Autism – Treatment Interventions

It can be very overwhelming to learn that your child has received the diagnosis of autism.  As a parent it is important to keep hope alive, build a support system, and find a treatment program that is tailored to your child’s unique strengths and needs.  Research has shown that it is best to begin treatment as early as possible.  There are several treatment options that have been found to be effective for children.  This article is intended to provide an overview of a variety of current approaches and not to make any specific treatment recommendations.  The information is a summary of descriptions provided by the programs and is presented in alphabetical order.      

 

Applied Behavioral Analysis (ABA)

Description: Also known as positive behavior support, ABA is the science of applying experimentally derived principles of behavior to improve social behavior. ABA takes what we know about behavior and applies it to bring about positive change. Behaviors are defined in observable and measurable terms in order to assess change over time. The behavior is carefully analyzed within the environment to determine what factors trigger the behavior and what happens after that behavior to reinforce it. The idea is to reduce these triggers and reinforcers in the child’s environment. New reinforcers are then used to teach the child a more socially acceptable behavior in response to the same trigger.

Goal: Breaks down skills into manageable pieces and then builds upon those skills so that a child learns how to learn in the natural environment.

Techniques: ABA treatment can include any of several established teaching tools: discrete trial training, incidental teaching, pivotal response training,  and fluency building.  The Lovaas Model of Applied Behavior Analysis uses both incidental teaching and discrete trial teaching.  It was developed by Dr. O. Ivar Lovaas based on 40 years of research at UCLA.  Pivotal Response Treatment, which is offered at the Koegel Autism Clinic at UCSB, is based on the teaching of pivotal behaviors and uses specific motivational principles.

Treatment sessions:  Intensive one-on-one structured training sessions provided by certified behavior analysts.  35 to 40 hours per week.

For more information:  http://www.abainternational.org/

 

The Developmental Individual Difference Relationship-Based Model (DIR)

Description: DIR provides a framework for a comprehensive assessment and the development of an intervention program tailored to the unique challenges and strengths of children with Autism Spectrum Disorders (ASD) and other developmental challenges. The model looks at the Developmental level of the child as compared to six basic developmental milestones that children must master for healthy emotional and intellectual growth.  These are attention and self-regulation, engagement, two-way purposeful communication, shared social problem-solving, symbolic play and building bridges between ideas and emotional thinking, which leads to the capacity for abstract gray area thinking.  DIR also takes into account the child’s Individual differences in sensory processing, motor planning and sequencing.  Relationship-based, refers to the learning relationships through which growth occurs.

Goal: To build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors.

Techniques: DIR/Floortime works on the fundamental capacities for relating, communicating and thinking, and tends to help the child use fundamental skills capacities in a wide range of naturally occurring situations.  DIR uses playful, affect based interactions to help children master each of the developmental levels.  The model is child-centered and multidisciplinary, with professionals from special education, mental health, speech, physical and occupational therapy.  It was developed by  Dr. Stanley Greenspan and Dr. Serena Weider, and based on years of studying typical child development.   

Treatment sessions: Therapists train parents to conduct 20 minute Floortime sessions several times a day.  Treatment may also include sensori-motor activities, semi-structured problem-solving and peer play groups.    

For more information: http://www.icdl.com

 

 

Relationship Development Intervention Program for Autistic Spectrum Disorders (RDI) 

Description: RDI is a clinical intervention program that addresses the debilitating core deficits of autism, such as rigid thinking, aversion to change, inability to understand other’s perspectives, failure to empathize and absolute “black-and-white” thinking.  It does this by teaching the skills of experience sharing, dynamic analysis, flexible and creative problem-solving, episodic memory, self-awareness and resilience.  It aims to provide a path for people on the autism spectrum to learn friendship, empathy, and a love of sharing their world and experiences with others.     

Goal:  To produce successful adults by building the many different abilities that are essential for success in dynamic systems.  

