Treatments

 

Discovering that your child has an autism spectrum disorder (ASD) can be an overwhelming experience. For some, the diagnosis may come as a complete surprise; others may have had suspicions and tried for months or years to get an accurate diagnosis. In either case, a diagnosis brings a multitude of questions about how to proceed. A generation ago, many people with autism were placed in institutions. Professionals were less educated about autism than they are today and specific services and supports were largely non-existent. Today the picture is much clearer. With appropriate services and supports, training, and information, children on the autism spectrum will grow, learn and flourish, even if at a different developmental rate than others.

 

While there is no known cure for autism, there are treatment and education approaches that may reduce some of the challenges associated with the condition. Intervention may help to lessen disruptive behaviors, and education can teach self-help skills that allow for greater independence. But just as there is no one symptom or behavior that identifies individuals with ASD, there is no single treatment that will be effective for all people on the spectrum. Individuals can learn to function within the confines of ASD and use the positive aspects of their condition to their benefit, but treatment must begin as early as possible and be tailored to the child's unique strengths, weaknesses and needs.

 

Throughout the history of the Autism Society of America, parents and professionals have been confounded by conflicting messages regarding what are, versus what are not, appropriate treatment approaches for children and adults on the autism spectrum.

 

The purpose of this section is to provide a general overview of a variety of available approaches, not specific treatment recommendations. Keep in mind that the word "treatment" is used in a very limited sense. While typically used for children under 3, the approaches described herein may be included in an educational program for older children as well.

 

It is important to match a child's potential and specific needs with treatments or strategies that are likely to be effective in moving him/her closer to established goals and greatest potential. ASA does not want to give the impression that parents or professionals will select one item from a list of available treatments. A search for appropriate treatment must be paired with the knowledge that all treatment approaches are not equal, what works for one will not work for all, and other options do not have to be excluded. The basis for choosing any treatment plan should come from a thorough evaluation of the strengths and weaknesses observed in the child.

 

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Understanding your options

 

Treatment approaches are constantly evolving as more is learned about the autism spectrum. There are many therapeutic programs, both conventional and complementary, that focus on replacing dysfunctional behaviors and developing specific skills.

 

As a parent, it's natural to want to do something immediately. The literature states time and time again the importance of early treatment for individuals on the autism spectrum However, it is important not to rush in with changes. It does no good to push ahead with a treatment that is not appropriate for the individual or one that may be harmful. You also much consider the larger implications of beginning a new treatment. A child may have already learned to cope with his or her current environment and sudden changes or unexpected different expectations could be stressful and confusing. Various treatment approaches should be investigated and information gathered concerning various options before proceeding with any child's treatment.

 

Parents will encounter numerous accounts from other parents about successes and failures with many of the treatment approaches mentioned. Professionals also differ in their theories of what they feel is the most successful treatment for autism. It can be frustrating! Parents do learn to sift through the information, examine options with a critical eye and make rational, educated decisions on what is appropriate given the individual circumstance. Parents live with the individual on the spectrum every day and best know his/her needs and the unique ways that autism impacts their lives. Parents must be empowered to trust their instincts as various options are explored, considered and implemented.

 

The descriptions of treatment approaches provided here are for informational purposes only. They serve as overviews and should always be followed with contact with qualified professionals and should be discussed with parents or individuals on the spectrum who have person experiences. The Autism Society of America does not endorse any specific treatment or therapy.

 

While doing research, parents and professionals will hear about many different treatments approaches, such as auditory training, discrete trial training, vitamin therapy, anti-yeast therapy, facilitated communication, music therapy, occupational therapy, physical therapy, and sensory integration. These approaches can generally be broken down into three categories:

Some of these treatment approaches have research studies that support their efficacy; others may not. Some parents will only want to try treatment methods that have undergone research and testing and are generally accepted by the professional community. But keep in mind that scientific studies are often difficult to do since each individual on the autism spectrum is different.

 

For others, formal testing might not be a pre-requisite for them to try a treatment with their child. Even for those with "scientific" proof, the Autism Society of America recommends that all options available are investigated to determine the approach that is most appropriate.

