimed at infants may reduce likelihood of later diagnosis
Study suggests tailored therapy could help some children develop social skills before school age
Close-up of boy drawing with chalks
Ian Sample Science editor
@iansample
Mon 20 Sep 2021 16.40 BST
Doctors have shown for the first time that a new therapy aimed at infants can reduce autistic behaviour and the likelihood the children will go on to be diagnosed with autism before they reach school age.

Infants who received the therapy after displaying early signs of potential autism, such as avoiding eye contact and not responding to their name, were one-third as likely to have autism diagnosed at the age of three, compared with those who had standard care, the researchers found.

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The findings suggest intervening in the first year of life, when autism may be suspected but far from certain, can boost social development in autistic children, with long-term beneficial knock-on effects for their broader lives.

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“This is the first worldwide evidence that a pre-emptive intervention can reduce autism behaviours and the likelihood of a later diagnosis,” said Prof Jonathan Green at the University of Manchester.

“We think this is a landmark finding because it suggests intervention at this early time can have this substantial effect. It may well change the way services provide support to a large number of children worldwide.”

The international research team, led by Prof Andrew Whitehouse at the University of Western Australia in Perth, assessed 104 infants aged nine months to 14 months who had come to the attention of community healthcare services after displaying early signs of autism. While one half was randomly assigned to have routine care, the other received 10 sessions of therapy over five months. All were reassessed for autism behaviours at 18, 24 and 36 months.

In the therapy sessions, parents were videoed playing with their children. A therapist then reviewed the footage with the parent and helped them understand the different ways their child was trying to communicate, and how they might better engage the child. The aim was to strengthen the connection and improve the “back and forth” between parent and child, to help the infant develop their social communication skills.

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Writing in the journal Jama Pediatrics, the researchers describe how the therapy appeared to reduce some autism symptoms, a change that largely remained until the children turned three. At that point, independent clinicians assessed each of the children. While one-fifth who received standard care received an autism diagnosis, only 6.7% of those who had therapy did.

According to the study, the children scored better on social interactions but also on other symptoms, such as repetitive movements and unusual reactions to senses such as smell and taste. Further follow-up is needed to see if the therapy merely delays diagnosis or prevents it in some children.

The researchers stress that the therapy is not a cure for autism. Many of the children still had significant developmental problems when they turned three at the end of the study. But the findings suggest a tailored therapy may at least help some infants to develop their social skills before they reach school age.

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“The clinical impact that could be immediate is really gobsmacking,” said Whitehouse. “To date, no therapy has shown such positive effects on development that it has influenced child’s diagnostic outcomes.

“For this reason, the therapy has the very real potential to change how we provide support to children developing differently. At its most basic, this is a change from ‘wait and see’ to ‘identify and act’ – a new clinical model that could transform support for families.”

But the study raises serious questions about how autism services should be provided. Some children who improve on the therapy may still need specialist care but no longer qualify if they are not formally diagnosed. Green said the findings “highlight the flaws in the system”, adding that services should be designed around need, not diagnosis.

Tim Nicholls, the head of policy at the National Autistic Society, said the work had some positives but criticised the researchers for the lack of community involvement


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ASPartOfMe
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21 Sep 2021, 8:26 am

Groundbreaking WA study shows early intervention therapy can drastically reduce autism diagnosis in children

Quote:
Early intervention with infants at risk of autism through therapy led by their parents improves the child's social development to such an extent they are two-thirds less likely to meet the clinical criteria for an autism diagnosis, according to world-first research by the Telethon Kids Institute.

Advocacy group Autism Awareness said the research signaled the need for a complete rethink of early childhood approaches to autism "to give our children a chance to have their best outcome in life

The international research team, which included WA's Child and Adolescent Health Service, La Trobe University, University, the University of Western Australia and the University of Manchester, was led by Telethon Kids Institute Professor Andrew Whitehouse, who described the findings as a true breakthrough moment.

It was a four-year clinical trial with 89 infants aged from 9-14 months. Over five months, half received the intervention and half did not.

Professor Whitehouse said most therapies or interventions for autism tried to replace or shape the developmental differences in children with more "typical" behaviours.

They took the opposite approach.

What we wanted to do was to identify the unique behaviours of each and every baby and use those strengths as a foundation for future development," Professor Whitehouse said.

They videotaped the parents and children playing and interacting and then gave them feedback on the unique way their child was communicating, to help the parents interact with their children.

They wanted to boost the back-and-forth communications between the parent and the child as the building blocks for brain development.

"What we're doing is helping give the parents the secret as to how their baby's communicating with them through their body, through their face, through their vocal expressions and how they can best communicate back to get those back and forth interactions to build the brain," Professor Whitehouse said.

The children who received our therapy, they were two-thirds less likely to meet criteria for autism.

