How Much Early Intervention Is Enough?

Today, parents of newly diagnosed children are often given a similar treatment recommendation by paediatricians or other allied health professionals: 2 hours of speech therapy and occupational therapy a fortnight.

The expectation is that parents will do the rest to fill in the gaps at home. The problem is that this recommendation falls well short of what every research study and research review to date tells us is best practice!

Research consistently indicates that optimal outcomes in autism early intervention are achieved with upwards of 20 hours of therapy per week.

The Early Intervention for Children with ASD ‘Guidelines for Good Practice’ (2012) states: ‘High intensity interventions which address the child and family’s clearly documented needs, using behavioural, educational and/or developmental approaches have been shown to be the best of currently available early interventions. The amount of intervention is usually described as number of hours of treatment per week. Fifteen to twenty-five hours per week is generally recommended for autism early intervention in the research literature (Roberts & Prior, 2006) with some programs recommending as much as 40 hours per week.’

The recommended number of hours of therapy may seem high, and parents and funding agencies may be reluctant to undertake such an intensive program. However, this recommendation is based on research findings regarding the intensity required to produce good outcomes.

The more time the child spends away from intensive intervention (or the more time the child spends participating in non-intensive or non-evidence-based interventions), the more likely it is that the child will fall further behind typical developmental trajectories. As a result, the family and society will incur much greater costs, and the child will likely be dependent on more intensive services across his or her lifespan.

We at Lizard argue that the cost of effective, intensive early intervention should be compared to the long-term cost of not intervening, which may carry a considerably more expensive burden over the longer term.

We advocate that intervention should start as soon as characteristics of autism are detected, and should continue for as long as required.

Characteristics of autism are life-long, however the need for support varies among individuals and according to their age and stage.

At Lizard, the intensity, timing and duration of intervention is based on individual child and family needs – there is no ‘one size fits all’ model.

We prefer to provide an INTENSIVE program for a SHORT duration, rather than a non-intensive program for a long time.