 

Experts agree though, that early intervention is important in addressing the symptoms associated with ASD. The earlier treatment is started, the more opportunity for the individual to reach their highest potential. Many of the approaches described can be used on children as young as age 2 or 3. They may also continue to be used in conjunction with special education programs or traditional elementary school for children who are mainstreamed.

 

Programs for children under 3

 

If a child is younger than 3 years old, he or she is eligible for "early intervention" assistance. This federally-funded program is available in every state, but may be provided by different agencies. Contact the local chapter of the Autism Society of America in your area for more specific information, search program listings in Autism Source™ located on the web at autismsource.org, or obtain a state resource sheet from the National Information Center for Children and Youth with Disabilities.

 

This early education assistance may be available in two forms: home-based or school-based. Home-based programs generally assign members of an early intervention team to come to the home to train parents or caregivers to educate the child on the spectrum. School-based programs may be in a public school or a private organization. Both of these programs should be staffed by teachers and other professionals who have experience working with children with disabilities specifically autism. Related services should also be offered, such as speech, physical or occupational therapy, depending on the needs of each child. The program may be only for children with disabilities or it may also include typically developing peers.

 

Programs for school-aged children

 

From the age of 3 through the age of 21, every child diagnosed on the autism spectrum is guaranteed a free appropriate public education supplied by the local education agency. The Individuals with Disabilities Education Act (IDEA) is a federal mandate that guarantees this education. Whatever the level of impairment, the educational program for an individual on the autism spectrum should be based on the unique needs of the student, and thoroughly documented in the IEP (Individualized Education Program). If this is the first attempt by the parents and the school system to develop the appropriate curriculum, conducting a comprehensive needs assessment is a good place to start. Consult with professionals who are well versed in the spectrum of autism and related conditions about the best possible educational methods that will be effective in assisting the student to learn and benefit from his/her school program. Educational programming for students with ASD often addresses a wide range of skill development, including: academics, language, social skills, self-help skills, behavioral issues, and leisure skills.

Parents can and should be an active and equal participant in deciding on an appropriate educational plan for their child. Parents know the child best and can provide valuable information to teachers and other professionals who will be providing educational services. Collaboration between parents and professionals is essential; open communication will certainly lead to better evaluation of progress and improved outcomes for the student.

 

To learn about other services specific to an area, contact resources in the community, such as the local ASA chapter, a local University Affiliated Program for Developmental Disabilities, the local ARC, Easter Seals, or Parent Training and Information Center. Be persistent but be patient it may take days or weeks to find the information you need. If a local resource is not able to provide the information or services sought, ask for a referral to another agency or local resource that may be helpful.

 

Evaluating Approaches

 

Because no two children on the autism spectrum have the exact same symptoms and behavioral patterns, a treatment approach that works for one child may not be successful with another. This makes evaluating different approaches difficult and that much more essential. There is little comparative research between treatment approaches. Primarily this is because there are too many variables that have to be controlled. So, it's no wonder that parents might be confused about what to do.

 

The Autism Society of America has long promoted the empowerment of individual consumers (including people on the spectrum, parents and professionals) to critically examine a variety of available options and be forearmed with a set of parameters under which they can better determine associated threats and opportunities and, therefore, make informed decisions. Further, better educated consumers, would help control the embracing of unproven notions that may distract from effective courses of treatment for individuals with ASD.

 

In the article "Behavioral and Educational Treatment for Autistic Spectrum Disorders" (Autism Advocate, Volume 33, No. 6), Bryna Siegel, Ph.D., suggests thinking about "each symptom as an autism specific learning disability…" that tells "something about a barrier to understanding." Using this model, what the student can and cannot do well can be evaluated. "…take stock of which autistic learning disabilities are present," and "then select treatments that address that particular child's unique autism learning disability profile."

 

Understanding these learning differences is the first step in assessing whether a specific treatment approach may be helpful; understanding a child's strengths is equally important. For example, some children are good visual learners, while another child may need written, rather than oral, cues.

 

 

Source: The Autism Society of America  (view source page here)