UA Researcher Leads Statewide Effort on Autism Education, Early Intervention

Early intervention can significantly improve developmental outcomes for children with autism.
April 10, 2013
Recognizing early signs of autism and interveneing quickly can dramatically improve a child's developmental outcomes, says Ann Mastergeorge, Arizona's Act Early Ambassador.
Recognizing early signs of autism and interveneing quickly can dramatically improve a child's developmental outcomes, says Ann Mastergeorge, Arizona's Act Early Ambassador.
Ann Mastergeorge, associate professor of family studies and human development
Ann Mastergeorge, associate professor of family studies and human development
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Child Development Milestones

The following milestones provide guidelines for tracking healthy development from 3 months to 5 years of age. Parents are advised to monitor if their child is achieving typical milestones. If not, it may be time to talk to a physician.

By 3-4 months:

  • Watches faces with interest and follows moving objects 
  • Recognizes familiar objects and people; smiles at the sound of your voice 
  • Begins to develop a social smile
  • Turns head toward sounds

By 7 Months:

  • Responds to other people's emotions 
  • Enjoys face-to-face play; can find partially hidden objects
  • Explores with hands and mouth; struggles for out of reach objects 
  • Responds to own name
  • Uses voice to express joy and displeasure; babbles chains of sounds

By 12 Months (1 year):

  • Enjoys imitating people; tries to imitate sounds 
  • Enjoys simple social games, such as "gonna get you!"
  • Explores objects; finds hidden objects
  • Responds to "no;" uses simple gestures, such as pointing to an object 
  • Babbles with changes in tone; may use single words ("dada,""mama," "Uh-oh!")
  • Turns to person speaking when his/her name is called.

By 24 Months (2 years):

  • Imitates behavior of others; is excited about company of other children 
  • Understands several words
  • Finds deeply hidden objects; points to named pictures and objects 
  • Begins to sort by shapes and colors; begins simple make-believe play 
  • Recognizes names of familiar people and objects; follows simple instructions 
  • Combines two words to communicate with others, such as "more cookie?"

By 36 Months (3 years):

  • Expresses affection openly and has a wide range of emotions 
  • Makes mechanical toys work; plays make-believe 
  • Sorts objects by shape and color, matches objects to pictures 
  • Follows a 2- or 3-part command; uses simple phrases to communicate with others, such as "go outside, swing?"
  • Uses pronouns (I, you, me) and some plurals (cars, dogs)

By 48 Months (4 Years):

  • Cooperates with other children; is increasingly inventive in fantasy play
  • Names some colors; understands concepts of counting and time 
  • Speaks in sentences of five to six words
  • Tells stories; speaks clearly enough for strangers to understand 
  • Follows three-part commands; understands "same" and "different" 

By 60 Months (5 Years):

  • Wants to be like his/her friends; likes to sing, dance and act 
  • Is able to distinguish fantasy from reality 
  • Shows increased independence 
  • Can count 10 or more objects and correctly name at least four colors 
  • Speaks in sentences of more than five words; tells longer stories

 (Source: Autism Speaks)


Additional Autism Resources
A variety of resources on autism can be found on the CDC's Act Early website, on the Autism Speaks website and on the First Signs website.

One in 50 school-aged children in the United States is diagnosed with autism, according to statistics recently released by the Centers for Disease Control and Prevention.

Ann Mastergeorge, associate professor of family studies and human development at the University of Arizona, is leading a statewide effort to educate parents, health-care providers and other professionals about how to identify the signs of autism in very young children and how early intervention can help.

Mastergeorge recently was appointed by the CDC as the Act Early Ambassador for Arizona, one of 25 states participating in the initiative, which focuses on early identification of autism and other developmental disabilities. April is National Autism Awareness Month.

Autism – a neurodevelopmental disorder characterized by impaired communication and social interaction and behavioral challenges – most often is diagnosed around age 3 or 4, but potential signs of the disorder often appear much earlier, by a child's first birthday, Mastergeorge said.

"We know that we can identify signs in children as young as 6 months of age, not that they have autism but they have signs," Mastergeorge said. "There are specific criteria that we look for at 6 months, at 12 months, at 18 months. We can catch these children very, very young and provide them with intensive early interventions, and it makes a huge difference in terms of their developmental outcomes."

Although there is no known cure for autism, early intervention can significantly improve a child's social and communication skills, Mastergeorge said.

Interventions might include in-home "parent-mediator interventions," in which parents and therapists work together to engage children in activities that promote social play, like turn-taking games. Also important are interventions that place children with autism in the same space with typically developing children, who can provide important motivation for social interaction, Mastergeorge said.

"It's not that children with autism can't learn to interact. They just don't have the steps for interacting," Mastergeorge said. "We have to recruit them into activities with much more vigilance that you would with a child who doesn't have autism, so we utilize parents and other children and we have teachers involved as well."

The cause of autism is not entirely clear, although a number of environmental, biologic and genetic factors are believed to contribute to risk. For example, children who have a sibling or parent with an autism spectrum disorder are at greater risk for developing autism themselves.

Through her work as an Act Early Ambassador, Mastergeorge hopes to raise awareness of the early signs of autism by providing education materials, like simple child-development checklists, to parents, pediatricians and other professionals, like therapists, teachers and child-care providers. Materials are available in both English and Spanish.

Mastergeorge also will provide "train the trainer" classes to other individuals statewide who are interested in helping to educate people about early autism awareness.

"The goal is to develop an Act Early team across the state," she said.

The number of children diagnosed with autism has increased significantly since 2002, when the CDC reported that autism affected about one in 150 children nationwide.

In Arizona, it's estimated that about one in 64 children are now diagnosed with the disorder.

Early indicators of autism vary and may include the following, according to the science and advocacy organization Autism Speaks:

  • No big smiles or other warm, joyful expressions by 6 months or thereafter
  • No back-and-forth sharing of sounds, smiles or other facial expressions by 9 months
  • No babbling by 12 months
  • No back-and-forth gestures such as pointing, showing, reaching or waving by 12 months
  • No words by 16 months
  • No meaningful, two-word phrases (not including imitating or repeating) by 24 months
  • Any loss of speech, babbling or social skills at any age

Mastergeorge's work with the CDC is an extension of her ongoing research at the UA looking at early autism intervention.

She is conducting her work as an Act Early ambassador in collaboration with UA's Sonoran UCEDD – which stands for University Center for Excellence in Developmental Disabilities Education, Research and Service – and with the UA College of Medicine's ArizonaLEND program – which stands for Leadership Education in Neurodevelopmental Disabilities.

"We don't know how to cure autism, but there is so much optimism for children who have early signs, or even have autism," Mastergeorge said. "We have wonderful interventions that make huge differences. There's a lot of hope."