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03-10-2011 | Article

Combined therapy improves social communication in autistic children


Free abstract

MedWire News: Intense behavioral, speech, and occupational therapy, especially at an early age, is effective at improving social communication skills in children with autism spectrum disorders (ASD), suggest study results.

"It's important for children with autism to begin treatment as soon as possible," said study author Micah Mazurek, from the University of Missouri-Columbia, USA.

"The more intense or comprehensive the therapy, the better it is in terms of helping children improve social and communication skills."

The team collected data from 1433 children and adolescents with ASD. They measured 15 social-communication skills forming part of the Autism Diagnostic Interview-Revised (ADI-R) at baseline (age 4-5 years) and at follow-up (mean age 10.2 years; range 6-17 years). These included facial expressions, gestures, language comprehension, appropriate social responses, and sharing enjoyment.

A large majority of the children (95.4%) had improvement in these skills at follow-up compared with baseline, with 2.2% having no change and 2.4% having worsening symptoms at follow-up.

However, the team notes that children who received all or a combination of behavioral, speech, and occupational therapy had a greater improvement in social-communication skills than those who did not. This was particularly evident in those who began therapy at an early age.

In total, 83.0% of the children received speech therapy, 74.8% occupational therapy, and 31.8% behavioral therapy. Age at treatment initiation ranged from 2 to 15 years, with a median initiation age of 3 years for all three types of therapy.

There was a significant positive association between a child's nonverbal IQ and their response to treatment, with the best response seen in those with the highest IQ. High IQ and intensity of speech therapy were the best predictors of successful speech acquisition for children who were nonverbal at age 5 years, add the researchers.

When age and symptom severity at baseline were adjusted for, Mazurek and colleagues found that children who received more intensive treatment had a better response to therapy.

"With regard to social-communicative symptom severity, our study reveals that it is not IQ alone that contributes to improvements over time," Mazurek commented.

"Instead, having a higher IQ may allow children to make greater gains in various types of treatments. Although IQ scores of children with ASD may be strongly influenced by their capacity for attention and ability to comply with tasks results indicate the need to design and examine alternative treatment approaches for those with intellectual impairments."

By Helen Albert