Medically Reviewed By Sonam Kothari, Written By Tejasvi Parekh
Autism Spectrum Disorder (ASD) can manifest in different ways in people. Moreover, its symptoms can also vary from person to person. These symptoms can also change over time, in response to various interventions, and environmental and personal factors.
While it is common for autism to get diagnosed by the age of 30 months, many people particularly those with high-functioning autism do not receive this diagnosis until adulthood. This dynamic nature of autism is one of the reasons why there isn't a universally accepted protocol for the treatment of autism.
Interventions and treatment programs tailored to the needs of autistic individuals are known to be effective. Structured and specialised treatments and interventions that cater to the unique needs of an individual with autism have proven to yield the desired results.
The aim of the treatment is not to “cure” but rather reduce the symptoms of autism and enhance the daily functioning of the individual. Autism is a lifelong condition. Rather than cure, the primary goals for intervention and treatment programmes of autism are to minimise the disturbance in behaviour, reduce the symptoms and improve social and occupational functioning.
This article discusses in depth the treatment programmes that are available for autism to facilitate a thorough understanding.
Play Therapy is often used for children with autism who display repetitive patterns of behaviour, are more likely to stay alone and stick to only a limited number of activities that don't allow them to learn and grow as they are unable to explore their abilities and potential.
Through play therapy, emotions and feelings can be communicated in a non-verbal way, and a child can also learn to speak and develop social skills. It's worth noting that play therapy becomes beneficial for the child and their caregivers and parents as they can understand how their child interacts and communicates. This facilitates an understanding of the child’s needs and forms are closer bond between the parent/caregiver and the child.
It is said that play therapy is most beneficial for children between the ages of 3 to 12 years. One of the major questions that arises is why would a child with autism need to see a play therapist. Here it is important to keep in mind how children with autism are different from other children. They might not engage in “pretend play” like others, for example, they might not see soft toys as animated beings who can talk to each other. Similarly, they might also intensely focus on one particular toy as a form of self-stimulation.
Therefore, a play therapist will pay attention to the way a child engages with the toys, what interests them and how they interact with them. A play therapist’s goal would be to inculcate skills such as turn-taking and sharing as well as imaginative skills such as seeing a doll as an actual baby or pretending to cook a meal. These skills can help in the later development of abstract thinking.
In Floortime, the parent or caregiver engages in play with the child by getting down on the floor and interacting with the child at their level. It is often used alongside applied behaviour analysis (ABA) or as an alternative to ABA.
With floor time, the aim is to achieve emotional and intellectual growth. It helps a child develop complex communication, and emotional thinking, as well as intimacy and interest to engage in relationships.
The therapist acts as a guide to the parent by teaching them a process called “opening and closing circles of communication,” which is central to the Floortime approach. The process entails helping and guiding the parents to direct their children into more complex ways of communicating.
The therapy sessions can last from anywhere between three to four hours. As the parents join the child in the sessions, the emphasis is laid on back-and-forth interaction.
Caregivers and therapists assist the child in maintaining concentration to enhance interactions and develop abstract, logical reasoning skills.
Occupational therapy (OT) aids individuals in enhancing cognitive, physical, social, and motor skills to foster independence and engagement in various activities. Specifically tailored for autism, OT emphasizes play skills, learning techniques, self-care, and sensory management.
Initial assessments evaluate the individual's learning, play, self-care, and environmental interaction abilities, identifying barriers to daily participation. From this assessment, therapists establish goals and strategies targeting key skills.
Objectives may include promoting independent dressing, eating, grooming, bathroom use, and refining fine motor skills such as writing and cutting. Sessions, typically lasting 30 minutes to one hour, are personalized based on individual needs, with practice encouraged outside of therapy in home and school settings.
Some OTs specialize in addressing feeding and swallowing challenges in individuals with autism, offering tailored treatment plans for overcoming such obstacles.
Children with autism might have a deficit in using and understanding language in a social context. To overcome this, speech therapy as an early intervention strategy has been proven to be beneficial.
While speech therapy can be beneficial for both children and adults with autism, it is important to note that the first five years of a child are very critical for brain development. Therefore, providing an early intervention can prove to be highly beneficial. The speech therapist will also be able to help a child with autism who has flattened prosody.
Speech therapy helps children with autism to develop language fluency which will aid in their holistic development later in life. Language fluency also aids in facilitating social skills and communication skills. A child can better express their emotions, feelings and thoughts which in turn helps in improving their self-esteem and overall quality of life.
