There is no single best treatment package for all
children with ASD. One point that most professionals agree on is
that early intervention is important; another is that most
individuals with ASD respond well to highly structured, specialized
programs.
Before you make decisions on your child's treatment, you will want
to gather information about the various options available. Learn as
much as you can, look at all the options, and make your decision on
your child's treatment based on your child's needs. You may want to
visit public schools in your area to see the type of program they
offer to special needs children.
Guidelines used by the Autism Society of America
include the following questions parents can ask about potential
treatments:
Will the treatment result in harm to my child?
How will failure of the treatment affect my child and family?
Has the treatment been validated scientifically?
Are there assessment procedures specified?
How will the treatment be integrated into my child's current
program? Do not become so infatuated with a given treatment that
functional curriculum, vocational life, and social skills are
ignored.
The National Institute of Mental Health suggests a
list of questions parents can ask when planning for their child:
How successful has the program been for other children?
How many children have gone on to placement in a regular school and
how have they performed?
Do staff members have training and experience in working with
children and adolescents with autism?
How are activities planned and organized?
Are there predictable daily schedules and routines?
How much individual attention will my child receive?
How is progress measured? Will my child's behavior be closely
observed and recorded?
Will my child be given tasks and rewards that are personally
motivating?
Is the environment designed to minimize distractions?
Will the program prepare me to continue the therapy at home?
What is the cost, time commitment, and location of the program?
Among the many methods available for treatment and
education of people with autism, applied behavior analysis (ABA) has
become widely accepted as an effective treatment. Mental Health: A
Report of the Surgeon General states, "Thirty years of research
demonstrated the efficacy of applied behavioral methods in reducing
inappropriate behavior and in increasing communication, learning,
and appropriate social behavior."19 The basic research done by Ivar
Lovaas and his colleagues at the University of California, Los
Angeles, calling for an intensive, one-on-one child-teacher
interaction for 40 hours a week, laid a foundation for other
educators and researchers in the search for further effective early
interventions to help those with ASD attain their potential. The
goal of behavioral management is to reinforce desirable behaviors
and reduce undesirable ones.
An effective treatment program will build on the child's interests,
offer a predictable schedule, teach tasks as a series of simple
steps, actively engage the child's attention in highly structured
activities, and provide regular reinforcement of behavior. Parental
involvement has emerged as a major factor in treatment success.
Parents work with teachers and therapists to identify the behaviors
to be changed and the skills to be taught. Recognizing that parents
are the child's earliest teachers, more programs are beginning to
train parents to continue the therapy at home.
As soon as a child's disability has been identified, instruction
should begin. Effective programs will teach early communication and
social interaction skills. In children younger than 3 years,
appropriate interventions usually take place in the home or a child
care center. These interventions target specific deficits in
learning, language, imitation, attention, motivation, compliance,
and initiative of interaction. Included are behavioral methods,
communication, occupational and physical therapy along with social
play interventions. Often the day will begin with a physical
activity to help develop coordination and body awareness; children
string beads, piece puzzles together, paint, and participate in
other motor skills activities. At snack time the teacher encourages
social interaction and models how to use language to ask for more
juice. The children learn by doing. Working with the children are
students, behavioral therapists, and parents who have received
extensive training. In teaching the children, positive reinforcement
is used.
Children older than 3 years usually have school-based,
individualized, special education. The child may be in a segregated
class with other autistic children or in an integrated class with
children without disabilities for at least part of the day.
Different localities may use differing methods but all should
provide a structure that will help the children learn social skills
and functional communication. In these programs, teachers often
involve the parents, giving useful advice in how to help their child
use the skills or behaviors learned at school when they are at home.
In elementary school, the child should receive help in any skill
area that is delayed and, at the same time, be encouraged to grow in
his or her areas of strength. Ideally, the curriculum should be
adapted to the individual child's needs. Many schools today have an
inclusion program in which the child is in a regular classroom for
most of the day, with special instruction for a part of the day.
This instruction should include such skills as learning how to act
in social situations and in making friends. Although
higher-functioning children may be able to handle academic work,
they too need help to organize tasks and avoid distractions.
During middle and high school years, instruction will begin to
address such practical matters as work, community living, and
recreational activities. This should include work experience, using
public transportation, and learning skills that will be important in
community living.
All through your child's school years, you will want to be an active
participant in his or her education program. Collaboration between
parents and educators is essential in evaluating your child's
progress.
The Adolescent Years
Adolescence is a time of stress and confusion; and it
is no less so for teenagers with autism. Like all children, they
need help in dealing with their budding sexuality. While some
behaviors improve during the teenage years, some get worse.
Increased autistic or aggressive behavior may be one way some teens
express their newfound tension and confusion.
The teenage years are also a time when children become more socially
sensitive. At the age that most teenagers are concerned with acne,
popularity, grades, and dates, teens with autism may become
painfully aware that they are different from their peers. They may
notice that they lack friends. And unlike their schoolmates, they
aren't dating or planning for a career. For some, the sadness that
comes with such realization motivates them to learn new behaviors
and acquire better social skills.
Recent studies have shown that there is
currently a worldwide autism epidemic. In fact, more than 1.5
million people are affected in the United States alone, with one in
every 250 children diagnosed.
It's true that early detection and early treatment are the two key
factors in improving prognosis -- but too often parents get bogged
down in denial or confusion about this still mysterious disorder,
and are unable or unwilling to take the necessary steps.
The Essential Guide to Autism contains advice and information that
will help you make the right treatment decisions for your child.
Today, many youngsters can be helped to attend school alongside
their peers. Some programs are demonstrating that with appropriate
support, many people with autism can be trained to do meaningful
work and participate fully in community life.
All of the materials on this site have been included for the purpose of
providing general information, and they should not be relied on as a
substitution for professional advice.
