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Play-Focused Program Might Help Kids With Autism

By Barbara Bronson Gray
HealthDay Reporter

WEDNESDAY, Oct. 31 (HealthDay News) -- Laughing, giggling and making silly faces. Building a tower of blocks together and then crashing it down. Engaging young children with autism in a program that involves such fun, interactive play can affect their brain activity, making it resemble that of children without the disorder, a new study shows.

The research is the first trial to demonstrate that early behavioral intervention may be associated with normal patterns of brain activity and improved social behavior in young children with autism.

Researchers used a tested behavioral program that has been shown to raise intelligence, language and adaptive behavior in children with autism to evaluate whether such therapy might be associated with measurable improvements in their brain activity.

The investigators found that interventions designed to enhance the ability of children with autism to attend to social cues -- like human faces -- and engage with others may help their brains develop more normally.

"After the treatment, the EEGs [brain activity tests] of the children with autism looked like those of children who were developing normally," said Sally Rogers, a study author and professor of psychiatric and behavioral sciences at the MIND Institute at the University of California, Davis, in Sacramento, Calif.

"This study should make parents optimistic and hopeful, and motivate decision makers to provide more intensive interventions for young children," Rogers added. "Results of this study underscore the importance of early detection of and intervention in autism."

The research was published online Oct. 26 in the Journal of the American Academy of Child & Adolescent Psychiatry.

The behavioral program, called the Early Start Denver Model (ESDM), was first shown in 2010 to have a measurable positive impact on children with autism spectrum disorder. The therapy involves interactive play-based, developmental activities.

Autism is a developmental disorder that appears in the first three years of life, and affects the brain's normal development of social and communication skills, according to the U.S. National Library of Medicine.

ESDM is thought to stimulate the kind of brain activity associated with the ability to recognize and perceive social information and language.

While babies and young children without autism are drawn to view such social stimuli as faces, those with autism tend to focus on objects instead.

The research involved 48 male and female children diagnosed with autism between 18 and 30 months of age. The children were randomly assigned to receive either ESDM therapy or other community intervention for two years.

Those in the ESDM group received about 20 hours a week of therapy from trained clinicians plus five hours of intervention directly from their parents, who were specially trained. The other group of children received a similar number of hours of therapy from a variety of community-based programs that did not use the ESDM approach.

After two years, all of the children were given EEGs while looking at both faces and objects. Their EEGs were compared with those of children of comparable age without autism.

"Children with autism who received ESDM had greater brain activity when looking at faces than did those who did not get ESDM therapy," Rogers said.

Twice as many of the children who received ESDM therapy showed greater brain activation when looking at faces rather than objects, such as toys, which is considered more typical of a child without autism. But the majority of those in the community therapy groups showed the reverse, or autistic pattern, responding more to objects than faces.

One expert reacted to the study with guarded enthusiasm.

Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven and Alexandra Cohen Children's Medical Center of New York, in New Hyde Park, was concerned that the researchers had not performed baseline EEGs on the children before starting the therapy. He also noted that valid EEGs were obtained from only a little more than half of those who received the treatment.

Despite such issues, Adesman did say the results of the study were encouraging. "It suggests that clinical improvement is associated with neurophysiological improvement, in terms of EEG," he noted.

Rogers said that it was critical that parents of children with autism understand the importance of playing with their children. "Some children with autism don't know how to communicate 'Come play with me' to their parents or they don't respond to the parents as enthusiastically as other children would," she explained.

"Parents have to take the initiative that most other children would take on their own," said Rogers.

More information

Learn more about autism at the U.S. National Library of Medicine.

SOURCES: Sally J. Rogers, Ph.D., professor of psychiatric and behavioral sciences, MIND Institute, University of California, Davis, Sacramento, Calif.; Andrew Adesman, M.D., chief, developmental and behavioral pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, N.Y.; Oct. 26, 2012, Journal of the American Academy of Child & Adolescent Psychiatry, online

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