The time period from birth to 3 years old is often thought to be an easy part of life. We are almost completely dependent on others and our responsibilities are to eat, sleep and grow. However, the expectations for development during this brief period are actually higher than at any other point in our lives. We examine the importance of early intervention services to improve independent living skills.
There are numerous developmental processes infants and toddlers are expected to naturally progress through in their first 36 months (document). These time-based milestones are clearly defined and agreed upon by many researchers and pediatricians alike, but for some infants and toddlers achieving them is no easy feat.
According to the Center for Disease Control (CDC), in 2020 approximately 1 in 54 children were diagnosed with an autism spectrum disorder (ASD) in the United States. For some of these children, the earliest signs of ASD can be traced back to these delicate developmental stages. Thankfully, with the growing field of early intervention, there is an opportunity to support these children and provide them with the services and attention they deserve.
Early intervention is defined by the CDC as “the services and supports that are available to babies and young children with developmental delays and disabilities and their families”. These services are available from birth to 3 years old, and target five major areas of development: Physical, Cognitive, Communication, Social/emotional, and Self-help.
Some examples of services included in early intervention are behavioral therapy, physical therapy, occupational therapy, speech and language services, nutrition counseling, and assistive technology screening. Research has shown early diagnosis and intervention for ASD are more likely to create long-term positive effects on symptoms and skills, so for these infants and toddlers, early intervention can be the first step toward their independent future.
Read more: The Risks of Delaying Autism Diagnosis.
There are several specific early intervention strategies that have been proven effective in infants and toddlers with symptoms of ASD. One specific strategy called Early Intensive Behavioral Intervention (EIBI) has been successfully applied to children under 3 years old, making it a key player in an early intervention plan. This type of treatment consists of intensive one-on-one instruction with a trained therapist for up to 40 hours per week. Of those five developmental areas listed above, EIBI is aimed to address cognition, communication, social/emotional skills and self-help.
The therapists leading EIBI aim to provide these young children with important skills at this age before they move onto more stressful environments, such as daycare or school. The theory behind the intensity of this intervention is to grasp onto the brain's plasticity to prevent more challenging behaviors from developing in the future.
While EIBI has been proven to be beneficial in many aspects for infants and toddlers with ASD, one of the five developmental areas it does not focus on as much is physical need. To address the physical challenges infants and toddlers with ASD may experience, physical and occupational therapy become important players.
Early intervention physical and occupational therapists will complete in-depth evaluations by observing how the child moves, plays, and interacts with objects or other children. The therapists create individualized treatment plans to maximize the child’s abilities while improving their independence and function. In addition, self-care activities such as fine motor assessments for eating, grooming, or using the bathroom are assessed. Treatment can include sensory integration techniques, muscle stretching or strengthening as needed, and functional mobility training.
Addressing the physical needs as an infant or toddler can prevent the child from falling behind their peers when they face more difficult tasks ahead such as walking in a line at school or doing a jumping-jack during gym class.
As the saying goes “you need to learn to walk before you can run”. For infants and toddlers with ASD, early intervention can take that task even a few steps back. Let’s first give them the tools to accept sensory input, regulate mood and affect, coordinate bodily movements, manage social/emotional needs, and self-advocate. Then we can let them walk and run with the rest of their peers, instead of falling behind them.