McGlade et al 2023: Effectiveness of Early Intervention Therapies

My take: If early childhood therapy was so "effective", then the thousands of kids who have had massive amounts of therapy all through childhood (starting with early intervention) would have "RECOVERED" may times over. Why are my challenges still significant - ie: all that therapy did not make a dent. Currently there is no such thing as gold-standard childhood therapy. Most autism therapy is hit-or-miss, at any age. Its just $$$$ spent on trial and error. Lots of careers and promotions. 

Recently there was a twitter post pointing out that since were were no readily available "statistics" (referring to it as a "cool autism fact")  showing numbers of the more significantly impacted adult autistics meant that numbers of this group must be overstated. Others in the thread  questioned if adult autistics who did not not speak, even existed, since that autistic posting had learned to speak at age 3. This an irresponsible statement and an erasure of the huge number of non-speaking or minimal verbal adults who need to be part of the autism solutions. 

Onto the paper. 

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Key Takeaways from paper. 

• Limited evidence  to recommend very early interventions for infants and toddlers with autism.
• Limited impact of early intervention for at-risk infants/toddlers (by age 3. 
• No significant treatment effects for autism symptoms, cognitive outcomes, receptive/expressive language. Even neurocognitive outcomes (EEG and eye tracking) were inconsistent. 

• Gold-standard early intervention is yet to be developed.  Future treatment will need to include novel and individualized intervention targets alongside the targeting of parental responsiveness.

Questions that arise. 

• What are the implications of these findings for clinical practice and policy related to early intervention for autism?
• What are the long-term outcomes of very early interventions for infants and toddlers with autism beyond age 3 years?
• What are the ethical considerations related to intervening in infants and toddlers at increased likelihood of autism dx, and how can these be addressed in future research and practice?

McGlade, A., Whittingham, K., Barfoot, J., Taylor, L., & Boyd, R. N. (2023). Efficacy of very early interventions on neurodevelopmental outcomes for infants and toddlers at increased likelihood of or diagnosed with autism: A systematic review and meta-analysis. Autism Research, 16(4), 698-710. https://doi.org/10.1002/aur.2924