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

Lonnie Zwaigenbaum¹, Margaret L Bauman², Roula Choueiri³, Connie Kasari⁴, Alice Carter⁵, Doreen Granpeesheh⁶, Zoe Mailloux⁷, Susanne Smith Roley⁸, Sheldon Wagner⁹, Deborah Fein¹⁰, Karen Pierce¹¹, Timothy Buie¹², Patricia A Davis¹³, Craig Newschaffer¹⁴, Diana Robins¹⁴, Amy Wetherby¹⁵, Wendy L Stone¹⁶, Nurit Yirmiya¹⁷, Annette Estes¹⁸, Robin L Hansen¹⁹, James C McPartland²⁰, Marvin R Natowicz²¹

Affiliations

¹ Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada; lonniez@ualberta.ca.
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.

PMID: 26430170
PMCID: PMC9923898
DOI: 10.1542/peds.2014-3667E

Practice Guideline

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

Lonnie Zwaigenbaum et al. Pediatrics. 2015 Oct.

. 2015 Oct;136 Suppl 1(Suppl 1):S60-81.

doi: 10.1542/peds.2014-3667E.

Authors

Affiliations

¹ Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada; lonniez@ualberta.ca.
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.

PMID: 26430170
PMCID: PMC9923898
DOI: 10.1542/peds.2014-3667E

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.

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Conflict of interest statement

FINANCIAL DISCLOSURE: Dr Zwaigenbaum was the site Principal Investigator of a study sponsored by SynapDx (he received operating funds but no honoraria). Drs Fein and Robins are co-owners of M-CHAT, LLC, which licenses use of the Modified Checklist for Autism in Toddlers in electronic products. Dr Stone is the author of the Screening Tool for Autism in Two-Year-Olds and receives a share of royalties from sales of this instrument. The authors received an honorarium as well as travel expenses from Autism Forum for contributing to the expert panels.

References

1. Zwaigenbaum L , Bryson S , Lord C , et al. . Clinical assessment and management of toddlers with suspected autism spectrum disorder: insights from studies of high-risk infants. Pediatrics. 2009;123(5):1383–1391 - PMC - PubMed
1. Zwaigenbaum L, Bauman ML, Stone WL, et al. Early identification of autism spectrum disorder: recommendations for practice and research. Pediatrics. 2015;136(suppl X):XXX–XXX - PMC - PubMed
1. Zwaigenbaum L, Bauman ML, Fein D, et al. Early screening of autism spectrum disorder: recommendations for practice and research. Pediatrics. 2015;136(suppl X):XXX–XXX - PMC - PubMed
1. Guthrie W , Swineford LB , Nottke C , Wetherby AM . Early diagnosis of autism spectrum disorder: stability and change in clinical diagnosis and symptom presentation. J Child Psychol Psychiatry. 2013;54(5):582–590 - PMC - PubMed
1. Chawarska K , Klin A , Paul R , Volkmar F . Autism spectrum disorder in the second year: stability and change in syndrome expression. J Child Psychol Psychiatry. 2007;48(2):128–138 - PubMed

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical