Toddlers with symptoms of autism can show dramatic improvement if they are given early, intensive therapy. The finding, from the first randomised controlled trial in such young children, should settle the question of whether early screening and treatment of autism are worthwhile.

Sally Rogers, a psychologist at the Mind Institute of the University of California, Davis, and colleagues randomly assigned autistic toddlers aged 18 to 30 months to receive either conventional care or an intensive programme of behavioural therapy known as the Early Start Denver Model. This emphasises fun, child-directed activities rather than the repetitive exercises used in conventional autism therapies, which are less suitable for very young children.

Learning from fun

“Being able to follow children’s leads and build fun into their interactions is an important teaching tool. That may sound like common sense, but with autism nothing is common sense,” says Rogers.

After two years, the 24 children in the ESDM programme achieved significantly higher scores in IQ tests and in several measures of language use, everyday skills and social interaction than the children given conventional care. Psychologists who had not encountered the children before the treatment considered that seven of them no longer met the diagnostic criteria for autism, as compared with just one of the 21 who received conventional care.


Techniques for detecting autism in very young children have been improving for several years, but until now it has not been clear that parents and doctors could do much with the information.

Rogers’s study should settle that question, says Laura Schreibman, a psychologist at the University of California, San Diego. “The cost of providing this treatment when the child is very young is way less than the cost of providing adult care to these individuals,” she adds. “You have to look at it as an investment. There is a treatment we know is effective. Let’s get on with it.”

Journal reference: Pediatrics, DOI: 10.1542/peds.2009.0958