Implementation of the Homeostasis-Enrichment-Plasticity (HEP®) Approach for an Infant at Risk for Autism Spectrum Disorder: A Case Report

Background and Clinical Significance: This case report explicates the implementation and outcomes of the Homeostasis-Enrichment-Plasticity (HEP®) Approach in a 10-month-old male infant with an increased risk of Autism Spectrum Disorder (ASD) who exhibited challenges in sensory functioning and motor development. Case Presentation: The intervention was carried out utilizing the eleven-step HEP® Approach process. The Peabody Developmental Motor Scale-2 (PDMS-2), Test of Sensory Function in Infants (TSFI), Adaptive Behavior Assessment System-3 (ABAS-3), and Goal Attainment Scale (GAS) were used as outcome measures before and after the intervention. A pediatric physical therapist conducted an hour-long intervention weekly for 10 weeks using the HEP® Approach implementation guide. Post-intervention, the infant's fine and gross motor skill scores in the PDMS-2 and General Adaptive Composite in the ABAS-3 exhibited significant improvement, as determined by the 95% confidence interval overlap analysis. The TSFI total score also improved categorically. An overall GAS score of +1.6 corresponded to a t-score of 74.12, indicating significant progress towards the individualized intervention goals. Conclusions: The HEP® Approach enhanced motor development, sensory functioning, general adaptive skills, and parental goals in a 10-month-old infant at risk for ASD. The results support further examination of the HEP approach's effectiveness in infants at risk for ASD.