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The Sooner the Better

New research on the importance of early intervention for children with autism.

By Rachel Rabkin Pechman | null , null

Special Report: Autism Awareness Month

Instilling a love of learning in a young child is a wonderful goal for any parent to pursue. For parents of children with autism spectrum disorders (ASD), however, early learning appears to be crucial. According to Rebecca Landa, Ph.D., director of the Center for Autism and Related Disorders at the Kennedy Krieger Institute in Baltimore, MD, signs of autism begin before the age of 3. “If treatment starts only at age 3, we are at a real disadvantage for strengthening a child’s outcome,” says Dr. Landa, who recently completed a study that found that the capabilities of toddlers with ASD improved dramatically when they attended specially designed classes with other toddlers. In observance of Autism Awareness Month, we spoke to Landa about her research.

Parent & Child: What made you choose to focus your research on toddlers?
Dr. Rebecca Landa: Autism often isn’t diagnosed until age 3 or older — yet we know children can show signs of ASD before then. It was important to me to develop a program for young toddlers because early intervention is crucial.

P&C: Most research with ASD children occurs in a one-on-one setting. Why did you use group intervention instead?
Dr. Landa: Children with autism have trouble interacting with others, so learning to connect with their peers is important. When young children learn to socialize before preschool, they get ahead. They can start to gain social acceptance, and then they can concentrate on what else preschool has to offer.

P&C: How was the group setting designed?
Dr. Landa: Twenty-four toddlers with ASD were separated into groups of five. We ran each group like a nursery school classroom — with art, circle time, gym, and such—for two and a half hours, four days a week for six months. But we were very strategic in the way that we engaged with the children. Our aim was to give them the kinds of experiences they would need to motivate them to learn and communicate with others.

P&C: What were the results?
Dr. Landa: The ASD toddlers improved their language and social skills. It was very exciting to see how quickly they learned these things — and that they were able to use these skills in real-life situations, not just in one context.

P&C: Can you give us an example of a teaching method you used in the classes to help the children learn?
Dr. Landa: Sure. When a typical toddler reads a book about a bunny, he learns that the word “bunny” goes with the picture of the bunny. But a child with autism doesn’t do that. He may be paying attention to the butterfly in the corner of the picture. So we change the sentences of the book to be one to four words in length. And then we let each child do something that’s related to those words. We might point to the bunny in the book and say, “There is the bunny. The bunny goes hop, hop.” Then we give the child a stuffed bunny and help him make it hop. This teaches the children that the picture of the bunny is a symbol that has a meaning — which builds literacy and language skills and stimulates their ability to play in more creative ways with toys. 

P&C: What happens next?
Dr. Landa: Eventually, we ask the children to give the bunny to another child and say, “Here is the bunny.” So the child is not only learning how the object relates to pictures, the child is also learning how to share the object with other children. When we see that competence and confidence emerge in a child, it’s just beautiful.

P&C: Can parents use similar techniques at home?
Dr. Landa: Absolutely. We want parents to incorporate intervention strategies at playtime, bathtime, and bedtime, so that their children are engaged in a productive learning environment throughout the day. The first thing we have parents do is pick three toys, clear the floor except for these items, and just watch their child play with them. Once the parents know how their child plays with those toys, we tell them to use similar toys to imitate their child. Your child will look at you and get that you’re on the same topic, and suddenly he’ll be with you. And then you can “trick” him into learning by simply changing it up a little bit. Give the doll a voice, for example, or make a home for his stuffed animal using a box. Your child thinks it’s a game, but you’re actually expanding his play by modeling other things he can do with toys. 

P&C: What do you hope people will take away from your study?
Dr. Landa: That early intervention is very powerful, and that it can improve the core symptoms of ASD in very young children. I don’t believe in the “wait and see” approach. A variety of early intervention therapies are federally funded, so concerned parents only stand to gain by getting a free assessment. Ultimately, I hope that we’ll be able to provide more options for children under 3 with ASD, and that we can consider putting them into group settings for part of their intervention since it is cost-effective and improves the children’s outcomes. 



Dr. Landa’s top picks for books to best engage toddlers with ASD:

Where’s Spot? by Eric Hill 

Simple questions, repetition, and pull-out flaps make your child an active participant in this easy-to-understand story.

Brown Bear, Brown Bear, What Do You See? by Eric Carle  

Teach your child how to follow pointing gestures as you point out each new animal that appears.

Go Away, Big Green Monster! by Ed Emberley 

Helps your child learn to recognize faces and emotions as a friendly monster is assembled one body part at a time.

Where Is Baby’s Puppy? by Karen Katz  

Look for the missing puppy on each page. Then, hide your child’s stuffed puppy and search for it together.

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