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Previous studies have suggested between 3 percent and 25 percent of autistic kids recover. Fein says her studies have shown the range is 10 percent to 20 percent.

But even after lots of therapy - often carefully designed educational and social activities with rewards - most autistic children remain autistic. Recovery is "not a realistic expectation for the majority of kids," but parents should know it can happen, Fein said.

The children in Fein's study, which is still ongoing, were diagnosed by an autism specialist before age 5 but no longer meet diagnostic criteria for autism. The initial diagnoses were verified through early medical records.

The researchers are also doing imaging tests to see if the recovered kids' brains look more like those of autistic or nonautistic children.

Imaging scans also are being done to examine brain function in formerly autistic kids.

Results from those tests are still being analyzed.

Most of the formerly autistic kids got long-term behavior treatment soon after diagnosis, in some cases for 30 or 40 hours weekly.

Many also have above-average IQs and had been diagnosed with relatively mild cases of autism. At age 2, many were within the normal range for motor development, able to walk, climb and hold a pencil.

Significant improvement suggesting recovery was evident by around age 7 in most cases, Fein said.

None of the children has shown any sign of relapse. But nearly three-fourths of the formerly autistic kids have had other disorders, including attention-deficit problems, tics and phobias; eight still are affected.

An initial retrospective study is comparing two groups of 20 children initially diagnosed with autism who were functioning well after two or more years of treatment, either with a discrete trial training approach or the DIR approach. The study aims to determine if treatment differences lead to subtle differences in outcome, for example, in terms of flexibility, emotional range, creativity and richness of the child's inner life. Investigators are planning to follow this research with a prospective, randomized, more rigorous study of the two approaches.

"In our previous studies we found out that it looks like you can't just deliver a standard treatment to autistic kids, that there's so much variability among the children that what works for one child doesn't work for another child," he says. "Our hypothesis is that...unless you individualize treatment, you're not going to get the best effect."

Researchers at the University of Maryland are testing an intervention to trigger children's "social engagement system," which includes behaviors such as listening, looking, facial expressions and vocalizations that support social interaction, says psychologist Stephen Porges, PhD. The treatment is designed to improve autistic children's ability to interact with others, thereby making them more receptive to traditional therapies.

The intervention is based on the theory that tensing the middle ear muscles enables people to pick out the human voice from lower frequency sounds in the environment, Porges says. Treatment involves exercising middle ear muscles by playing music that has been altered to include only frequencies associated with the human voice, which improves one's ability to listen to human voices. This, in turn, stimulates the entire social engagement system, Porges says. About 80 percent of 50 children with autism or other behavioral problems receiving this treatment via five 45-minute sessions in a double blind, randomized controlled study showed marked improvements in listening, language and other communication skills.

In a report last year in the Journal of Autism and Developmental Disorders (Vol. 28, No. 1, p. 15-23) evaluating an intensive home-based discrete trial training intervention, Stephen Sheinkopf, PhD, of the University of Miami and Bryna Siegel, PhD, of the University of California, San Francisco, noted that children receiving an average of only 21 hours per week of treatment showed gains in IQ comparable to those achieved by children receiving 32 hours per week. The intensity question remains an issue of importance for the autism community. "If we need 40 hours a week, fine," says psychologist Geraldine Dawson, PhD, of the University of Washington. "But if you only need 25, you have to realize that 40 hours is a tremendous burden not only financially, but on families and on the child."

First and foremost, children think of it as fun and learn skills by doing what they enjoy.

PRT is effective in all of the child’s environments and versatile enough to use at home, in clinical settings, in an inclusive classroom, and in the community, and parents can easily start folding PRT strategies into the child's established routine right away.

How does PRT decrease stress for parents?

1988 was the first time the word pivotal was used to describe this method. It was referred to previously as the NLP. It is considered a behavior intervention with similarities to the Lovaas method/ABA. 

What exactly are "pivotal responses?"

"areas that are central to wide areas of functioning such that improvements occur across a large number of behaviors." 

Once they understand the connection between using their own words and getting something they want, they will start to use words spontaneously to communicate their needs. Mastering this one pivotal behavior, motivating the child to understand the connection between their own efforts to communicate with the outcomes of their efforts, will have an enormous ripple effect on other skills.

It works because there is a motivator that makes the child want to work to accomplish the task at hand, the reward for accomplishing the task has a direct connection to it.

PRT was named by the National Research Council of the National Academy of Sciences in 2001 as one of the top 10 state-of-the-art treatments for autism in the United States.

A child who is highly motivated to communicate and is having fun doing it will learn much more rapidly than a child who is not motivated and not enjoying what they are learning.