Harnessing curiosity may allow researchers to design more effective treatments for children with autism, a new Yale study has found.
Researchers at the Yale School of Medicine and Oslo and Akershus University College (HiOA) in Norway found that in children diagnosed with autism spectrum disorders, the level of interest in toys, activities and social routines was a strong predictor of their subsequent acquisition rate of verbal, nonverbal and social adaptation skills. Children with ASD who displayed more interest in the world around them at two years of age were better at picking up those skills than those who showed less interest in the activities.
In the study, the researchers also developed a novel scoring system, the Interest Level Scoring for Autism (ILSA), to quantify interest level in toddlers with ASD. The study was published in the journal Autism on Nov. 14.
“Curiosity about the environment and drive to explore it is likely to play a very powerful role in the learning and development of children with ASD,” said Katarzyna Chawarska, a senior author of the paper and a professor at the Yale Child Study Center.
These results extend recent findings by study authors Lars Klintwall, a PhD fellow in behavioral sciences at HiOA, and HiOA professor Svein Eikeseth. According to Eikeseth, a previous study they conducted found that children with ASD showing higher interest in objects and toys also benefited more from ASD treatment than their peers who displayed less interest. Child Study Center associate research scientist and one of the study’s authors Suzanne Macari said that the current study adds on this past research by utilizing a larger sample of children, direct observation and more outcome measures.
Chawarska explained that while some toddlers with ASD show significant progress over time with treatment, others receiving such treatment show limited or no progress. Therefore, a key area of research interest lies in identifying reliable predictors of treatment outcome at the time of diagnosis — in other words, why do certain kids respond better to treatment?
“If we know what the risk factors for poor outcomes are, we can design new interventions to address challenges specific to this group,” Chawarska said.
Ultimately, the study indicates that children at risk of poor progress in behavioral interventions can be identified as soon as two years of age, which Chawarska noted is remarkably early. She said she believes that designing more effective ways to naturally motivate such toddlers can allow researchers to improve their long-term outcomes.
The ILSA scoring system that the researchers created was applied retroactively to video recordings of 70 toddlers, who were about two years of age at the time of initial examination. The researchers measured the children’s interest in ten different toys, routines and activities — all of which could potentially serve as positive reinforcers in a behavioral intervention — used in the assessment. They also collected data on the toddlers’ adaptive and cognitive function at the time of intake and after 16 months of treatment.
The study discovered that the ILSA score was a far stronger predictor of the toddlers’ rate of acquisition of adaptive, verbal and nonverbal skills than several other independent variables. Those other variables included the severity of autism symptoms and cognitive and adaptive functioning at intake, Eikeseth said.
Macari said that in addition to its findings, the study’s methods were also significant.
“Our findings suggest that a relatively simple rating system [ILSA] allows us to quantify what we had previously considered to be a bit of an intangible quality in children,” she said. She added that the system could be used to identify and monitor the progress of children who may be at high risk for poor treatment outcomes.
Nevertheless, the study acknowledged that the lack of control for the presence and types of intervention that toddlers received makes it difficult to conclude whether ILSA was predicting specific benefits drawn from early intervention.
In this vein, Eikeseth suggested that further research could be carried out to investigate whether interventions can be made more effective by increasing children’s interest in objects.
“[The] possibilities are endless if behavioral techniques are used to create reinforcers for children where few previously existed,” Macari said.
According to the Centers for Disease Control and Prevention, one in 68 children in the U.S. has autism, a 30 percent increase from one in 88 two years ago.