Can early interventions alter the course of autism?

Interventions for autism have come a long way since the condition was described by Kanner in the 1940s. At that time, autism was considered to be closely linked to schizophrenia, and inadequate parenting was viewed as the principal cause. Psychoanalysis was often the therapy of choice, but there was also widespread use of the drugs and even electroconvulsive treatments that had been developed for use in schizophrenia. Over the years, as autism has come to be recognized as a developmental disorder, interventions have focused instead on enhancing developmental skills and on ways of ameliorating behavioural difficulties. Recognition of the role that language deficits in particular play in causing behaviour problems has led to a focus on the teaching of more effective communication skills. The need for early support for families and appropriate education is also widely acknowledged. Nevertheless, follow-up studies indicate that the prognosis for the majority of individuals with autism remains poor. And despite claims to the contrary, there is little evidence that very early, intensive interventions can significantly alter the long-term course of the disorder. The paper discusses findings from follow-up studies over the years and assess the impact of different intervention procedures on outcome.