Early Intervention for Children With Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research

Author:

Zwaigenbaum Lonnie1,Bauman Margaret L.2,Choueiri Roula3,Kasari Connie4,Carter Alice5,Granpeesheh Doreen6,Mailloux Zoe7,Smith Roley Susanne8,Wagner Sheldon9,Fein Deborah10,Pierce Karen11,Buie Timothy12,Davis Patricia A.13,Newschaffer Craig14,Robins Diana14,Wetherby Amy15,Stone Wendy L.16,Yirmiya Nurit17,Estes Annette18,Hansen Robin L.19,McPartland James C.20,Natowicz Marvin R.21

Affiliation:

1. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada;

2. Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts;

3. Division of Developmental and Behavioral Pediatrics, University of Massachusetts Memorial Children’s Medical Center, Worcester, Massachusetts;

4. Graduate School of Education & Information Studies, University of California Los Angeles, Los Angeles, California;

5. Department of Psychology, University of Massachusetts, Boston, Massachusetts;

6. Center for Autism and Related Disorders, Tarzana, California;

7. Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania;

8. USC Mrs T.H. Chan Division of Occupational Science and Occupational Therapy, Los Angeles, California;

9. Behavioral Development & Educational Services, New Bedford, Massachusetts;

10. Department of Psychology, University of Connecticut, Storrs, Connecticut;

11. Department of Neurosciences, University of California San Diego, La Jolla, California;

12. Harvard Medical School and Massachusetts General Hospital for Children, Boston, Massachusetts;

13. Integrated Center for Child Development, Newton, Massachusetts;

14. A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania;

15. Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, Florida;

16. Departments of Psychology, and

17. Department of Psychology, Hebrew University of Jerusalem Mount Scopus, Jerusalem, Israel;

18. Speech and Hearing Sciences, University of Washington, Seattle, Washington;

19. Department of Pediatrics, University of California Davis MIND Institute, Sacramento, California;

20. Yale Child Study Center, New Haven, Connecticut; and

21. Genomic Medicine Institute, Cleveland Clinic, Cleveland, Ohio

Abstract

This article reviews current evidence for autism spectrum disorder (ASD) interventions for children aged <3 years, based on peer-reviewed articles published up to December 2013. Several groups have adapted treatments initially designed for older, preschool-aged children with ASD, integrating best practice in behavioral teaching methods into a developmental framework based on current scientific understanding of how infants and toddlers learn. The central role of parents has been emphasized, and interventions are designed to incorporate learning opportunities into everyday activities, capitalize on “teachable moments,” and facilitate the generalization of skills beyond the familiar home setting. Our review identified several comprehensive and targeted treatment models with evidence of clear benefits. Although some trials were limited to 8- to 12-week outcome data, enhanced outcomes associated with some interventions were evaluated over periods as long as 2 years. Based on this review, recommendations are proposed for clinical practice and future research.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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