How Well Does Early Intervention Work for Children with Autism?

Is early intervention really effective for kids on the autism spectrum?

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Common knowledge says that parents, upon receiving an autism diagnosis for their child,  should run -- not walk -- to the nearest early intervention center.

Early intensive intervention, it is said, is the key to "optimal outcomes" for autistic children. Scientists have long known that the brain grows quickly between the ages of zero and three, which suggests that early intervention would be an ideal way to treat a childhood disorder.

But what does the science say about the outcomes of early intervention for children with autism?

Can Early Intervention Cure Autism?

At least one study suggests that about 14% of autistic children who undergo two intensive years of a program called the Early Start Denver Model will improve radically. In fact, those children would no longer qualify for autism diagnoses if they were being evaluated at a later age. A similar program called LEAP had similar outcomes. There is even some evidence that these programs can change the way the brain functions.

There are, however, a few caveats to this finding.

  • First, of course, is the fact that the vast majority of children who undergo intensive early intervention do NOT improve radically. Yes, their symptoms may improve--but they may still have very significant delays and challenges.
  • Second is the finding that even those children whose autism symptoms improve radically are left with developmental and/or behavioral challenges. In fact, those children are often diagnosable with disorders such as ADHD, learning disabilities, intellectual disability, and so forth.
  • Third, an accurate autism diagnosis is, by definition, a lifelong diagnosis.Symptoms that are difficult to identify in a 6-year-old can become serious challenges in a 20-year-old.  Problems with pragmatic speech, anxiety, and repetitive behaviors often emerge as people are exposed to more complex and challenging situations.

    Do the Outcomes of Early Intervention Last Over Time?

    Studies suggest that certain types of intensive early intervention do make a difference for at least a couple of years following the treatment. To what degree such improvements will last past age six is, at present, unknown.

    Is It Best to Get Into Therapy as Early as Possible?

    While there are solid practical reasons for early intervention, there are few research studies that show that earlier intervention offers more hope of improvement than later intervention.

    One small study looked at a program called "Infant Start." The treatment was administered by parents over a six-month period to 6- to 15-month-old infants who exhibited marked autism symptoms, such as decreased eye contact, social interest or engagement, repetitive movement patterns and a lack of intentional communication. Six out of seven infants in the study improved dramatically.

    Does this mean all infants with delays should get intensive early intervention? At this point, we really don't know.

    In fact, Geraldine Dawson, Ph.D., Professor of Psychology and Director of the University of Washington Autism Center, makes the following point: "For all we know, a child with a developmental delay may have a longer window of opportunity for growth. I think it's not helpful to alarm parents in that way. I've seen kids who start late and quickly catch up -- a lot of kids with intensive early intervention who progressed slowly and then took off in elementary schools."

    Why Early Intervention for Autism Makes Sense

    Early intervention is clearly a good idea. But it's by no means clear that the earlier and more intensive the intervention, the better the outcome. Parents who rush to early treatment with the hope that their child will quickly "recover" from autism may be disappointed -- while parents who waited "too long" may see surprisingly positive outcomes.

    But why wait?

    It makes sense to treat an autistic child as early as possible. The reasons are both research-based and common-sensical:

    1. Toddlers and preschoolers have no other obligations, so their whole day can be devoted to therapy (as opposed to academics).
    2. Two-year-olds have few ingrained habits, so it's relatively easy to stop negative behaviors before they become intractable.
    3. Helping children to learn socially acceptable behaviors at a very young age is a great idea whether they're autistic or not.
    4. Early intervention is almost always provided free of charge, so there is no financial risk.
    5. Even if, for some reason, your child has been inaccurately diagnosed with autism, the types of early intervention programs offered to kids on the spectrum are usually fun, play-based, and risk free. You don't need to worry that your child will receive potentially harmful treatments.

    How well does such therapy work? That depends upon the child. As each individual child has his own profile, abilities, and challenges, each child will have his own outcomes. But even a little progress is far better than none, especially when that progress comes in the form of new communication skills that allow a child to express his desires and needs.

    The Bottom Line

    Yes, early intervention is a good idea. There is nothing to lose and everything to gain from getting a child with autism into age-appropriate therapy as early as is feasible. Having said this, however, it is important to remember that early intervention is unlikely to wipe out autistic symptoms. And even if your child's autistic symptoms improve significantly, there is a very good chance that other behavioral, developmental, and/or intellectual symptoms may remain.


    Interview with Geraldine Dawson, Ph.D., Professor of Psychology and Director of the University of Washington Autism Center. January, 2007.

    Dawson G, Toth K, Abbott R, Osterling J, Munson J, Estes A, Liaw J. Early social attention impairments in autism: social orienting, joint attention, and attention to distress.Dev Psychol. 2004 Mar;40 (2):271-83.

    Dawson G, Zanolli K. Early intervention and brain plasticity in autism.Novartis Found Symp. 2003;251:266-74; discussion 274-80, 281-97

    Estes et al. "Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder." Journal of the American Academy of Child and Adolescent Psychiatry. July 2015, Volume 54, Issue 7, Pages 580–587

    Matson JL. Determining treatment outcome in early intervention programs for autism spectrum disorders: A critical analysis of measurement issues in learning based interventions.

    UC Davis. Intervention in 6-month-olds with autism ameliorates symptoms, alleviates developmental delay." September 8, 2014

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