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Dear Ms. Coorey,

We are writing in response to your thoughtful article, “Mum Julia Coorey on surviving an autism diagnosis and importance of early diagnosis.”  Your article is not only a moving personal story of your journey through an autism diagnosis, but an educational article for other families of newly diagnosed children.  In Australia, the number of children receiving a diagnosis of autism continues to rise.  In 2012, Autism Asperger’s Advocacy Australia (A4) reported that 1 in every 63 Australian school children have a formal autism diagnosis.  However, an autism diagnosis is often delayed for many Australian children.  Fewer than 3% of children with an autism diagnosis are identified before the age of two (the earliest age it can be reliably identified by healthcare professionals), with the average age of diagnosis being four years and one month.

Upon learning of Michael’s diagnosis (at the age of 19 months), you write, “…I did not feel unhappy, desperate, or even surprised.  Actually I was pretty happy…You see, I had actually pushed for this diagnosis and had gotten it in under four weeks…an early diagnosis was his best chance to improve his future.”  This reflects a keen understanding of the importance of early detection.  Early detection of autism is critical because it leads to early intervention.  Several decades of peer-reviewed research indicates that early intensive behavioural intervention (EIBI) is the most effective treatment for young children with autism.  EIBI is characterised by the following components:

  • Early: Intervention begins as soon as a diagnosis is confirmed. EIBI may produce the greatest gains when intervention is started before age 2.
  • Intensive: Intervention is provided for no less than 20 hours per week, with some studies recommending 30-40 hours per week.
  • Behavioural: Intervention is focused on the objective identification of skill deficits and behavioural excesses, and the use of a broad array of teaching tactics derived from applied behaviour analysis to build functional skills.

In summary, early intensive behavioural intervention leads to a higher degree of independence and better outcomes for children with autism.  This finding is not new or experimental, but is firmly rooted in decades of peer-reviewed scientific research.  These research findings have been translated into best practice recommendations regarding the intensity of intervention, and are reflected in recent Australian publications.  The Australian Guidelines for Good Practice (Prior & Roberts, 2012) and the Autism Spectrum Disorder: Evidence-Based/Evidence Informed Good Practice for Supports Provided to Preschool Children, Their Families and Carers (Roberts et al., 2016) recommend 15-25 hours per week of autism-specific intervention for young children with an autism diagnosis.

Thank you again for sharing your story in such an authentic and heartfelt manner.  It is essential that young children with autism are diagnosed early and have access to evidence-based early intervention.  The more that parents are informed about the importance of early detection and intervention, the more likely they will be to seek help from qualified professionals to help their children reach their full potential.  Readers may be interested in some of the resources available on ASAT’s website such as this 2009 article and 2011 article about what early intervention may involve as well as a summary of the available research related to early intervention.

Sincerely,

Erin Leif, PhD, BCBA-D and David Celiberti PhD, BCBA-D

Association for Science in Autism Treatment

References

Autism spectrum disorder: Evidence-based/evidence-informed good practice for supports provided to preschool children, their families and carers (2016).  Retrieved from http://www.ndis.gov.au/sites/default/files/Early%20Intervention%20for%20Autism%20research%20report.pdf

Bent, C. A., Dissanayake, C., & Barbaro, J. (2015). Mapping the diagnosis of autism spectrum disorders in children aged under 7 years in Australia, 2010–2012. Med J Aust, 202(6), 317-320.

Early Intervention for Children with Autism Spectrum Disorders: ‘Guidelines for Good Practice’ (2012). Retrieved from https://www.dss.gov.au/our-responsibilities/disability-and-carers/program-services/for-people-with-disability/early-intervention-for-children-with-autism-spectrum-disorders-guidelines-for-good-practice-2012

 

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