Editorial: Trials and Tribulations in Early Autism Intervention Research.

Despite a slow start, the past 15 years has seen an unprecedented increase in the number and quality of randomized controlled trials (RCTs) being conducted in the early autism field. This is welcome, because many young children with autism struggle to communicate and interact with others, restricting their opportunities to learn and develop, and impacting on their parents who can find their child's behavior perplexing and challenging to manage. However, as with so many areas of clinical science, with progress come challenges. Rogers et al. report on a multi-site RCT of the Early Start Denver Model (ESDM), an intensive, naturalistic developmental-behavioural intervention program. The original small-scale (n = 48) ESDM study found improvements in IQ and adaptive behavior (on both measures largely in the language/communication domains) and a marginal improvement in diagnostic classification but no differences on continuous measures of autism severity. The study is highly cited and has been influential as a key part of the evidence for proponents arguing for the effectiveness of comprehensive early intervention programs.