Friday, November 30th, 2012
Autism is a biological disorder. That said, recent research continues to reinforce the power of behavioral interventions – and a recent study may be pointing the way to a small breakthrough.
In October, Dr. Geraldine Dawson and colleagues published a paper showing exciting results from a relatively new intervention called the Early Start Denver Model (ESDM). Previous studies demonstrated that the ESDM leads to improvements in a number of developmental domains – including reduction of symptoms, and increases in social behavior, language and IQ performance. The latest study revealed something especially remarkable – ESDM resulted in “normalized patterns of brain activity” in kids with autism when viewing a human face as compared to other objects. Since a fundamental goal of behavioral intervention is to improve interest in the social world, these results were especially powerful – the kids who participated in ESDM not only behaved differently, but their brains were functioning differently in real time.
ESDM applies learning principles – such as those used in more traditional ABA interventions – to shape and reinforce social behaviors as they happen in the stream of daily interaction. Parents as well as therapists are trained to administer the intervention program. And it is very intensive – it takes lots of hours every week, and the recent study evaluated kids after two years of intervention. No doubt, all these features are critical reasons why it may be having such a beneficial effect.
I see this work as signaling a breakthrough in intervention in two ways. First, it reminds us that just because a developmental disorder may be biological/genetic in origin, that does not mean that interventions need to be biological to produce substantial changes in developmental patterns. Second, creative interventions that utilize learning principles within the flow of everyday interaction – and incorporate the collaboration of therapists and parents – may be particularly effective in “reprogramming” both social behavior and how the brain processes social information.
We will continue to see lots of research on the biology of autism, and this work continues to be extremely important. But I do hope that we see more and more effort (and scientific and social resources) aimed at developing and refining behavioral interventions that hold considerable promise for promoting positive developmental changes in kids with autism.