Autism Interventions

There is no cure for autism at present. Therapies or interventions are designed to remedy specific symptoms in each individual. The best-studied therapies include educational, behavioral and biomedical interventions. Although these interventions do not cure autism, they often bring about substantial improvement.

Many strategies emphasize highly structured and often intensive skill-oriented training that is tailored to the individual child. Therapists work with children to help them develop social, play and language skills as well as remedy inappropriate behavior and reduce self-stimulatory behavior that impedes the learning process.

Applied Behavior Analysis (ABA), behavior modification or Lovaas Method

Applied Behavior Analysis or ABA s a science which involves the application of basic behavioral practices (positive reinforcement, repetition, and prompting) and the use of systematic data tracking methods to evaluate the efficacy of the behavioral applications used to reach a desired outcome. For example ABA methodologies are used to facilitate the development of language, positive skills development such as self-help, appropriate play and social behavior. ABA reduces problems like self-injurious behavior, tantrums related to transition and communication problems, and self-stimulatory behavior which impedes the learning process.

Many techniques can be used in an ABA program. Discrete Trial Teaching (DTT) is a primary methodology but not the only instructional method used in ABA programs for individuals with autism. DTT involves breaking down skills into small sub-skills and teaching each sub-skill, intensely, one at a time. It involves repeated practices with prompting and fading of prompts to insure the child’s success. DTT also uses reinforcement to help shape and maintain positive behaviors and skills. Other ABA methodologies include but are not limited to errorless teaching, pivotal response training, verbal behavior, fluency/precision teaching, and incidental teaching methods.

ABA approaches are consistent in their use of operant conditioning principles and techniques (reinforcement, shaping, prompting, chaining, behavior extinction, etc.,). All place a high priority on data collection and qualified interpretation of the data to drive the program.

Tested by research and experience for more than 40 years, ABA practices have been endorsed by the Surgeon General, the National Institute of Health (NIH), and the Association for Science in Autism Research. The skills and experience of an ABA professional are essential for success. Systematic and continuous evaluation of effectiveness is paramount for a successful program. Who is qualified to oversee intensive, comprehensive behavioral programming for young children with autism/PDD (PDF), to learn more about ABA professionals working with your child.

Sensory Integration(SI)

Sensory Integration (SI) is a therapeutic approach, which was developed by Dr. Jean Ayres incorporating the vestibular, proprioceptive and tactile systems. This input facilitates the development of the nervous system. It is through the familiar sensory systems of touch, sight, smell, taste, and hearing that we receive input and information about our world. This information is taken in by the vestibular, proprioceptive and tactile systems which sorts and connects the information to the environment. Additionally, information is processed combining with the perception of position in space, an awareness of body posture, and the ability to discriminate and plan motor movements.

Children diagnosed with disorders in the autism spectrum commonly experience problems with sensory integration. These problems can vary from low arousal levels and a decreased sensitivity to visual or auditory input, to poor organizational and motor planning skills, to hypersensitivity.

Sensory integration is most commonly used by Occupational Therapists however many speech and language pathologists as well as physical therapists are using sensory integration to enhance their treatments.

Biomedical Treatment

Defeat Autism Now Practitioners use health assessment methods that use specific immune, allergic, or metabolic tests to identify subgroups of children with autism who may respond to specific medication, supplementation, or dietary interventions.

The justifications for such testing are based on various theories about the causation of autism. The proponents of these medical tests maintain that in some children, autism may be caused by certain immune, allergic, or metabolic processes related to diet, yeast infections, prior viral infections, or other causes.

Relationship Development Intervention (RDI)

Relationship Development Intervention (RDI) Program is a parent-based clinical treatment for individuals with autism spectrum and other relationship-based disorders.

The RDI Program is based upon the model of Experience Sharing developed by Steven Gutstein Ph.D. Dr. Gutstein studied the means by which typical children become competent in the world of emotional relationships.

The primary goal of the RDI Program is to systematically teach the motivation for and skills of Experience Sharing interaction. Deficits in Experience Sharing have been found to rest at the core of autism spectrum disorders.

The RDI Program provides a path for people on the Autism Spectrum to learn friendship, empathy and a love of sharing their world with others. Language comes alive when integrated with real emotion. People with Autism and Asperger’s learn not only to tolerate, but to enjoy change, transition and going with the flow. It begins at the edge of each person’s current capability and carefully teaches the skills needed for competence and fulfillment in a complex world.

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Floor Time

An 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.

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Social Stories

Social 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.

Before developing and using social stories, it is important to identify how the child interacts socially and to determine what situations are difficult and under what circumstances. Situations that are frightening, produce tantrums or crying, or make a child withdraw or want to escape are all appropriate for social stories. However, it is important to address the child’s misunderstanding of the situation. A child who cries when his/her teacher leaves the room may be doing so because he/she is frightened or frustrated. A story about crying won’t address the reason for the behavior. Rather a story about what scares the child and how he can deal with those feelings will be more effective.

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Integrated Play Group

Children with autism have a difficult time learning to play and socializing with their peers; play is not a trait which comes naturally to them. Nevertheless, children need these skills to understand and relate to the social world.

Integrated Play Group Model, developed by Pamela Wolfberg, is one way to help facilitate development of play skills. The children participate in small groups organized around social/pretend play activities. Children with autism are called the “novice players,” and their typically developing counterparts are the “expert players.” The expert players are guided by a trained adult who can monitor, interpret and build on the children’s play interests and social interaction.

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PECS

Picture Exchange Communication System (PECS), is a visually based communication system that teaches the non-verbal child to initiate communication beginning with small concrete steps that gain in complexity. PECS, the work of Andrew Bondy and Lori Frost, offers a well thought out sequential communication system that can be used easily and effectively in the classroom and home, giving the child with little or no spoken language a system that connects them to peers, family, and others in their school, home and community.

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Individual Speech and Language Therapy

Speech therapy must be based on individual need. Therapy may include oral motor facilitation, articulation therapy, social pragmatics, and language therapy. The approaches used in each child’s therapy should be contextually based and multi-modal. This means that the therapist evaluates a child’s needs and strength in several areas of language and communication (writing, vocabulary, reading, understanding), and combines different aspects of learning in order to facilitate a child’s functional communication skills. If a child responds well to visual cues and music, for example, but is not yet able to say words, the therapist may choose an activity that involves listening to a song, showing the words or icons to the song and asking the child to attempt to say a specific word.

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Medication

Doctors may prescribe a variety of drugs to reduce self-injurious behavior or other troublesome symptoms of autism, as well as associated conditions such as epilepsy and attention disorders. Most of these drugs affect levels of serotonin or other signaling chemicals in the brain.

The Autism Education Network focuses its interests on education. We do not advocate for or against medication for any symptoms associated with Autism Spectrum Disorder. Parents should use caution before subscribing to any particular treatment. Counseling for the families of people with autism also may assist them in coping with the disorder.