What is 'early intervention' for infants with signs of autism? And how valuable could it be?

Most early support programs for autistic children (also called “early interventions”) are provided after diagnosis. But long waiting times can leave families feeling stressed that they are “missing out” on critical opportunities to support their child.

With last week’s government announcement of A$22 million for two new pilot programs, support for babies and their parents is set to become more available – and potentially ease demand for National Disability Insurance Scheme (NDIS) supports.

Our team recently consulted with more than 200 community members, including autistic and non-autistic parents, clinical professionals, and researchers to understand their views on what very early supports might look like.

So what do families need to know about these types of early support and are they worth the hype?

Read more: Autism and ADHD assessment waits are up to 2 years' long. What can families do in the meantime?

Increasing support needs

Currently 88,617 children under seven are supported by the NDIS. Some 10% of boys and 4% of girls aged five to seven access the scheme and half of all child participants are registered for autism supports.

The substantial need for services has led government to consider other options for supporting neurodivergent children. Rather than waiting until after an autism diagnosis, very early supports for infants may promote better outcomes while also taking pressure off an overloaded system.

Government interest in very early support programs has increased following research suggesting that for every $1 invested in supporting neurodivergent infants and parents, the NDIS could save at least $3 down the track. The Australian study modelled service costs through to children’s 13th birthday.

Read more: Therapy for babies showing early signs of autism reduces the chance of clinical diagnosis at age 3

What are autism supports for babies?

Supports provided very early in life, before a diagnosis, are sometimes called “pre-emptive interventions”. The idea is that a relatively small amount of support early on can help prevent future difficulties, as families are better equipped to understand their baby’s skills and needs and respond supportively.

Until now, there has been very limited support available for families before diagnosis. Several different models have been developed and trialled, but these are not widely available in the community.

Our work with the autistic community has identified key recommendations for supports for neurodivergent infants, to assist parents to make informed decisions about what is best for their child.

Because these very early programs are aimed at supporting such young babies, the work should be with the parents, rather than with the child. Supports can involve parent training and education focused on helping parents understand and support their child. Parents might learn strategies and ways of interacting that they can then use at home with their little one.

An example of this might be a clinician and parent observing an infant together and practising noticing their communication cues, or following the infant’s lead and engaging together in activities the infant is interested in (regardless of whether these are “usual” for neurotypical children).

This type of support can be valuable because neurodivergent children can communicate in different ways, and parents might need some help to understand what their baby wants and needs.

Becoming a new parent brings many changes, and insights from the autistic community indicate parents of neurodivergent children may require additional support. Many parents of autistic children may also be neurodivergent or exhibit autistic traits, including sensory sensitivity.

But this won’t look the same for everyone. Supports should be tailored according to what the infant and family needs. The amount of support families need will also vary. It’s got to be balanced so that children can continue to play and participate in the community without the burden of attending too many appointments.

But not all babies who show early signs of neurodivergence will be autistic. Ideally, support provided will be something that is helpful for any child. Community members told us that programs for infants should aim to foster an enriching and supportive environment around the child – promoting secure attachment and supporting infants as they grow into happy, healthy children (and adults).

Similarly, supports should not be aimed at making children appear neurotypical, trying to “fix” or eliminate autism. Rather the aim should be to promote understanding of a baby as an individual, with their own unique strengths and ways of communicating.