Typically, therapies are designed to address difficulties in communication, social skills, and sensory issues. In addition, therapies attempt to mitigate aggressive, self-injurious, or repetitive behaviors such as rocking and hand flapping.
As you may have already discovered, new therapies or treatments for autism are announced frequently. It is important to remember that many therapies have not been proven by scientific research.
Be skeptical of any treatment that promises a “cure”.
Check references; read, read, read; talk to your physician; talk to other families who have tried a particular therapy; interview and consult with several experts before deciding. Different individuals with autism will respond to different treatments. Some behaviors or symptoms may improve with no treatment. Some individuals will respond simply by receiving one-to-one attention and care regardless of the method.
There may be more than one option or combination of treatments that will work best for your child. The Center for Autism and Related Disorders at the Kennedy Krieger Institute in Baltimore recommends using a mixed method – using techniques and strategies from a variety of therapies.
- Applied Behavioral Analysis (ABA)
- Pivotal Response Training (PRT)
- Verbal Behavior
- Auditory Integration Training
- Floortime (Greenspan Method)
- Relationship Development Intervention (RDI)
- Occupational Therapy (OT)
- Sensory Integration Therapy (SI)
- Speech Therapy
- TEACCH - Treatment and Education of Autistic and Communication-handicapped Children
- Vision Therapy
- Cognitive-Behavioral Therapy
In addition to these therapies, There are many medical and biomedical treatments targeting symptoms or underlying physical or neurological conditions that make life difficult for someone with autism. Most treatments have not been validated by rigorous peer-reviewed scientific research. Many are based on anecdotal reports from family members, professionals, and proponents. The following treatments and interventions are aimed at improving overall functioning, communication, social behavior, as well as reducing aggressive, self-injurious, and/or hyperactive behavior:
Applied Behavioral Analysis or ABA, is the methodology based on the well-researched principles of operant and respondent conditioning. A key focus in ABA is to change behavior and increase communication by using two components: teaching (utilizing Discrete Trial Training or DTT) and behavior modification. DTT is the instructional strategy that uses repeated practice of giving a cue for a student to perform, and providing a reward or reinforcement for the desired response. By utilizing repetition and ongoing evaluation of student performance, complex tasks can be learned in a simple step-by-step manner. Based on the work of Dr. Ivar Lovaas, this frequently home-based program generally involves therapists who work intensely, one-on-one, with a child from 20 to 40 hours each week. A hallmark of DTT is ongoing performance evaluation with an emphasis on data collection. DTT is currently a widely accepted learning strategy and is being utilized in some school settings. Back to list
Pivotal Response Training or PRT is a naturalistic treatment approach developed by Robert L. Koegel & Laura Schreibman. PRT teaching is generally done in the child’s home by parents, and others who are in frequent contact with the child. Researchers have identified two pivotal behaviors that affect a wide range of behaviors in children with autism: motivation and responsivity to multiple cues. PRT seeks to teach central skills, such as self-management, turn taking, and joint attention, which can then be used to facilitate communication, improve behavior, and improve social skills. Back to list
Verbal Behavior or VB focuses on teaching specific components of expressive language skills often before expressive language is present. Verbal Behavior or VB training typically involves a detailed assessment of the child’s language profile in terms of elementary verbal relations, such as mand (requesting wants and needs), tact (labeling), echoic (verbal imitation), and receptive repertoire (non-verbally following directions). Verbal Behavior or VB teaches a child to request a desired item or activity, so that he or she learns that words have the function of getting their wants and needs met. Back to list
Auditory Integration Training or AIT is sensory training based on the theory that individuals with autism are unable to process or integrate auditory information, as evidenced by over or under sensitivity to certain sounds, tones, and frequencies. This therapy seeks to recalibrate auditory processing by having the individual listen to individually tailored processed music for about an hour per day for 10 to 12 days. AIT claims to improve auditory processing, decrease or eliminate sound sensitivity, and improve behavior in some children with autism. Back to list
Floortime is a philosophy and therapeutic approach developed by Dr. Stanley Greenspan, designed to build relationships between children with communication and social difficulties and their caregivers. The term “floortime” derives from observing that many activities of children occur on the floor. During therapy sessions and throughout the day, adults attempt to open a “circle of communication” with the child in order to support the development of increasingly sophisticated interactive behaviors. Parents and therapists attempt to create opportunities for interaction by building upon the child’s intense interests. Floortime does not seek to teach specific skills; the goal is to develop the child’s sense of pleasure in relating to others. Back to list
Relationship Development Intervention or RDI, developed by Dr. Steven Gutstein, is a parent-based program that strives to help individuals become flexible thinkers and problem solvers. This step-by-step program focuses on building and learning to generalize skills. Back to list
Occupational Therapy or OT used with individuals with autism to develop skills used to perform purposeful activities including work, play, and self-help skills. An occupational therapist will determine the child’s ability to perform age-appropriate tasks, and develop a program to address deficits and teach skills. Back to list
