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7 November 2012
"Striking" brain changes from early autism therapy

When given pivotal response therapy at an early age, children with autism showed significant improvements in behavior and communication. Interestingly, the researchers also report "striking" changes in brain function. The Yale School of Medicine team who carried out the study has reported their findings in the Journal of Autism and Developmental Disorders.

The results suggest that the brain systems in children as young as two respond well to pivotal response treatment, particularly those areas involved social perception. Rather than target individual behaviors, pivotal response therapy targets "pivotal" areas of a child's development. These include motivation, response to multiple cues, self-management and the initiation of social interactions. By targeting these critical areas, say its proponents, the treatment produces broad improvements across areas of sociability, communication, behavior, and academic skill building.

In the new study, the researchers used functional magnetic resonance imaging (MRI) to measure changes in brain activity after two five-year-olds with autism received pivotal response treatment. Study co-author Pamela Ventola used this treatment method to identify distinct behavioral goals for each child in the study, and then reinforced these targeted skills with treatment involving motivational play activities.

The team found that children who received therapy showed improvements in behavior, and being able to talk to other people. In addition, the MRI and electroencephalogram revealed increased brain activity in the regions supporting social perception.

Researcher Fred Volkmar said the new findings are especially exciting given the younger ages at which autism is diagnosed. Until recently, autism diagnosis typically did not occur until a child was 3 to 5 years-old, but doctors are now diagnosing children as young as one. Pivotal response treatment, says Volkmar, is easy to implement in children younger than two.

Volkmar sees the results as a first step in a novel approach to treatment planning. "Autism research has come a long way," he said. "These findings are exciting because they show that early intervention works in autism."

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Source: Yale University

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