Techniques: Dynamic intelligence skills are taught in a step-by-step program that focuses first on building the motivations so that skills will be used & generalized, followed by carefully and systematically building the skills for competence and fulfillment in a complex world.  RDI was developed at The Connections Center in Houston, Texas, which was established in 1995 by clinical psychologists Steve Gutstein, Ph.D. and Rachelle Sheely, Ph.D.

Treatment sessions: RDI is a parent-based intervention program where parents are provided the tools to effectively teach Dynamic Intelligence skills and motivation to their child.

For more information: http://www.rdiconnect.com

 

 

Social Stories 

Description: A Social Story™ describes a situation, skill, or concept in terms of relevant social cues, perspectives, and common responses in a specifically defined style and format.  

Goal: To improve the individual’s understanding of events and expectations which may lead to more effective responses. 

Techniques: Social Stories or scripts are created that are specific to an individual, describing social situations that the person may encounter. The Stories are designed to share accurate social information in an easily understood, patient and reassuring manner.  Half of the stories should affirm something that the individual does well.  This technique was developed by Carol Gray in 1991.   

Treatment sessions: Social Stories may be read to or by the individual multiple times in advance of a social situation to help them anticipate what may happen and how to respond.

For more information: http://www.thegraycenter.org/   

 

 

Treatment and Education of Autistic and related Communication-handicapped CHildren (TEACCH)

Description: TEACCH developed the concept of the “Culture of Autism” as a way of thinking about the characteristic patterns of thinking and behavior seen in individuals with this diagnosis.  The “Culture of Autism” involves relative strength in processing of visual information, attention to detail but difficulty understanding how those details fit together, difficulty combining ideas, difficulty organizing ideas, difficulty with attention, communication problems, difficulty with concepts of time, tendency to become attached to routines, strong interests, marked sensory preferences.

Goal: To develop skills and fulfill fundamental human needs such as dignity, engagement in productive and personally meaningful activities, and feelings of security, self-efficacy, and self-confidence. 

Techniques: TEACCH uses a structured teaching approach that is individualized, rather than a standard curriculum.  The physical environment is structured using visual supports to make the sequence of daily activities predictable and to make individual tasks understandable. Support is provided from early childhood through adulthood. TEACCH was founded in the early 1970s by the late Eric Schopler, Ph.D. and is administered through the University of North Carolina at Chapel Hill.

Treatment sessions: Structured teaching using organizational strategies and visual learning modalities, such as  visual schedules or visual work stations.  Services can be provided in a variety of settings, including school and work, up to 25 hours per week.  Parents are included as co-therapists.   

For more information: http://www.teacch.com

 

Biomedical Approaches

There are several dietary interventions that are being tried for children with autism.  Claims have been that vitamin and mineral supplements, such as vitamin B and magnesium, may improve the symptoms.  It is important to have a laboratory assessment and consult with someone who is knowledgeable in nutritional therapy, if you are considering adding any supplements to your child’s diet.

The second type of dietary intervention involves removing certain types of food if allergies or sensitivities are present.  Many families have found a gluten and casein free diet to be helpful.  Research has found elevated levels of certain peptides in the urine of children with autism spectrum disorders that suggests foods containing gluten and casein are not broken down properly which can affect brain function. For more information: http://www.gfcfdiet.com/   

 

 

Additional Services 

When developing a comprehensive treatment program, in addition to addressing any biomedical needs and choosing intervention techniques that meet the child’s developmental, educational, social-emotional and behavioral needs; decide whether any of the following ancillary services may be beneficial.  All should be available to the child and can be used in combination with any of the above interventions.    

• Speech therapy
• Augmented communication systems (picture exchange, electronic) 
• Physical therapy
• Occupational therapy (sensory integration, Wilbarger brushing protocol)
• Therapeutic riding programs (improve coordination and motor development, while creating a sense of well-being and increasing self-confidence) 
• Art and Music.

 

Innovative Learning is providing this forum for families to share information, resources and support.  We do not endorse any particular treatment approach.  If you have tried any of these or other interventions, please tell us about your experience!