Autism Awareness chief executive Nicole Rogerson said the research demonstrated how much good could be achieved from this form of early intervention.

"What this research has shown is what a limited amount of work very early that could be done could have a radical change for these children and their ultimate outcome," she said

"This research shows us we have to look at early childhood completely differently. We can't wait until children are three or four years old to see where they are developmentally

The researchers stressed parent-child interactions were not the cause of autism and parents were not to blame in any way, rather children were born with a developmental vulnerability that was related to genetics.


Effect of Preemptive Intervention on Developmental Outcomes Among Infants Showing Early Signs of Autism A Randomized Clinical Trial of Outcomes to Diagnosis - JAMA Pediatrics

First of all if their therapy really causes the child not to meet the diagnostic criteria that they would have sans therapy they cured the child. Too contentious a word to use I guess.

Focusing on improving communication with parents rather then changing behaviors is a better way. The issue with this study is was for 4 years meaning the children were around 5 years old when study ended. The parents and child might understand each other but once they start mainstream schooling that is no guarantee their teachers and classmates probably will. In which case they have cured nothing.


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carlos55
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21 Sep 2021, 2:39 pm

I mentioned this on another thread it’s in the UK news too so it’s a huge announcement they want to push, but not particularly great news, as it will be used to blame and guilt mothers who supposedly didn’t do enough early intervention. It will also promote the money grabbing more so-called early intervention AKA ABA therapy rather than addressing the real micro biology reasons that has been found to have an extremely negative effect on autistic people like mitochondrial & auto immune dysfunctions. :(

Many ND advocates are probably just waking up to the fact that this is a devastating blow to the neurodiversity movement, since not only is there now official scientific evidence that autism can possibly be prevented, but one of the cornerstones of the movement was the abolishment of ABA therapy.

Now ABA proponents will smugly cite this research while saying early intervention ABA works, here’s the proof we need more of it please around the world.


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21 Sep 2021, 6:32 pm

While it shares the idea of early intervention it is not ABA.

Quote:
Professor Whitehouse said most therapies or interventions for autism tried to replace or shape the developmental differences in children with more "typical" behaviours.

They took the opposite approach.

What we wanted to do was to identify the unique behaviours of each and every baby and use those strengths as a foundation for future development," Professor Whitehouse said.

ABA practitioners want to extinguish(their own word) autistic behaviors. What the Professor is describing is what ND people have been advocating in lieu of ABA. Therapy building on autistic behaviors that makes a person lose their diagnosis ie cure them seems incongruous.

This is not a new approach. Son-Rise therapy has been around since the 70s. That therapy has parents getting down on the floor with the children and stimming with them. Supporters of Son-Rise claim their therapy recovers ie. another way of saying cure autistics. A similar seeming incongruity.


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21 Sep 2021, 6:55 pm

a way to cure a genetic disorder by inducing a external stimulus : that is Autism .
Seriously people will publish anything these days .


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21 Sep 2021, 9:19 pm

ASPartOfMe wrote:
First of all if their therapy really causes the child not to meet the diagnostic criteria that they would have sans therapy they cured the child.

Not quite. In all likelihood the child still has other underlying neurological issues/differences, even if they no longer manifest in ways that meet the specific criteria for "autism." Indeed, according to the Guardian article Autism therapy aimed at infants may reduce likelihood of later diagnosis, "Many of the children still had significant developmental problems when they turned three at the end of the study." So these kids are still neurodivergent even if no longer "autistic" per se.


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22 Sep 2021, 12:46 am

More ableist BS from the PNT's


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Mona Pereth
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22 Sep 2021, 2:23 am

It appears that you may be misunderstanding this "therapy" and the claims of the researchers. See the separate thread Very Early Intervention therapy said to be “breakthrough”.

Look again at a key paragraph in the above-quoted article: "The researchers stress that the therapy is not a cure for autism. Many of the children still had significant developmental problems when they turned three at the end of the study. But the findings suggest a tailored therapy may at least help some infants to develop their social skills before they reach school age."

This is NOT "refrigerator moms" as cause of autism -- although I can see why it might look that way at first glance.

Also, this is NOT ABA.

But a big potential problem is the following:

"But the study raises serious questions about how autism services should be provided. Some children who improve on the therapy may still need specialist care but no longer qualify if they are not formally diagnosed. Green said the findings “highlight the flaws in the system”, adding that services should be designed around need, not diagnosis."

Another problem I see: If these kids are still developmentally disabled or at least neurologically freaky in some way, but no longer fit a diagnostic label, then they have no way to access a community of similarly disabled/freaky peers. Hopefully someone will create a new category for these kids so they won't have to grow up feeling namelessly freaky.


