Intervention Overview

INTERVENTIONS FOR AUTISM SPECTRUM DISORDER*

There are many different treatments for ASD.  Deciding which intervention to pursue may seem like an overwhelming decision.  When choosing an intervention, it is critical to examine the evidence (or supporting research) for the treatment you are considering. It is also important to consider a child’s needs/skills are and the goals for intervention.  It will often be necessary to investigate multiple intervention programs available to determine what will best fit the child’s needs. 

The CDC breaks treatments for ASD into the following categories:

Behavior and Communication Approaches

  • Applied Behavior Analysis (ABA)
    • There are different types of ABA. The following are some examples:
      • Discrete Trial Training (DTT): DTT is a style of teaching that uses a series of trials to teach each step of a desired behavior or response. Lessons are broken down into their simplest parts and positive reinforcement is used to reward correct answers and behaviors.  Incorrect answers are ignored.
      • Early Intensive Behavioral Intervention (EIBI): This is a type of ABA for very young children with an ASD, usually younger than five, and often younger than three.
      • Pivotal Response Training (PRT): PRT aims to increase a child’s motivation to learn, monitor his own behavior, and initiate communication with others. Positive changes in these behaviors should have widespread effects on other behaviors.
      • Verbal Behavior Intervention (VBI): VBI is a type of ABA that focuses on teaching verbal skills.

Other therapies that can be part of a complete treatment program for a child with an ASD include:

      • Developmental, Individual Differences, Relationship-Based Approach (DIR; also called “Floortime”): Floortime focuses on emotional and relational development (feelings, relationships with caregivers). It also focuses on how the child deals with sights, sounds, and smells.
      • Treatment and Education of Autistic and Related Communication-handicapped Children (TEACCH): TEAACH uses visual cues to teach skills. For example, picture cards can help teach a child how to get dressed by breaking information down into small steps.
      • Occupational Therapy: Occupational therapy teaches skills that help the person live as independently as possible.  Skills might include dressing, eating, bathing, and relating to people.
      • Sensory Integration Therapy: Sensory integration therapy helps the person deal with sensory information, like sights, sounds, and smells. Sensory integration therapy could help a child who is bothered by certain sounds or does not like to be touched. 
      • Speech Therapy: Speech therapy helps to improve the person’s communication skills.  Some people are able to learn verbal communication skills.  For others, using gestures or picture boards is more realistic.
      • The Picture Exchange Communication System (PECS): PECS uses picture symbols to teach communication skills. The person is taught to use picture symbols to ask and answer questions and have a conversation

Dietary Approaches

·         Changes in diet are frequently recommended as part of popular biomedical interventions for ASD. Removal of certain types of foods (e.g., foods containing gluten, casein, artificial coloring/flavors) and/or additions of certain vitamins and minerals may be included in these approaches. Dietary treatments are based on the idea that food allergies or lack of vitamins and minerals cause symptoms of ASDs.  There is currently insufficient scientific evidence to support the use of dietary changes or restrictions in children with ASD. If you are thinking about changing your child’s diet, talk to his or her doctor first. If in consultation with your child’s physician you decide to implement any special diet with your child, it may also be important to consult with a nutritionist to be sure your child is still getting adequate amounts of important macronutrients and vitamins and minerals.

Medication

·         There is currently no medication treatment that has been shown effective in treating all the core symptoms of ASD. There are, however, medications that can help some people manage symptoms related to the diagnosis. For example, medication might be prescribed to help address hyperactivity, attention and focus, depression, or seizures. Also, the U.S. Food and Drug Administration approved the use of risperidone and aripripazole (antipsychotic drugs) to treat severe tantrums, aggression, and self-injurious behaviors in children with ASDs who are over a certain age.

Complimentary and Alternative Treatments

·         Some parents and health care providers use or advocate for treatments that are outside of what is typically recommended by medical professionals. These types of treatments are known as complementary and alternative medical (CAM) approaches. They might include special diets, chelation (a treatment to remove heavy metals like lead from the body), biologicals (e.g., secretin), or body-based systems (like deep pressure).

These types of treatments are very controversial. Current research shows that as many as one third of parents of children with an ASD may have tried complementary or alternative medicine treatments, and up to 10% may be using a potentially dangerous treatment. Before starting such a treatment, check it out very carefully, and be sure to talk to your child’s doctor.

Please note that this is not an inclusive list of treatment options but rather provides examples of available interventions.  Inclusion in this description does not mean endorsement by Autism Wonders, the Division of Developmental-Behavioral Pediatrics, Division of Pediatric Psychology or Greenville Health Systems.

*Information for this section adapted from the Centers for Disease Control and Prevention (CDC) website http://www.cdc.gov/NCBDDD/autism/treatment.html