Autism Interventions Parents Can Provide for Young Children

Father plays blocks with his toddler

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Your child is not yet talking. Or seems to have trouble responding to peers. Or spends more time than usual twirling, rocking, or opening and closing doors. These could be signs of autism, but many other reasons could explain such behaviors.

While you wait for a diagnosis (or even after a diagnosis has been made), you can provide do-it-yourself interventions in your own home that can make a positive difference in your child's life.

Interventions vs. Therapies

There is no absolute difference between an intervention and a therapy. In fact, the two concepts overlap. In general, however:

  • Therapy is provided by a trained expert. Intervention may be provided by a parent or caregiver.
  • Therapies have specific sets of procedures and guidelines which should be followed. Interventions may be more open-ended and creative.
  • Therapies generally have specific goals and objectives to be met (such as speaking X number of words by a specific time). Interventions should lead to improvements, but the gains aren't necessarily measured formally.
  • Therapies usually have formal names and are created by someone in particular. For example, Ivor Lovaas is credited with the development of Applied Behavioral Analysis. Interventions can be based on a particular set of guidelines but may also be idiosyncratic and based on the needs of the child and the person providing the intervention.

While parents can provide informal but helpful interventions, the bottom line is it takes a lot more training and experience to set up and provide formal therapies.

What's more, because therapies are quite formal and intense, it can be problematic for parents to become their children's therapists. After all, therapists aren't there to provide love and emotional support: they're simply there to teach and improve skills and behaviors.

That's not to say parents can't provide therapies. Many can and do. But for young children, informal interventions are a good option—particularly in areas or situations where it's tough to find early intervention experts.

Why Interventions Before Diagnosis?

Symptoms of autism must appear before a child is 3 years old (according to diagnostic criteria). Those symptoms may not set off alarm bells if they are relatively mild or if they mimic the symptoms of other disorders (as is often the case).

Late speech, social delays, and similar issues can reflect normal differences in child development or can be caused by issues such as apraxia of speech, hearing issues, or auditory processing issues.

Once it becomes clear that symptoms are significant, it can take quite a while to set up a proper evaluation to determine if an autism diagnosis is appropriate. And even after a diagnosis, there are hoops to jump through before early intervention becomes available.

In some areas, early intervention therapists are few and far between, and services can be spotty. This becomes even more of an issue if your family doesn't speak English as its first language.

The Value of Early Intervention

Early intervention for children under the age of 6 can be very valuable for children with autism. While there is no "window of opportunity" for growth and development, you can never go wrong by spending extra time with your child, helping them to build skills, expand emotional connections, and learn appropriate behaviors. It's really just part of good parenting.

In addition to the basic reality that early intervention can only help and can never hurt your child:

  • In some cases, early intervention can help to remediate symptoms to the point where a child can enter kindergarten with age-appropriate skills and behaviors.
  • In many cases intervention, especially in the area of emotional connection, can make it easier for a child to learn even if their symptoms are more severe.
  • Providing a child with the tools of communication, whether through speech, sign, or picture boards, is a huge leap forward and can make it much easier for the child to learn at school and/or through therapies.
  • Understanding a child's sensory challenges can make it easier to accommodate your child's needs at home, and to communicate your child's needs to therapists and teachers. A child who is in physical pain because of sensory assaults will find it very difficult to behave, think, or learn properly.
  • It can be hard to bond with a child with autism. Caregiver-provided early intervention can be a wonderful tool for making connections through developmentally appropriate play and communication.
  • Children with autism rarely learn through imitation; instead, they learn best through direct instruction. Ages 2-6 is the ideal time to actively teach your child typical play skills as well as physical skills such as throwing, kicking, cutting with scissors, and so forth. By jumping in early, you'll give your child a head start, which is very important if your child has difficulties or delays.

Appropriate Children and Parents

While it can never hurt your child to receive positive parental attention and support, some children will benefit more than others. In addition, there are some parents for whom interventions may be overwhelmingly difficult.

Dr. Pamela Dixon is Director of Clinical Services and Inclusion for Autism Speaks. Along with the World Health Organization, she has been involved with the development of the Caregiver Skills Training Program (CST), which teaches caregivers strategies to help them support their child’s development. 

The program has been used largely in parts of the world where therapies are unavailable or in U.S. communities where parents are non-English speakers. The approach, however, is appropriate for anyone under the right circumstances. As she explains:

CST is best for caregivers with children who are younger and have limited language. It’s mostly about getting communication and engagement started.

But it may not be the best match for a child who is quirky but verbal and engaged. It's most useful if you’re really struggling to know what your child wants and for managing challenging behavior.

Dixon goes on to explain that there are limits to parental involvement, "We have to be really careful about asking parents to do things that are most of a therapists’ role. We can empower and equip parents to use therapeutic strategies and also think about the capacity of the caregiver. It’s unfair to ask a caregiver who’s dealing with their own emotional issues to also be the child’s therapist."

Dixon adds that, while parents do know their own children best, they lack the "toolbox" of therapeutic techniques and experience that comes with years of professional practice.

