Early behavioral intervention is associated with normalized brain activity in young children with autism

Abstract

Objective: A previously published randomized clinical trial indicated that a developmental behavioral intervention, the Early Start Denver Model (ESDM), resulted in gains in IQ, language, and adaptive behavior of children with autism spectrum disorder. This report describes a secondary outcome measurement from this trial, EEG activity.

Method: Forty-eight 18- to 30-month-old children with autism spectrum disorder were randomized to receive the ESDM or referral to community intervention for 2 years. After the intervention (age 48 to 77 months), EEG activity (event-related potentials and spectral power) was measured during the presentation of faces versus objects. Age-matched typical children were also assessed.

Results: The ESDM group exhibited greater improvements in autism symptoms, IQ, language, and adaptive and social behaviors than the community intervention group. The ESDM group and typical children showed a shorter Nc latency and increased cortical activation (decreased α power and increased θ power) when viewing faces, whereas the community intervention group showed the opposite pattern (shorter latency event-related potential [ERP] and greater cortical activation when viewing objects). Greater cortical activation while viewing faces was associated with improved social behavior.

Conclusions: This was the first trial to demonstrate that early behavioral intervention is associated with normalized patterns of brain activity, which is associated with improvements in social behavior, in young children with autism spectrum disorder.

Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Electrodes in the anterior and posterior left and right hemisphere regions (gray) and anterior and posterior central regions (black). Note: EAR, COM, and REF are anatomically marked locations for EEG sensor net placement.

Figure 2

Event-related potential waveforms in response to faces (black, solid) and objects (gray, dotted) from children with typical development, Early Start Denver Model (ESDM) intervention, and community intervention.

Figure 3

Differences in peak latency of component (Nc) responses to faces and objects for children with typical development, Early Start Denver Model (ESDM) intervention, and community intervention. Note: Negative scores represent faster responses to faces than to objects.

Figure 4

Differences in patterns of brain activation in children with typical development, Early Start Denver Model (ESDM) intervention, and community intervention. Note: Dependent variables are log EEG spectral power during viewing of the faces minus objects. Positive θ and negative α scores indicate greater brain activation during viewing of people's faces than of objects.

Figure 5

(Left) Relation between log θ power during viewing of faces versus objects and Pervasive Developmental Disorder–Behavior Inventory (PDD-BI) composite scores for Expressive Social Communication (asterisk) and Receptive/Expressive Social Communication (circles) and (right) relation between log α power during viewing of faces versus objects and the PDD-BI Social Pragmatic Problems score (squares). Note: Greater θ power difference scores indicate increased cortical activation during viewing of faces, which is associated with improved social communication scores. Lower α power difference scores indicate increased cortical activation during viewing of faces, which is associated with fewer social pragmatic problems.