Sensory Integration Therapy or SI is based on the work of Jean Ayres and addresses a person’s inability to process and integrate sensory information from one’s own body and the environment. SI trained occupational therapists base treatment on a person’s over or under- sensitivity to movement and information from the senses. Activities and exercises using props such as swings, balance balls, or scooter boards are said to improve the ability to regulate movement and sensory information. Back to list
Speech Therapy is often the first step for parents of children with autism and treats speech and language disorders. Speech disorder refers to problems actually producing sounds. Language disorder refers to difficulty understanding or putting words together to communicate ideas. Individual with autism can demonstrate either or both. Speech Language Pathologists (SLPs) hold at least a masters degree and state certification as well as a certificate of clinical competency from the American Speech-Hearing Association. Speech therapy involves having a SLP work with a child in a private one-on-one session, in a small group, or directly in a classroom to improve articulation, voice tone, pragmatic or social skills, receptive and/or expressive language, or to establish a non-verbal communication system. Back to list
TEACCH—Treatment and Education of Autistic and related Communication-handicapped Children was developed in the early 1970’s by Eric Schopler at the University of North Carolina at Chapel Hill, The TEACCH approach to education of children and adults with autism includes a focus on the person and the development of a program based on the individual’s interests, skills, and needs. Structured teaching is an important priority. Organizing the physical environment, developing schedules and work systems, making expectations clear and explicit, and using visual materials develop skills and allow people with autism to use these skills without prompting or cueing from teachers or other staff. TEACCH curriculum strives to develop communication skills and to pursue social and leisure interests. TEACCH is used primarily in school or work settings. Back to list
Vision Therapy is physical therapy for the eyes and brain. Vision therapy treats many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and learning related vision disabilities. Vision Therapy can also be used for individuals with autism spectrum disorders to improve efficient eye coordination and visual information processing. Methods for evaluating the vision of people with autism will vary depending on individual's level of emotional and physical development. Testing may be done while the patient performs specific activities while wearing special lenses. Depending on the results of testing, lenses to compensate for nearsightedness, farsightedness, and astigmatism (with or without prism) may be prescribed. Vision Therapy activities can be used to stimulate general visual arousal, eye movements, and the central visual system. The goal of treatment may be to help the patient with autism organize visual space and gain peripheral stability so that he or she can better attend to and appreciate central vision; gain more efficient eye coordination; and visual information processing. Back to list
Cognitive-Behavioral Therapy is based on the idea that how we feel, think, and behave are naturally intertwined. For this reason, CBT sets out to help patients identify the relationships between unhealthy thinking patterns, disruptive behavior, and negative emotional responses in upsetting or impairing situations. Overall, the treatment requires active participation by the patient in the form of in-session exercises, as well as homework assignments to be completed in between sessions. For more details, visit Parent Tips: Cognitive-Behavioral Therapy. Back to list
Medical and Biomedical Treatments
Medications are often used to modify symptoms of autism by acting upon the central nervous system or correcting chemical imbalances of neurotransmitters in the brain. Medications must be prescribed and supervised by a licensed physician who, ideally, should have significant experience in treating individuals with autism. Common types of medications include antidepressants, mood stabilizers, antipsychotics, stimulants, sedatives, and anti-anxiety medications. Pharmalogical intervention should be considered carefully, as few medications are approved specifically for treatment of the symptoms of autism, and are rarely approved for use in children. Side effects may be significant and long-term effects, particularly on children, are unknown. However, for many people with autism, medication has had a positive effect on symptoms that have interfered with their ability to learn and function as independently as possible. Back to list
Dietary is often the simplest intervention that you can try for your loved one. Two popular diets among the autism community are the Specific Carbohydrate Diet (SCD) and Gluten Free/Casein Free (GF/CF). Both restrict the use of gluten, a protein mixture present in cereal grains (wheat, oat, barley, etc.) although the SCD also restricts rice. Click here to read a description of these as well as other dietary approaches. The best approach is to try an altered diet for six months, observe changes, and consult with your medical providers. Back to list
Vitamins and Supplements are a key component of many biomedical interventions include the use of high doses of vitamins, minerals and nutritional supplements to address malabsorption problems and nutritional deficiencies. Like special diets, vitamins and supplements are relatively easy changes to make in your child’s eating routine and may have positive benefits. It is recommended, however, that you do this under the supervision of a physician as some vitamins can be toxic at too high levels. The most popular nutritional treatments include high dose B6 and magnesium, and DMG (dimethylglycine). Other interventions may include Methyl B12 and glutathione. Back to list
Chelation is an extremely controversial intervention used to treat heavy metal overload (lead, arsenic, mercury, cadmium, etc.), which many people feel may cause autism. Diagnosis of heavy metal toxicity must be made by a physician based on clinical symptoms in conjunction with laboratory testing. Back to list
If you are interested in pursuing any of the biomedical treatments above, you can find providers, including those familiar with the DAN! (Defeat Autism Now!) protocol, listed in the Pathfinders for Autism resource database under provider type "Health Care". You can also find a list of DAN! practitioners at Autism Research Institute.