The Earlier, The Wordier
Watching 5-year-old Trinity rattle off answers to flashcards, you'd never know she once used grunts and screams to communicate.
|Five-year-old Trinity practices writing skills with her early intervention therapist.|
"What's he doing?" asked her therapist, Tammi Perry, pointing at a picture of a man behind the wheel of a car, at a recent session.
"Driving," responded Trinity, or as her mom calls her, Tinky.
A high-five ensued.
Labeling the actions and emotions of other people builds a basic foundation to understand other people, which improves social skills. While it might not seem like a major feat for your average kindergartner, for a little girl with autism who almost broke her grandma's nose because she didn't like getting dressed, it's a big deal.
And it's all because of early intervention at UNMC's Munroe- Meyer Institute (MMI).
"I think early intervention will be the difference between whether she would've attended college or not," said her mom, Brooke. "Now I know, Tinky's going to college. The sky is the limit for her."
About half of the children who receive intensive early intervention services at MMI go on to be educated in typical classrooms with minimal support. The other half shows improvement, though not as dramatic as children like Trinity.
"The brain is the most malleable at a young age," said Wayne Fisher, Ph.D., director of the Center for Autism Spectrum Disorders at MMI. "If we don't intervene early, we lose valuable time.
"We can make progress in those that are older, but a long history of reinforcing negative behaviors takes its toll."
Once Tinky's combative behaviors were under control, she became an "easy-to-educate sponge" said her mom. Goals in early intervention often start small.
"Everything is individualized. We do assessments to evaluate social, communication and pre-academic skills and find the gaps," said Nicole Rodriguez, Ph.D., coordinator of early intervention at MMI. "Often we find barriers to learning. For example, a child may have difficulty sitting in a chair and attending to academic materials. In that case, we might start by working on sitting and attending before we begin teaching more complex skills."
|Diagnosed with autism at age two, Trinity is now educated in a typical kindergarten classroom.|
Though at first applied behavior analysis methods of measuring every little behavior made it seem like her child was a series of numbers, Brooke now sees the reason for it.
"She's doing awesome academically, has tons of friends and is the most outgoing kid at the Children's Museum, always engaging everyone, but the results-based data and graphs help to see how far she's come," she said.
Those same goal meetings that helped Trinity are now helping her younger brother Roy, 2, who was diagnosed with autism at age 1.
"He was cooing, babbling and using silverware, but just stopped progressing at 12 months," Brooke said. "Luckily, we had him in early intervention by 14 months. So far, his vocabulary is jumping off. He recently said, 'Mama, I need help please,' which is huge for him."
Without intensive treatment like early intervention, the long-term outcomes for children with autism remain bleak. In a follow-up study of adults with autism, only 26 percent had one or more friends, 13 percent had independent jobs - most of which were low paying positions - and only 4 percent lived independently.
Dr. Fisher's program turns those numbers on their heads.
"We typically start by reducing stereotypic, repetitive and problem behaviors and replace those behaviors with language and social skills."
Once skills are developed to 90 percent or better accuracy at MMI, Dr. Fisher's team goes into the child's home and school to educate parents and teachers on how to implement the skills across settings.
While that might seem cost-prohibitive, several cost-benefit analyses found that for every $1 spent on effective treatment like early intervention, more than $10 are saved.
Still, it's not all about money.
"There's a lot of information out there saying individuals with autism will never live on their own or go to college, but with treatment that all changes," Brooke said. "Absolutely anything is possible with early intervention."Five