During the course of typical development, children learn to interact
with others in socially meaningful ways. Measures of social communication
Initiation of joint attention—spontaneously directing others attention
to something of interest, such as by pointing or holding something
up to show for social purposes rather than to ask for help
Affect sharing—sharing emotions with others through facial
expressions paired with eye contact
Socially engaged imitationimitating others actions while showing
social connectedness through eye contact.
Deficits in such measures are hallmark symptoms of ASD and can severely
limit a child's ability to engage in and learn from interactions with
others or from the world around them.
"This new report is encouraging, as the effects on social behavior
appear to provide a scaffold for the development of skills beyond the
research setting," said NIMH Director Thomas R. Insel, M.D. "We
need better early interventions for the core deficits of autism."
Funded through the Studies to Advance Autism Research and Treatment
(STAART) Network ( http://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-pervasive-developmental-disorders/nih-initiatives/staart/index.shtml ),
Rebecca Landa, Ph.D., of Kennedy Krieger Institute, Baltimore, and colleagues
randomly assigned 50 toddlers, ages 21-33 months old, who were diagnosed
with ASD to one of two six-month interventions: Interpersonal Synchrony
(IS) or Non-Interpersonal Synchrony (non-IS). Both interventions incorporated
classroom-based activities led by a trained intervention provider, and
a home-based component involving parents who received specialized education
and in-home training.
The interventions were designed to encourage children to make frequent
and intentional efforts to engage others in communication or play. The
single difference between interventions was that the IS group received
more opportunities for joint attention, affect sharing, and socially
engaged imitation. The toddlers were assessed at the start and end of
the intervention and again six months later.
Children in both groups made improvements in social, cognitive and language
skills during the six-month intervention period. Children who received
IS made greater and more rapid gains than those in the non-IS group.
The researchers also noted that children in the IS group used their newly
acquired abilities with different people, locations, and type of activity.
This is noteworthy because children with ASD have particular difficulty
doing so. They tend to use new skills mostly within familiar routines
At the six-month follow-up, children in the IS group showed slower improvements
in social communication compared to when they were receiving the intervention,
but did not lose skills gained during the intervention period. In contrast,
children in the non-IS group showed reduced social communication skills
at follow-up compared to their performance during the intervention period.
"This is the first randomized controlled trial to examine an intervention
focused on core social deficits of ASD in toddlers, and the first to
show gains in these deficits resulting from intervention," said
Landa. "Though preliminary, our findings provide promising evidence
that such a supplementary curriculum can help improve social and communication
skills in children younger than 3 who have ASD."
The researchers received additional study funding from the Health Resources
and Services Administration.
The mission of the NIMH is to transform the understanding and treatment
of mental illnesses through basic and clinical research, paving the way
for prevention, recovery and cure. For more information, visit the NIMH
website ( http://www.nimh.nih.gov ).
The National Institutes of Health (NIH) — The Nation's Medical
Research Agency — includes 27 Institutes and Centers and is
a component of the U.S. Department of Health and Human Services. It is
the primary federal agency for conducting and supporting basic, clinical
and translational medical research, and it investigates the causes, treatments,
and cures for both common and rare diseases. For more information about
NIH and its programs, visit www.nih.gov .
Landa RJ, Holman KC, ONeill AH, Stuart EA. Intervention Targeting Development
of Socially Synchronous Engagement in Toddlers with Autism Spectrum Disorder:
A Randomized Controlled Trial. J Ch Psychol Psychiatry. 2010 Dec 8. [epub
ahead of print]