Early intervention for autism - parents are the experts
A road leads steeply uphill past orange trees and lavender through the small Israeli village of Rosh Pina. Where it ends, parents with autistic children are to start a new life. At least that's what the name of the Mifne centre promises. Mifne translates as «the turning point». The large brick building rests majestically on the hill. The Chula Plain stretches into the distance, with the Golan Heights behind it. The only sound comes from a wooden wind chime.
Eating problems are one of the eight early signs of autistic disorders.
This is the setting for an intensive therapy programme: 3 weeks, 7 days a week, 8 hours a day, parents work here with their autistic toddlers and therapeutic specialists. They often travel from far away and pay 25,000 US dollars for the programme.
What is special about the Mifne approach? Why do parents go to all this trouble? A special feature is revealed on the desk of autism expert and director of the Mifne Centre, Dr Hanna Alonim. The live recording from the therapy room is playing on a small television. 35-year-old Diego Barbosa* from Brazil is engrossed in a game with his son Rafael*. Rafael is 1.5 years old.
What are the signs of autism?
«Age is key,» says Hanna Alonim. «We only take toddlers up to 2 years old.» That wasn't always the case. When the psychologist co-founded the Mifne Centre in Israel in 1987, she also took older children into therapy. In her 30 years of working with autistic children and their families, however, the autism landscape has changed considerably - not least the age of diagnosis.
«We also give the diagnosis to 1 to 1.5-year-old infants,» says Hanna Alonim. «Some people say that "labelling» a child so early is irresponsible. But we know from our studies that 89 per cent of 110 autistic children already showed early signs in the first year of life.
We can exert the most influence on the neuronal network up to the age of two.
And in 2016, we were able to prove in a follow-up study that with early intervention, the majority of children show age-appropriate development in the first 24 months." Hanna Alonim backs up her observations with studies from brain research.
«The neuronal network on the basis of which personality, learning ability and IQ develop is formed up to the second year of life. This is the time when we can have the most influence.» US autism researcher Geraldine Dawson even refers to early intervention as a «preventative measure».
Parents as experts
Back in the therapy room. Father and son eat lunch in the presence of therapist Veronica Jacubson. Rafael remains silent with a full spoon in his hand. «He refuses to touch the food.» That's what Giora Shaynface says. He watches the scene from behind a mirrored glass wall.
Eating problems are one of the eight early signs of autistic disorders. «The father's reaction is typical: he takes over the feeding.» «What would happen if you waited a moment before bringing the spoon to your son's mouth?» asks the therapist in the debriefing.
Some parents suppress the abnormalities. Others have undergone numerous investigations.
«I see what parents do, but not what they think. They should develop a deeper understanding of their child's special needs and at the same time understand the reasons for their own actions. This gives parents more self-esteem and confidence, which improves the interaction between them and their child.»
This is another special feature of the Mifne approach: both mother and father are seen as the child's most important resource and are therefore both present during therapy. «They are the ones who have to act when the child cries or doesn't eat. I could be the best therapist in the world and still have no influence on the child,» says Hanna Alonim. «At the beginning, however, parents are often in a crisis and need help.» Some parents suppress the abnormalities. Others have already undergone several investigations.
- Excessive passivity (no crying, hardly any movement, little interest in the environment), hardly any direct eye contact with people
- hardly any reaction to the parents' voice or presence
- Excessive activity (continuous crying, lack of rest)
- refuses to eat
- rejects parental touch
- Delayed motor development
- Accelerated growth of the head circumference
Further information: www.mifne-autism.com
The child at the centre
Diego Barbosa is no exception. Not knowing is difficult for him. «I'm a scientist,» he says on the day of arrival. «I need facts.» Hanna Alonim nods. «But we work with your child, not with facts.» Giora Shayngesicht also takes this stance. «Sometimes people question whether the early signs are really caused by an autistic disorder. We don't know for sure. However, if the therapy alleviates the family's suffering, the diagnosis ultimately doesn't matter.»
However, if there is a diagnosis, there is a chance of a contribution to the therapy costs from the public purse. The Mifne Switzerland Foundation, based in Zurich, also provides support where necessary. Hanna Alonim and the Mifne team are also endeavouring to make their concept known in other countries.
In Basel, for example, the FIAS centre emerged from the Mifne approach in 2010. Treatment at home facilitates follow-up care. The family continues to be supported by Mifne therapists until the child is integrated into kindergarten. Rafael is not quite there yet. He still lives in seclusion, dependent on his parents to organise the chaos of stimuli in the outside world for him. At the moment, the family is taking a break. Rosh Pina is quiet at midday. Even the wind chimes have died down.
* Names known to the editors