How to Provide Interventions

The idea behind caregiver-provided interventions is to connect with your child and help them build basic social-communication and behavioral skills that will allow them to learn and engage with others. Several methods are specifically designed to help you do just that, and you can start them with or without the involvement of a professional therapist.

If you decide to move forward with any of these techniques, however, it is worthwhile seeking out professional support in the long run: experienced therapists will help you craft a program, set goals, and troubleshoot when it seems you've hit a plateau.

Virtually all of the techniques available are developmental rather than behavioral. In other words, they focus on a child's emotional engagement, symbolic play skills, and communication skills rather than on concrete or behavioral skills such as the ability to use words correctly, sit quietly in a chair, write correctly, or complete academic tasks.

Developmental skills are more important than behavioral skills in the development of a young child. Perhaps more importantly, they are also the skills that will help you and your child make emotional connections and learn to communicate with one another.

Floortime

Floortime is a developmental therapy created by Dr. Stanley Greenspan. It has been studied for decades and has been shown to be effective. Its purpose is to help parents literally get down on the floor with their children with autism and play in such a way that they build engagement, communication, and emotional connection.

It's important to know that Floortime play isn't like ordinary play: it's intentional, child-centered, and requires some specific skills to be successful. It can be hard to get children with autism to "play," so you will need to build some skills.

Fortunately, Floortime has created some parent training materials that are easy to access. You'll find video series, online training programs, virtual parent groups, and Floortime coaches through the Interdisciplinary Council on Development and Learning (ICDL) website.

JASPER

Dr. Dixon highly recommends JASPER as a parent-friendly approach to early intervention. According to the JASPER website, it "targets the foundations of social communication (joint attention, imitation, play) and uses naturalistic strategies to increase the rate and complexity of social communication."

JASPER has a lot in common with Floortime: it is a well-researched technique that helps to build social, emotional, and symbolic thinking skills. Its most important feature is a focus on "joint attention," which can be described as "more than one person paying attention to something at the same time."

Joint attention is a difficult skill for many autistic children to learn—and it is critically important for social communication and academic education. Unlike Floortime, however, JASPER does not have a lot of parent resources on its website; to learn the techniques, you may need to contact the organization.

Early Start Denver Model

Another highly-regarded early childhood program for autism is the Early Start Denver Model (ESDM). ESDM has been around for a while, and while it is often offered in preschool settings, it can also be applied at home.

ESDM offers parent workshops (both in-person and virtual) to get you started, and the ESDM website offers a whole list of parent coaches along with their email addresses. This is a great resource and a good way to get started with early intervention.

Upcoming CST Online Training

Starting in the fall of 2021, according to Dr. Dixon, online training classes will be available for parents interested in the CST approach. This is a more basic approach than any of the therapeutic models, as it's intended for short-term use.

The idea is the CST will allow parents to get started working with their children "while they wait" for a full evaluation and the availability of a professional therapeutic schedule. To find out when CST is available, you can continue to monitor the Autism Speaks website.

A Word From Verywell

The early years are developmentally important for all children, and early intervention can be very helpful for children with autism. It's important, however, to remember that autism is a lifelong diagnosis, and your involvement will be needed throughout your child's life.

Even the best early intervention and the most committed parental involvement will not "cure" autism, though it can make a very significant difference in your child's life. Over time, your child will probably need a variety of therapies to help with social skills, academics, executive functioning, sensory challenges, and more.

As Dr. Dixon says, this is a marathon and not a sprint. You have to, of course, do all that you can to meet the needs of the child with autism but remember they need you to have the energy for them at all their major milestones of life. Take care of yourself.

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Article Sources
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  1. Landa RJ. Efficacy of early interventions for infants and young children with, and at risk for, autism spectrum disordersInt Rev Psychiatry. 2018;30(1):25-39. doi:10.1080/09540261.2018.1432574

Additional Reading
  • Goods KS, Ishijima E, Chang YC, Kasari C. Preschool based JASPER intervention in minimally verbal children with autism: pilot RCT. J Autism Dev Disord. 2013 May;43(5):1050-6. doi: 10.1007/s10803-012-1644-3. PMID: 22965298; PMCID: PMC4222903.

  • Landa R. J. (2018). Efficacy of early interventions for infants and young children with, and at risk for, autism spectrum disorders. International review of psychiatry (Abingdon, England)30(1), 25–39. https://doi.org/10.1080/09540261.2018.1432574

  • Malucelli ERS, Antoniuk SA, Carvalho NO. The effectiveness of early parental coaching in the autism spectrum disorder. J Pediatr (Rio J). 2020 Oct 15:S0021-7557(20)30213-8. doi: 10.1016/j.jped.2020.09.004. Epub ahead of print. PMID: 33069667.

  • Salomone, E., Pacione, L., Shire, S., Brown, F. L., Reichow, B., & Servili, C. (2019). Development of the WHO Caregiver Skills Training Program for Developmental Disorders or Delays. Frontiers in psychiatry10, 769. https://doi.org/10.3389/fpsyt.2019.00769