Interventions for Autism Spectrum Disorder
There are various interventions that have helped improve the quality of life for many individuals with an autism spectrum diagnosis. Some of them have been described below:
Applied behavior analysis (ABA)
ABA is used for describing programs that adhere to certain principles and not to any specific program or procedure. One of the key principles is the analysis and measurement of relations between environment and behavior. ABA programs aim to teach new skills and generalize them across different settings. The focus is on reinforcing desirable behaviors and decreasing behaviors of concern. They are used to teach academic and vocational skills, increase speech, social skills, play skills and also decrease problem behaviors. Also, in recent times, there has been an emphasis on implementing the program in the child’s naturalistic settings. For behaviors that are challenging, the most common approach is to conduct an assessment of the environmental events which elicit and maintain problem behaviors, called functional analysis. Following this an attempt is made to replace problem behavior with a more acceptable behavior like requesting for a toy.
Social skills training
ASD involves difficulties in social interaction. Social skills training teaches children the skills they need to interact with others, including conversation and problem-solving skills. Use of ABA methods, social narratives/stories, peer-mediated interventions or social skills group are some ways for teaching social skills.
Cognitive behavior therapy
The use of CBT with individuals with ASD is growing. The focus of CBT is on replacing negative or ineffective patterns of thought and behavior with strategies that are effective in enhancing mood and adaptive functioning. Support for ‘self-management’, a type of CBT, designed for higher functioning children/adolescents or adults with ASD is growing. This has been found to support the management of anxiety, depression, anger control, and social skills. It has helped people with ASD, to learn to independently regulate their own behaviors and act more appropriately in a variety of settings.
Medication
Many psychiatric disorders in children are managed by medications, some of which have symptoms overlapping with those seen in children with ASD. These include hyperactivity, inattention, obsessive-compulsive behaviors, anxiety, etc. But there are no medications that treat the social and language impairments of ASD. The medications used most frequently for children and adults include those for managing the above-mentioned symptoms though their use is challenging and not without risks.
Augmentative and Alternative Communication (AAC)
AAC is helpful to make up for the deficits in expressive communication with interventions ranging from the use of sign language to picture systems and more complex electronic communication devices. This intervention can be used at any age. One popular strategy is ‘Picture Exchange Communication System’ (PECS) wherein individuals are trained to exchange picture cards for desired items. The therapist uses a label for each item. It also reinforces attempts to initiate social contact.
Visual Supports
For many children with ASD the use of visual supports has been linked to a positive effect on their learning, behavior, and social skills. Some examples include the use of schedules, picture exchange systems, and structured teaching. More often than not they are used in conjunction with other interventions.
Other therapies include occupational therapy, sensory integration, and parent-implemented interventions. Sensory Integration (SI), is popular though not much evidence base has been found. Many children with ASD are thought to have a form of sensory integration dysfunction, which may lead to hypersensitivity or hyposensitivity to sensory input, activity levels which are unusually high or low, problems with coordination etc. It involves evaluating a child’s sensory needs to decide activities to support those needs which may include swinging, jumping and more. It is usually implemented by occupational therapists. Occupational therapy on the other hand teaches skills that help an individual live as independently as possible. Skills may include dressing, eating, bathing, and relating to people.
Complementary and alternative medicine (CAM) treatments
These include the use of melatonin. Research has found that melatonin can help children with ASD to fall asleep. A gluten-free, casein-free (GFCF) diet and nutritional supplements like B6, Magnesium, B12 are other treatments. Talking about the GFCF diet, an inability to effectively metabolize gluten and casein (proteins), in some severe cases, had been linked to gastrointestinal or neurological problems. It has been proposed that ASD symptomology may be associated with this process. Though there is limited research for the efficacy of these treatments.
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References
Kopelman, T. (n.d.). Interventions for autism spectrum disorders (ASD). Retrieved from
https://uichildrens.org/health-library/interventions-autism-spectrum disorders-asd
Lindgren, S., & Doobay, A. (2011). Evidence-based interventions for autism spectrum disorders.
Retrieved from
https://www.interventionsunlimited.com/editoruploads/files/Iowa%20DH %20Autism%20Interventions%206–10–11.pdf
