Treatments Options for Autism in Children

Behavioral Approaches (ABA therapy)

Applied Behavior Analysis (ABA) therapy is endorsed by the CDC and the US Surgeon General as the most effective therapy option for children with autism. ABA therapy is a lifechanging intervention with an enormous amount of research to support its success in increasing critical skills and reducing challenging behavior.

The main goals of ABA therapy are to increase 1) communication skills; 2) social skills, and 3) independent living skills such as toileting, dressing, and feeding. ABA therapy also looks to reduce challenging behavior (e.g., tantrums, aggression, noncompliance) that interfere with an individual’s well-being. ABA therapy can be done at a clinic, home-setting, school, or in the community and is often play-based. Anyone receiving ABA therapy has a 1:1 therapist, often called a Registered Behavior Technician (RBT) and is overseen by a master’s level Board Certified Behavior Analyst (BCBA). Data is taken on all aspects of an individual’s treatment plan in order to closely monitor progress and ensure the procedures of ABA are effective on increasing essential skills.

But what really is ABA therapy? ABA therapy is based on the science of learning and behavior. ABA therapy utilizes positive reinforcement, shaping, modeling, breaking down complex skills, and a variety of other empirically based procedures to increase skills and help individuals reach their milestones. ABA therapy is a medical necessity for individuals with autism and research supports that the earlier intervention begins, the better the prognosis.

Developmental Approaches

Developmental approaches focus on improving specific developmental skills, such as language and fine and gross motor skills.

According to the CDC, the most common developmental therapy for people with autism and related disorders is Speech therapy. Speech-language therapy addresses challenges with language and communication and can help individuals of all ages improve their verbal and nonverbal communication. One of the main goals of speech therapy is to help the person communicate in a more useful and functional way. For example, a speech therapist may teach an individual to communicate verbally, through signs, gestures, pictures, or an electronic communication device.

Occupational Therapy (OT) is another common developmental approach for treating autism symptoms. For individuals with autism, an occupational therapist will work on developing fine and gross motor skills needed for daily living skills. One of the most pivotal roles is also to assess and target an individual’s sensory processing differences.

Physical therapy (PT) includes activities and exercises that build motor skills and improve strength, posture, and balance. Skills taught through physical therapy can help children play games, sports, and increase their overall mobility.

** Often, an individual with autism will receive both ABA therapy and supplemental developmental therapies such as speech, OT, and PT. An ABA provider will work closely with other developmental therapists to take a collaborative approach to treating a child.

Educational Approaches

Educational interventions to treat autism are conducted in a classroom setting and are commonly done through an IEP (Individualized Education Plan). An IEP is a government-mandated plan for addressing the specific needs and learning goals for a student with a disability or developmental disorder. All public schools are required through The Individuals with Disabilities Education Act (IDEA) to provide a free and appropriate education to all students.

If a young child (i.e., under 6 years old) has an autism diagnosis and they have not yet entered first grade, families have the option of enrolling their child in an ABA program, daycare, or receive developmental services such as Speech/OT/PT rather than immediately enrolling in pre-school or kindergarten.

In Illinois, where The Place for Children with Autism is located, the compulsory legal age to attend school is 6 years old (i.e., first grade). Prior to enrolling your child in the school district, call your district school and say: “I have concerns about my child’s development and I would like to have my child evaluated through the school system for special education services.” If the person who answers is unfamiliar with special education, ask to speak with the school or district’s special education director.

Social-Relational Approaches (e.g., Floortime)

Social-relational treatments focus on improving social skills and building emotional bonds. The most common social-relational approach to autism treatment is the Developmental, Individual Differences, Relationship-Based model (also called “Floortime” or “DIRfloortime). Floortime encourages parents and therapists to follow the interests of the individual to expand opportunities for communication. This relationship-based therapy is called Floortime because the parents get down on the floor with the child to play and interact at the child’s level. Floortime does not work on speech, motor or cognitive skills in isolation but instead addresses these areas through its focus on emotional development.

Currently, research is limited on the use of Floortime to treat ASD (National Research Council, 2001). Additionally, the available research findings lack empirical validity as a stand-alone treatment. Several providers such as ABA, speech, occupational and physical therapy providers, will use aspects of Floortime in their treatment but not necessarily as a solitary treatment.

Pharmacological Approaches

It is important to note that there are currently no medications to treat the core symptoms of autism. However, there are some medications that can assist with various symptoms of autism that may help an individual better function at day-to-day tasks. For example, there is medication to help manage high energy levels, inability to focus, anxiety, depression, seizures, and sleep problems, all which may coincide with an individual’s autism diagnosis.

It is important to talk with a doctor about both prescription and over-the-counter medication for an individual with ASD. It is also important to not use pharmacological approaches as the sole treatment for autism. Pharmacological interventions should complement ABA therapy and other types of autism interventions.

Complementary and Alternative treatments

Some individuals and parents may use treatments that do not necessarily fit into one of the above categories and/or do not have research to support their effectiveness. Some of these may include art therapy, special diets (e.g., gluten free diet), chiropractic care, and animal therapy.  It is important to note that given the limited research to show effectiveness in reducing autism symptoms, these Complementary and Alternative treatments should not be used as a stand-alone treatment but rather to supplement more research-based approaches like ABA therapy. Families should always talk to a medical professional before starting complementary or alternative treatment.

Reference
National Research Council, Division of Behavioral and Social Sciences and Education, Committee on Educational Interventions for Children with Autism (2001). Educating children with autism. Washington, DC: National Academy Press.