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carlos55
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22 Sep 2021, 2:53 am

Mona Pereth wrote:
It appears that you may be misunderstanding this "therapy" and the claims of the researchers. See the separate thread Very Early Intervention therapy said to be “breakthrough”.


I know it’s not ABA

But..

It represents a decisive victory for early intervention proponents AKA ABA.

They’ll just piggy back on these findings with a 1/2 approach the reported therapy for babies followed by ABA for school age kids.

It will supercharge the industry.

A cornerstone of the ND movement was the abolishment of ABA.

NT Parents and experts were not interested in the “natural difference” of autism or old abuse stories so they used to say ABA doesn’t work as a more effective strategy.

However as mentioned the industry will just cite the effectiveness of early intervention with scientific evidence to back that up.

Unfortunately for ND they have just decisively lost the ABA battle just that some don’t realize yet.


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22 Sep 2021, 4:16 am

Mona Pereth wrote:
ASPartOfMe wrote:
First of all if their therapy really causes the child not to meet the diagnostic criteria that they would have sans therapy they cured the child.

Not quite. In all likelihood the child still has other underlying neurological issues/differences, even if they no longer manifest in ways that meet the specific criteria for "autism." Indeed, according to the Guardian article Autism therapy aimed at infants may reduce likelihood of later diagnosis, "Many of the children still had significant developmental problems when they turned three at the end of the study." So these kids are still neurodivergent even if no longer "autistic" per se.

I intended the quoted sentence to be cynical. I find the whole notion of determining who a person is at such a young age both ludicrous and harmful.

Velorum wrote:
More ableist BS from the PNT's

What does PNT stand for?


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carlos55
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22 Sep 2021, 7:38 am

ASPartOfMe wrote:
Mona Pereth wrote:
ASPartOfMe wrote:
First of all if their therapy really causes the child not to meet the diagnostic criteria that they would have sans therapy they cured the child.

Not quite. In all likelihood the child still has other underlying neurological issues/differences, even if they no longer manifest in ways that meet the specific criteria for "autism." Indeed, according to the Guardian article Autism therapy aimed at infants may reduce likelihood of later diagnosis, "Many of the children still had significant developmental problems when they turned three at the end of the study." So these kids are still neurodivergent even if no longer "autistic" per se.

I intended the quoted sentence to be cynical. I find the whole notion of determining who a person is at such a young age both ludicrous and harmful.

Velorum wrote:
More ableist BS from the PNT's

What does PNT stand for?


With respect to velorum without wanting to take words out of his mouth :-

predominant neurotype (PNT)


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22 Sep 2021, 7:47 am

Actually, the approach of establishing meaningful communication since early childhood is the way to go - and I believe many parents of undiagnosed and late diagnosed "high functioning" autistic people did exactly this, never thinking of it as "early autism intervention", only "caring for my baby the way they is".

The evaluation process of screening 5yos for classic autism symptoms is definitely lacking but I hope things like general mental health of these children 20-40 years from now - compared to recipients of other interventions and no interventions - will also be evaluated when it becomes possible.


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22 Sep 2021, 8:25 am

Just how much is this ableist therapy going to cost, anyway?  Is it covered by insurance?  Who can afford it?



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22 Sep 2021, 8:29 am

The way to do it.....is to do it in such a way where the child is having fun, rather than forcing the child to go beyond their "comfort zone."

This is something which could be rather difficult to pull off. But it certainly works if done correctly and in sort of a "gently maternal" manner.



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22 Sep 2021, 8:46 am

I know a woman who has designed treatment for autistic children, and think she used ABA, but what interested me is that she said most behavior problems were caused by an inability to communicate.

I find it interesting that when I meet any new client, with any disability, I move to their level. If they are on the floor, I get down on the floor. If they are in a wheelchair, I make sure wherever I sit, it is at or below their level. I also let the client communicate or do whatever suits them and that seems to be the most successful way of getting through to someone with autism, letting them know I accept them wherever they are. (This does not apply to truly dangerous autists, of which there are some.)

I've always thought that trying to teach people things they are not good at, it a program geared to failure. The program I work through always want goals to be about things the person cannot do. I've always thought it makes more sense to help people get better and things they are already good at, things they enjoy, things that improve their lives.

I think efforts to connect/communicate with babies or anyone is by getting to their level and recognizing how they communicate and what it is they want to say.


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22 Sep 2021, 9:07 am

The bottomless money pit of early intervention.

Many in the ABA industry will be very happy and pin a framed copy of this research to their reception wall and website.

Meanwhile more money will go into this neglecting more potentially treatable biological causes of disability.

Mothers will be partially blamed for their kids being autistic as it will be considered they obviously didn’t do enough early intervention or dumped their kid in a cot and neglected them instead of smiling or playing Peak A Boo.

Looks like back to the 50’s we come.


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