Autism Interventions
Treatments for Autism
Is there one cure all for autism? We all would like to find one, but so far no one has found it. Do some treatments make a remarkable difference for some people? Yes! Do some treatments unsupported by scientific research and scoffed at by your pediatrician truly work? Yes, for some children. Some children have essentially lost their diagnosis after successfully “healing their gut” by taking enzymes and avoiding food allergens. Others have seen similar dramatic results after being injected with methyl B-12. Other’s improved after being diagnosed with a vitamin D defficiency and dually supplemented.
Still others have found miraculous improvements at the hand of medicne: risperadone helps Conner play with his peers instead of acting out agressively toward them and being sent to the “safe room” at school where he cannot hurt himself or anyone else. Jerome can now be mainstreamed in Kindergarten with his peers after being treated with Nystatin for a bacterial overgrowth in his intestine that held him close to the severe end of the spectrum. There are hundreds of supplements, pharmesuticals, lab tests, music therapists, cranial therapists, you could spend every waking moment trying to incorporate into your child’s life, but a word of caustion: Do your homework. Be sure of the safety for your child. Be wary of those who will make a big profit from your desperate hope for a cure.
Scientific and medical research is going to need a lot of time and money to catch-up, to investigate the variety of therapies, medications, diets, supplements, and behavioral trainings, that have been credited with either bringing vast improvements in or completely curing autism. Parents of children who have ASD cannot wait for research and medicine to catch up when it comes to doing something now for our affected children. But at the same time, some of the widely touted “autism cures” such as chelation (removal of toxic heavy metals) have also resulted in injury or even death to children with autism. Choosing a doctor and interventions with care, paying attention to the safety record, risks, costs, and potential benefits for your child are so important.
Behavioral Interventions
Across the board, if you read “success story sites” of children with autism either drastically improving or even losing their diagnosis, you will see behavioral intervention therapies pop up more frequently than any other intervention. These therapies have been crucial to our son’s recent successes in language retention, compliance, understanding and following directions, and making transitions from an activity he prefers to one he doesn’t much more smoothly.
Here is a breakdown of some of the most common behavioral therapy interventions starting with evidence based strategies most often used in autism specific classrooms and followed by strategies not evidence based but effectively incorporated at home and used in individual therapy sessions.
Evidence Based Instructional Strategies
Applied Behavior Analysis (ABA)
This method is based on scientific principles intended to build social skills and useful behaviors as well as reduce or eliminate undesirable behaviors. The basic principles that form the foundation for this method include:
Teach complex skills segments in a systematic sequence, starting from easiest to most difficult.
Give clear, precise directions, so the child knows exactly what you want him or her to do.
Provide the least amount of assistance needed to help the child be successful.
Establish clear cut expectations for the desired response for each behavior or objective, that it is clear when he or she has successfully satisfied the objective.
Reward or reinforce correct behaviors.
Discrete Trial Teaching:
The goal of Discrete Trial Teaching (DTT) is to break down complex skills into simple, manageable segments. Simple segments are taught by showing the child a specific cue intended to invoke a specific response from the child. If the child responds correctly, a highly desired reward is given. If the child does not respond correctly, the teacher gives her a prompt to correct the behavior.
DTT focuses on foundational skills pertanent to early education such as attending, imitation, and compliance as well as receptive and expressive communication skills.
Example of DTT:
Teacher: Taps a drum 3 times.
Hands stick to child saying, “Tap, tap, tap!”
Child: Takes stick and taps the drum 3 times.
Teacher: Great tapping!
Gives child a fruit snack.
Pivital Response Training
Pivital Response Training (PRT) is similar to DTT except that it focuses on generalizing skills to many different contexts and functions. Another major difference is that PRT bases it’s success on finding what activities are motivating and interesting to the individual child to increase spontaneous language, better generalization of skills, and longer-term maintainence of skills. PRT primarily targets expressive language and play skills. The teacher rewards the child not only for accurate responses, but also for good attempts, which encourages spontaneous responses. The teacher will use wait time and control access to a desired item to encourage the child to respond.
Example of PRT:
Teacher: Shows child 2-3 toys to choose from.
Child: Picks up bubble container.
Teacher: Bubbles, you want bubbles?
Holds up bottle
Repeats, “Bubbles” holding wand near mouth.
Wait for child’s response.
Child: “Buhh.”
Teacher: “Yes, Bubbles!”
Blows bubbles.
Models popping bubbles, saying “Pop!”
Repeat series looking to increase and expand on child’s response. Possible prompts might be…”B-B-B….” “more” or a blowing sound to elicite the word “Bubble” or “more” or “Blow” or some approximation. More advanced speakers may be expected to say, “I want bubbles.” or “Blow bubbles please.”
Functional Routines
Teaching skills in a functional routine often makes to most sense, is more time efficient, and easier to naturally incorporate into your child’s day. This solves the common problem many children with ASD have: being able to generalize skills learned in an artificial context without needing heavy prompting.
Functional routines are easy to introduce, expand upon, and intersperse throughout your child’s day. Examples of functional routines you may want to start out with might be: morning routine, getting ready for school routine, using the potty routine, skills and activity routine, and a bedtime routine. Each functional routine is broken down into simple steps. For example, our bedtime routine includes a picture depicting each step: Go Potty, Take a Bath, Put on Pajamas, Brush Teeth, Read a Book, and Go to Bed.
These routines in conjunction with the visual picture reminders, have quickly expanded our son’s independent vocabulary and seem to be the answer to language retention issues he struggles with.
Picture Exchange Communication System (PECS)
Is a communication system intended to be used to teach expressive communication skills to children who have limited speech or no language at all. Using pictures, children learn how to request a desired food, activity, or toy. PECS is most effective when pictures are of highly desired or preferred activities, foods, or objects. The goal is for the child to be able to make requests independently, later moving on to answering questions and making comments.
Using the PECS communication system for a year or more with your preschooler can also lay a solid foundation for them to acquire independent speech.
Peer Mediated strategies
Peer Mediated Strategies is a social skills curriculum that teaches skills and strategies to children with autism, and can be effectifely used by typical peers and adults in your child’s environment. The goal of Pear Mediated Strategies is to increse levels of interaction between children and focuses on five social skills that are the basis for more lengthy interactions between children and can help your child learn how to build friendships. These skills are often naturally picked up by typical children, but usually must be specifically taught to children with ASD.
Speech Therapy
Offers support and advice for how to overcome the physical challenges of encouraging a child to speak.
Occupational Therapy
Focuses on overcoming any balance issues or fine moror / large motor coordination issues.
Sensory Integration Therapy
Focuses on helping your child to overcome sensory challenges and helps you discover your child’s particular sensitivities or sensory needs.
Many schools and therapists now use a combination of therapy approaches with great success. Our son’s school uses all of the above therapy approaches with great success.
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