By Sheryl A. Isaacs

Studies have shown that when early intervention occurs with children that experience developmental delays it will change the outcome for the child. In this article I will focus on the specific benefits of early intervention behavioral therapy (EIBT) for children that have autism. 

The signs of autism can be insidious and hard to recognize. In order to recognize the a-typical development that occurs with autism, it is important to know what typical development looks like.  This can be difficult, especially for first time parents. With an infant that has autism, it is a slight deviation from normal development. Many times it is the lack of or lessened occurrence of a typical pattern of development that occurs. Infants with Autism can be categorized as good babies that are not demanding. Many signs of autism can be seen before 2 years of age. 

Studies have shown that when early intervention behavioral therapy (EIBT) occurs before the age of two many
children can be mainstreamed in typical classrooms.  Intensive EIBT before the age of two has been shown to help “rewire” a child’s brain and in some cases reverse the signs of autism. When the deficient areas are targeted, such as imitation, joint attention and play skills, there is an increase in expressive and receptive language by the child who has autism. When imitation, joint attention and play skills increase it opens up a whole new world of interaction for the children. An increase in these areas enables the children to test better on developmental test and effectively can raise their IQ scores when tested.

The most effective EIBT program will increase the parent’s responsiveness to their child through therapy and in
home treatment.  Parents are given the tools to continue treatment on a daily basis with their child, which will
benefit the child and parent.  When a parent is taught to follow their child’s lead in communication, non-verbal communication will increase and possible verbal communications occur.  Parents will learn to require the child to vocalize during interactions and requests. At first these vocalization requests will be far from the targeted word, but in time closer approximations to the word will occur. As parents continue to utilize the skills that are learned through the EIBT program they will be more effective parents for their child with ASD.  

Parents must also learn to “scaffold” various skills. Scaffolding occurs when a larger skill is broken down
into smaller components. Help is provided to the child until they become familiar with the new items that have been introduced within the larger skill. Teaching continues in this manner until the child masters the task. This type of teaching will enable the parent to focus on their child’s level of learning and have the knowledge and ability to help their child reach the next level of learning, regardless of the present skill level.  This technique can increase many skills: play skills, self-help skills, language skills, motor skills and cognitive skills.  As parents continue to “scaffold” the child’s learning will solidify in these areas because they are always beginning the learning task at a level that is just above their acquired level, which increases success and a level of
mastery. 

Further research continues to be being done to increase recognition of autism at an earlier age. All research
points to early intervention being the key in providing the best outcomes for children with autism. One exciting study links weak head and neck muscles to ASD.  Here is a link to the video and information on the study.  This study was done the Kennedy Krieger Institute.

In this article EIBT was addressed as an early intervention for children that have autism.  It is important to remember that any child that is experiencing any delay in any developmental domain (physical, cognitive, social and emotional) should receive early intervention services. Below you will find warning signs for autism
and a list of links that can help determine what steps you can take in getting your child the help they need to succeed!

The following list was taken from helpguide.org:

 Early signs of autism in babies and toddlers

 

Doesn’t make eye contact  (e.g. look at you when being fed).
Doesn't smile when smiled at.
Doesn't respond to his or her name or to the sound of a familiar voice.
Doesn't follow objects visually.
Doesn't point or wave goodbye or use other gestures to communicate
Doesn't follow the gesture when you point things out
Doesn't make noises to get your attention
Doesn't initiate or respond to cuddling
Doesn't imitate your movements and facial expressions
Doesn't reach out to be picked up
Doesn't play with other people or show interest and enjoyment
Doesn't ask for help or make other basic requests

Physician guidelines:

No big smiles or other warm, joyful expressions by six months or thereafter
No back-and-forth sharing of sounds, smiles or other facial expressions by nine months
No babbling by 12 months
No back-and-forth gestures such as pointing, showing, reaching or waving by 12 months
No words by 16 months
No meaningful, two-word phrases (not including imitating or repeating) by 24 months
Any loss of speech, babbling or social skills at any age

If these signs are seen in your child then it is important to get them to your Doctor for a thorough examination.

Helpful Web Sites:

Developmental milestones birth through 12+ months

Overview of what early intervention is and has many helps and information.
 
MCHAT will help you determine if a professional should evaluate your child

Autism Speaks 100 Day Kit for newly diagnosed families

By Sheryl A. Isaacs

Play Therapy with children is a very important therapeutic tool because it utilizes the child's natural language, the language of play.  Children naturally seek to express themselves through play. Stories, metaphors, problem solving, fears and experimenting with new roles occur when a child plays. The Play therapist engages the child in this natural language of childhood to help the child process strong emotions, trauma and role play difficult situations that the child may face. Every day through play children are working out a myriad of problems that occur in their world.  
 
When participating with a child in their play, the therapist enters into the world of the child, accepting the play and the child unconditionally. The therapist follows the child’s lead, allowing them a sense of control that they might not otherwise feel. This integration into the child’s world allows the therapist to deeply connect with the child. The child can act out any situation that needs attention in their lives without fear of the therapist rejecting them.  When scenarios are acted out that are difficult, it gives the therapist the opportunity to empathize with the child's experience through play and gently mix into play therapeutic concepts and tools.  Utilizing the play format makes disclosure of severe experiences and strong emotions easier for the child to express to the therapist.  
 
The therapist can then help the child make sense of their world by finding metaphors that relate to the
child's life hidden within their play. Through this process the therapist can eventually help the child "restory" their play, which enables a child to move through difficult situations in their life. As play therapy continues, one can
see a normalization of play.  The child’s play becomes more typical developmentally and the child’s play becomes
more reciprocal in nature with the therapist. Often the themes that had been so important in play are abandoned. 
The child does not feel the need to work out through play the metaphors that he had been. For now, the issue has been resolved. 
 
However, it is important to note that when children experience a trauma they will continue to process this trauma
throughout their development. This occurs due to the changes that occur developmentally.  The trauma will most likely need to be processed again at key developmental stages or changes in their life, such as when a child begins
Kindergarten, enters into puberty, or becomes a teenager.  The child that processed trauma through play may need to verbally process this trauma as a teenager.  A young child will not feel the same feelings or have the same questions that a teenager might have in regard to their trauma experience.

 This of course, is just a general overview of the play therapy experience. There are many theories and
developmental models that are utilized as well as different models of play therapy. Play therapists engage in many different varieties of play as well, again following the child’s lead. Expressive arts, lego play, doll house play, imaginary play, active play, puppet play…any type of play that you can imagine is utilized in the play therapy room. The key is to allow the child to be who he is, express his story the way he needs to express it and follow his lead.