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All available research strongly suggests that intensive early
intervention makes a critical difference to children with autistic
spectrum disorders. Without early identification and diagnosis,
children with autism are unlikely to learn the skills they need to
benefit from education. Many treatment approaches have been developed to address the range of social, language, sensory, and behavioral difficulties. These include Applied Behavioral Analysis (ABA); Discrete Trial Training (discrete trials); TEACCH; PECS; Floor Time; and Social Stories, and sensory integration. Applied Behavior Analysis - ABAMany of the interventions used to treat children with autism are based on the theory of applied behavior analysis (ABA) - that behavior rewarded is more likely to be repeated than behavior ignored. Although ABA is a theory, many people use the term to describe a specific treatment approach with subsets that include discrete trial training or Lovaas. While the terms discrete trial and Lovaas have been used interchangeably, only practitioners who are affiliated with Lovaas can be said to implement "Lovaas Therapy."In discrete trial training, every task given to the child consists of a request to perform a specific action, a response from the child, and a reaction from the therapist. It is not just about correcting behaviors but is designed to teach skills, from basic ones such as sleeping and dressing to more involved ones such as social interaction. Discrete trial training is an intensive approach. Children usually work for 30 to 40 hours a week one-on-one with a trained professional. Tasks are broken down into short simple pieces, or trials. When a task has been successfully completed, a reward is offered, reinforcing the behavior or task. This method is not without controversy. Some practitioners feel it is emotionally too difficult for a child with autism, that the time requirement of 30 to 40 hours a week is too intensive and intrusive on family life; and that while it may change a particular behavior, it does not prepare a child with autism to respond to new situations. However, research has shown that ABA techniques show consistent results in teaching new skills and behaviors to children with autism. More information available at www.behavior.org. TEACCHThe first US statewide program for treatment and services for people with autism, TEACCH (Treatment and Education of Autistic and Related Communication Handicapped Children) was developed at the School of Medicine at the University of North Carolina in the 1970s. It is a structured teaching approach based on the idea that the environment should be adapted to the child with autism, not the child to the environment. It uses no one specific technique, but rather is a program based around the child's functioning level.The child's learning abilities are assessed through the Psycho Educational Profile (PEP) and teaching strategies are designed to improve communication, social and coping skills. Rather than teach a specific skill or behavior, the TEACCH approach aims to provide the child with the skills to understand his or her world and other people's behaviors. For example, some children with autism scream when they are in pain. The TEACCH approach would search for the cause of the screaming and then teach the child how to signal pain through communication skills. More information at: www.teacch.com. Picture Exchange Communication Systems - PECSOne of the main areas affected by autism is the ability to communicate. Some children with autism will develop verbal language, while others may never talk. An augmented communication program, such as Picture Exchange Communication Systems (PECS), is helpful to get language started as well as to provide a way of communicating for those children that do not talk.PECS was developed at the Delaware Autistic Program to help children and adults with autism to acquire functional communication skills. It uses ABA-based methods to teach children to exchange a picture for something they want - an item or activity. PECS begins with teaching a student to exchange a picture of a desired item with a teacher, who immediately honors the request. Verbal prompts are not used, thus building immediate initiation and avoiding prompt dependency. The system goes on to teach discrimination of symbols and then puts them all together in simple "sentences." Children are also taught to comment and answer direct questions. Many preschoolers using PECS also begin developing speech. The system has been successful with adolescents and adults who have a wide array of communicative, cognitive and physical difficulties. More information on PECS and materials available at www.pecs.com. Floor TimeAn educational model developed by child psychiatrist Stanley Greenspan, Floor Time is much like play therapy in that it builds an increasing larger circle of interaction between a child and an adult in a developmentally-based sequence. Greenspan has described six stages of emotional development that children meet to develop a foundation for more advanced learning - a developmental ladder that must be climbed one rung at a time. Children with autism may have trouble with this developmental ladder for a number of reasons, such as over-and under-reacting to senses, difficulty processing information, or difficulty in getting their body to do what they want.Through the use of Floor Time, parents and educators can help the child move up the developmental ladder by following the child's lead and building on what the child does to encourage more interactions. Floor Time does not treat the child with autism in separate pieces for speech development or motor development but rather addresses the emotional development, in contrast to other approaches, which tend to focus on cognitive development. It is frequently used for a child's daily playtime in conjunction with other methods such as ABA. Stanley Greenspan’s book is: THE CHILD WITH SPECIAL NEEDS: ENCOURAGING INTELLECTUAL AND EMOTIONAL GROWTH. Stanley I. Greenspan, M.D. and Serena Wieder, Ph.D., Addison Wesley: (1998, Reading, MA). Social StoriesSocial Stories were developed in 1991 by Carol Gray as a tool for teaching social skills to children with autism. They address "Theory of Mind" deficits, that is, the ability to understand or recognize feelings, points of view or plans of others. Through a story developed about a particular situation or event, the child is provided with as much information as possible to help him or her understand the expected or appropriate response. The stories typically have three sentence types: descriptive sentences addressing the where, who, what and why of the situation; perspective sentences that provide some understanding of the thoughts and emotions of others; and directive sentences that suggest a response. The stories can be written by anyone, are specific to the child's needs, and are written in the first person, present tense. They frequently incorporate the use of pictures, photographs or music.Information available at: www.thegraycenter.org Sensory IntegrationChildren with autism frequently have sensory difficulties. They may be hypo- or hyper-reactive or lack the ability to integrate the senses. Sensory integration therapy, usually done by occupational, physical or speech therapists, focuses on desensitizing the child and helping him or her reorganize sensory information. For example, if a child has difficulties with the sense of touch, therapy might include handling a variety of materials with different textures.Auditory integration therapy reduces over-sensitivity to sound. It may involve having the child listen to a variety of different sound frequencies coordinated to the level of impairment. More information available at www.out-of-sync-child.com and www.sensoryint.com. Biomedical and Dietary Treatments
Biomedical intervention is a relatively new field. While there are no
drugs, vitamins or special diets that can correct the underlying
neurological problems that seem to cause autism, parents and
professionals have found that some drugs used for other disorders are
sometimes effective in treating some aspects of or behaviors associated
with autism.
Autism Society of America |