Treatments
 


Right now there is no cure for Autism but there are a great number of interventions available to help you gain the knowledge you need to help yourself and your child.

For some children there are medical interventions, others are either emotional or educational approaches that people have tried and found varying degrees of success. Speak to parents, speak to early intervention services in your area and try and find a program that suits your child's needs and what can work for you and your whole family.

There is not one "cure all" intervention for autism, and this is by no means comprehensive and each item you look at must be researched thoroughly by yourselves before you contemplate using it for your child. Seek medical advice where relevant and try to contact parents that have used some of the educational programs to see how they have worked for their children.

The summaries of each intervention are taken from various sources and you need to be aware that there are financial implications and know how much a program will cost to complete as some can be quite expensive. You may or may not get help with funding. Click here for a listing of Alternative Therapies

Love, patience , understanding , care, determination, self belief and providing a loving compassionate environment for your child are all free.


A.I.A - Allergy Induced Autism - Autistic children often show signs of intolerance to certain foods. Gluten free and Casein free Diet Websites from America give advice on how to implement a Gluten and Casein free diet includes practical tips.

LOVASS (ABA Therapy) - Lovass is an educational program developed by Dr Ivar Lovass. It is based around intensive teaching methods sometimes for long periods at a time. Excellent results have been reported but this one is one of the most expensive programs available. Requires a lot of time and dedication.

Applied Behaviour Analysis (ABA) - Applied Behaviour Analysis (ABA) is the process of applying sometimes tentative principles of behaviour to the improvement of specific behaviours and simultaneously evaluating whether or not changes noted are indeed attributable to the process of application. The goal of ABA is to improve socially significant behaviours such as academics, social skills, communication, and adaptive living skills, to a meaningful degree. ABA is used to:
• Increase behaviours
• Teach new skills
• Maintain behaviours
• Generalize or to transfer behaviour from one situation or response to another
• Restrict or narrow conditions under which interfering behaviours occur:
• Reduce interfering or potentially harmful behaviours

Discrete Trial Training (DTT) - is one of the instructional methodologies frequently used in ABA-based programs. In DTT each training trial, consists of four major components:
Presentation of a brief, distinctive instruction or question (stimulus), the instruction is followed by a prompt, if the child needs one, to elicit the correct response, the child responds correctly or incorrectly (response), the teacher or therapist provides an appropriate “consequence.” Correct responses receive a reward, which may be an edible treat, a toy, hugs or praise; incorrect responses are ignored and/or corrected, data are recorded.

(Early) Intensive Behavioural Interventions (EIBI/IBI) - Early, intensive behavioural intervention (IBI or EIBI) appears to be a generic term that refers to behavioural interventions that are intensive and comprehensive. Severe behaviour disorders may be treated with intensive behavioural intervention. Proponents point out that children with autism typically do not learn from their environment spontaneously, and therefore need to be taught virtually everything they are expected to learn. Intensive programs refer to the number of hours of treatment the child receives per week as well as the intensity of training, curriculum, evaluation, planning, and coordination. IBI/EIBI intervention programs recommend between 30-40 hours of child: therapist sessions per week.

Key Behavioural intervention programs include: Douglas Developmental Disabilities Centre Program, Autism Preschool Program, Princeton Child Development Institute Program (PCDI), May Institute, Lovaas Program, In the Sydney metropolitan area, ABA programs are offered by four private service providers (Learning to Learn website, www.learningtolearnsydney.com.au, accessed August 2003. Autism Treatment Review Centre for Developmental Disability Studies ix There is universal agreement that behavioural interventions have produced positive outcomes for children with autism that are well supported by research. However, there continues to be a great deal of controversy about particular behavioural interventions and programs, concerns about methodological issues and differences in the interpretation of research findings. IBI/EIBI programs exemplified by the Lovaas program which use ABA and DTT are among the most controversial intervention strategies for children with autism. This controversy revolves around outcome claims, exclusivity, extensive use, and personnel. There is controversy as to whether ABA and DTT can lead to recovery. Controversy related to exclusivity pertains to whether ABA and DTT should be used to the exclusion of all other methods. While 40 hours of weekly DTT has been used, controversy exists regarding the extensive use of DTT and the appropriateness for some children and families.

Naturalistic/Developmental approaches - Generally naturalistic interventions follow a developmental approach, which is
relationship based and aims to help the child to learn to ‘attend, relate, interact, experience a range of feelings, and, ultimately, think and relate in an organized and logical manner’ (Atchison et al., 1997, p. 50). Naturalistic interventions are also known
as normalised interventions.

Developmental Social-Pragmatic Model (DSP) - This approach emphasises the importance of initiation and spontaneity in communication, following the child’s attentional focus and motivations, building on the child’s current communicative repertoire even if this is unconventional and using more natural activities and events as contexts to support the development of the child’s communicative abilities. The DSP approach differs from the contemporary ABA approach in its emphasis on sequences of language development and reduced emphasis on eliciting and measuring discrete trial behavioural responses. DSP focuses on successful participation in extended interactions as the measure of success with greater emphasis on enhancing communication abilities within meaningful events and routines. Research indicates there are some advantages to this approach.

Floor time or the Developmental Individual-Difference, Relationship-Based Model (DIR) - is a developmental approach for early intervention with infants and children with a disability. The program includes interactive experiences, which are child directed, in a low stimulus environment. Proponents contend that interactive play, in which the adult follows the child’s lead, will encourage the child to “want” to relate to the outside world.

