Interest in toys predicts effectiveness of autism treatment in toddlers

Toddlers who played with a limited number of toys showed more improvement in their communication skills following parent-guided treatment than those receiving other community-based treatments.

The report is the first to examine this autism treatment – called Hanen's More Than Words – for children younger than 2 showing early signs of an autism spectrum disorder. Caught early enough and treated with the right behavioral therapy, autism symptoms can improve dramatically.

The paper appears online March 22 in the Journal of Child Psychology and Psychiatry.

"This report adds to our emerging knowledge about which interventions work for which kids. It will help match children with the right intervention and not waste time enrolling them in treatments that are not well-suited for them," said co-author Wendy Stone, director of the UW Autism Center.

Stone said that parents often detect autism symptoms when their children reach about 17 to 18 months old. At this age, typical signs of autism include the child using fewer gestures and facial expressions to communicate, and being less likely to initiate social exchanges, such as pointing out something of interest, than other children the same age.

One in 110 children has autism spectrum disorders, which include autistic disorder, Asperger's syndrome and pervasive developmental disorder-not otherwise specified. More boys, one in 70, than girls are affected.

Few autism interventions focus on toddlers – children aged 1 to 3 – and those that do can be time-intensive and expensive. Stone and her collaborators wanted to study the effectiveness of a short-term, relatively low-cost intervention for toddlers showing warning signs.

"Our ultimate goal is to catch the symptoms early and find effective preventive interventions so that these children can attain their full potential," Stone said.

Sixty-two children (51 boys and 11 girls) younger than age 2 and meeting criteria for autism disorders, participated in the study with their parents. The researchers measured the toddlers' baseline social and communication skills during a pretest in which parents and their children played with toys and read books while a researcher observed.

Then the youngsters were randomly assigned either to the Hanen's More Than Words program or to a treatment-as-usual control condition. The program is intended to stimulate mature communication, language development and social skills.

The parents in the treatment group learned strategies to help their toddlers communicate, such as practicing taking turns, encouraging eye contact and modeling simple sentences from the child's perspective. For instance, when the child pointed to crackers, the parent wouldn't just hand over the food. Instead, the parent would get down at eye-level with the child and say, "I want crackers."