Aug
04

The average age of diagnosis for children with autism remains around 4 years of age in the United States, with children from historically underserved groups receiving a diagnosis over one year later than White children on average. However, we know that providing intervention as early as possible is critical to outcomes that deliver the best quality of life for children and their families as children with autism become adolescents and adults. Therefore, it is critical that early intervention providers recognize the social communication challenges in infancy and early childhood that may indicate a high likelihood of autism and begin using evidence-based interventions as early as possible, sometimes even before an official diagnosis is made. We now have many developmentally appropriate clinician- and caregiver-implemented intervention strategies to support developmental progress in children who may later receive an autism diagnosis.

Some highly recommended intervention strategies are grounded in applied behavior analysis (ABA), which has a strong evidence-base. However, autistic adults have recently raised strong concerns about the use of ABA-based therapy because of the perception that the focus is on compliance rather than learning and that using ABA strategies can be traumatizing for autistic individuals. Traditional ABA strategies developed based on the principles of learning in the late 1960s, were highly structured and often not developmentally appropriate and even used punishment as part of the teaching. Since those initial efforts at treatment, the field has made substantial progress and developed more appropriate strategies to support learning, especially in toddlers. Current state-of-the-art recommendations for early intervention call for a combination of developmental and behavioral strategies, delivered as early as possible, active involvement of caregivers in intervention, a focus on social communication needs and individualization based on family needs and culture. This is excellent news for early intervention providers who already focus on these areas.