Relationship Development Intervention(RDI) - is a series of techniques and strategies built upon the typical developmental processes of social competence. The goal of RDI is to increase motivation and interest in social relating in individuals with autism and provide activities and coaching to assist them to enjoy and become competent in social relationships. There appear to be no independent peer-reviewed, published studies of RDI’s effectiveness.

Learning Experiences-An Alternative Program for Preschoolers and Parents (LEAP) - is a comprehensive preschool service, designed for both children with autism and typically developing children. LEAP has the components of an integrated preschool program and a behaviour skills training program for parents. The program contains aspects of behavioural analysis, but it is primarily a developmentally based approach. There appear to be no independent peer-reviewed, published studies of LEAP’s effectiveness for children with autism.

Communication Therapies

Visual Supports/Alternative and Augmentative Communication (AAC) - There is considerable research evidence to support the use of visual strategies and visually cued instruction for children with autism. Augmentative systems of communication in autism, are used not just to replace speech, but to assist learning and communication, regardless of the level of speech. Symbols, pictures, photographs and objects of reference, are all well established as helpful for people with autism in supporting the comprehension of what is said and in getting needs met.

Picture exchange Communication System (PECS) - is a program that teaches children to interact with others by exchanging pictures, symbols, photographs or real objects for desired items. The goals of PECS include the identification of objects that may serve as stimuli for each child’s actions and the learning of responses to simple questions with multi-picture systems. It is a highly structured program that uses behaviourist principles of stimulus, response and reward to achieve functional communication. There are some studies that have evaluated PECS and show positive gains for participants.

Facilitated Communication (FC) - Proponents of FC claim that autism is primarily a motor disorder involving difficulty
producing voluntary movement, (apraxia) and therefore precluding the production of speech. Therapy involves teaching communication by physically prompting to form a pointing finger, supporting the hand as a point is made and assisting withdrawal from the point. Extensive research has been done to determine the efficacy of FC for people with autism. No evidence has been found of consistent, useful or spontaneous communication using this method.


Functional Communication training (FCT) - FCT is a behavioural strategy of teaching people with autism to use signs or other AAC techniques as substitutes for the ‘messages’ underlying their challenging behaviour. FCT interventions teach the individual to communicate one or more functional messages, while at the same time they provide a positive alternative to his or her challenging behaviour(s). A review of FCT studies published between 1985 and 1996 (Mirenda, 1997) found that for those participants with autism, there was an immediate and substantial reduction in challenging behaviour after the FCT interventions were initiated.

Sensory/Motor Therapies

Sensory Integration (SI) - therapy is a sensory-motor treatment based upon theories that children with autism and other developmental delays experience dysfunction in which sensory input is not integrated or organized appropriately by the brain. Sensory integration is described as providing the child with planned and controlled sensory experiences that aim to produce adaptive and functional responses to sensory stimuli. Current research does not support SI as an effective treatment for children with autism, developmental delays or mental retardation; nor has the limited research to date been able to identify SI as an independent variable responsible for positive change in a child’s behaviours or skills. In at least one study, SI was shown to actually increase self-injurious behaviours.

Auditory integration training (AIT) - Auditory integration training is said to address the hearing distortions, hyperacute
hearing, and sensory processing anomalies, which cause discomfort and confusion in people with a disability, including autism. According to the American Academy of Paediatrics Committee on Children with Disabilities, current information does not support the use of auditory integration training and, therefore, its use is not yet warranted other than in research protocols.

Combined Approaches

TEACCH (Treatment and Education of Autistic and related Communication
Handicapped Children)
- This approach is one of the most widely used approaches in autism. The major feature of the TEACCH approach is structure. Some of the difficulties in autism, which the TEACCH program identifies and addresses, are organisational difficulties, memory problems, difficulties with auditory processing and making transitions from one activity or topic to another. The environment is organised to help the child or adult understand and remind them what they are to do. The emphasis is on positive strategies of behaviour management and visually, rather than verbally, mediated teaching strategies. Types of intervention include structured teaching, communication training, leisure and social skill development and stress reduction. There is extensive research into the outcomes of the program however there are few peer-reviewed studies of outcome replications conducted by researchers not affiliated with TEACCH.

Autism Association NSW Satellite class program - The Autism Association of NSW satellite class program is a program designed to include children with autism in regular school settings, while meeting their specific needs. The content and delivery of the program is similar to the TEACCH model with heavy emphasis on visual supports, structure and routine, specific teaching of communication and social skills in the regular school setting. There is no empirical research into the outcomes of the satellite class program.

Elements of Successful Programs

Research suggests that program directors, regardless of philosophical orientation, describe the same key components of a successful program as follows:
• Autism specific curriculum content focusing on attention, compliance, imitation, language and social skills
• Need for highly supportive teaching environments and generalisation strategies
• Need for predictability and routine
• A functional approach to problem behaviours
• Transition from the preschool classroom
• Family involvement

Therefore there is no one program that will suit all children with autism and their families. Research suggests that there are substantial short and long term benefits from early, intensive, family-based treatment programs, whatever their theoretical basis, so long as these are appropriately adapted to the child’s pattern of strengths and weaknesses
and take account of family circumstances (Webster, Webster & Feiler, 2002).

 

Taken from: Roberts, J. M. (2004). A review of the research to identify the most effective models of
best practice in the management of children with autism spectrum disorders. Sydney:
Centre for Developmental Disability Studies. Download the entire document here.