Applied Behaviour Analysis or ABA, as the name suggests, is a strategy focused on identifying and modifying behaviour. Commonly used for children with autism who are under the age of five years old, safe ABA can cater to the unique needs of every individual.
It respects neurodiversity and aims to work with the children's strengths by using positive reinforcements and rewards to encourage positive behaviour. Simply put, applied behaviour analysis (ABA) is based on the theory of behaviour. Therefore, it rewards positive behaviour, reinforcing it to occur again and ignores negative behaviour, decreasing the likelihood of it happening again.
Moreover, ABA also pays attention to the triggers that lead a child with autism to behave the way they do, as well as the consequences of a child's behaviour. This helps one to understand whether certain modifications can be made in the child's environment that will lead to a positive change in the child's behaviour.
In Relationship Development Interventions (RDI) parents are given basic training to act as the autistic individual’s therapist.
The six key objectives of RDI include:
RDI employs a systematic approach tailored to the child's age and abilities, aiming to cultivate motivation and skills through guided participation between parents and children. The initial focus is on building a nurturing relationship, where the child learns as a "cognitive apprentice" under parental guidance. As the relationship strengthens, families progress through developmental goals, aiming to enhance neural connectivity and brain function.
Parents, teachers, and caregivers integrate RDI principles into the child's daily routine, utilizing positive reinforcement to bolster social skills, adaptability, and self-awareness. This holistic approach aims to support children in navigating social complexities and developing vital life skills.
Individuals with autism and other developmental disorders often face challenges in sensory processing, known as sensory integration disorders. These difficulties can lead to behaviours such as rocking or hand-flapping. Sensory integration involves the brain's interpretation of sensory input from the environment.
Dr. A. Jean Ayres has developed a theory and treatment approach for sensory integration based on neuroscience and physical development studies. Occupational and physical therapists evaluate and treat sensory integration processes, aiming to provide sensory input to organize the central nervous system and promote organized responses to stimuli.
The therapy aims to provide sensory input to organize the central nervous system, help the child regulate sensory information, and support the development of organized responses to stimuli.
The Picture Exchange Communication System (PECS) is useful for children who experience difficulty with verbal expressive language. The program teaches children to make use of cards with pictures to communicate their needs. For example, approaching a person and giving them a card with a picture of the desired item, to obtain that said item.
A fast and functional communication system is thus established as the individual with autism can now communicate and put forth a request or a thought in a symbolised form with the help of a picture card.
PECS begins with communication through the exchange of only simple items and later builds on more complex sentence structures. The method has been known to help aid in decreasing tantrums as well as odd behaviour.
Several studies have also revealed that it helps in the development of spoken language rather than hindering it. However, the biggest challenge in teaching this form of self-initiating communication is to discover a way that motivates children with autism to participate and learn.
The Early Start Denver Model (ESDM) is a behavioural therapy program for children between the ages of 12 months to 48 months. This early intervention aims to support children in developing skills from an early stage so that the differences between the child and their peers can be reduced significantly.
The caregivers of the child are actively involved in supporting the child’s development ESDM focuses on helping the child learn and grow by engaging them in activities that they truly enjoy, such as playing or daily activities. However, it is important to note that EDSM is time and resource-intensive. It also faces the limitation of being geographically and financially inaccessible.
There is no medication available that can cure autism. However, medication can be used to help reduce some of the symptoms associated with autism, such as irritability or lowered attention span thereby increasing the chances of the effectiveness of therapy.
Research suggests that medication is best effective when it is used with other behavioural interventions. All medications come with their risks and side effects and therefore a healthcare provider must be consulted before starting a course of medication for autism.
Seeking timely assistance through various evidence-based psychological intervention programmes can help improve social communication. It’s crucial that after an individual is diagnosed with autism, they, as well as their caregivers, get the appropriate help, care, and support that will cater for their unique needs as they grow and change.
Early intervention results in several positive outcomes for the autistic individual. By identifying and thereby addressing the challenges that a child with autism faces, a tailored intervention strategy can be provided that will optimise the developmental potential of the child.
The early stages of one's life are periods of critical brain development. Therefore, the intervention program can target areas of difficulty such as communication skills, social skills, learning, speech and other behavioural patterns during the critical period of development. Early intervention can therefore minimise delays and help a child reach their development milestones at an appropriate time.
Early intervention for autism is known to lead to enhanced social skills. Play-based therapy, relationship development Intervention (RDI) as well as other intervention programs enhance skills that become crucial in later life such as maintaining relationships, participating in group activities and forming friendships.
Early intervention strategy has also proven to lead to better academic performance and higher independence levels.
Overall, it is recommended to provide intervention that caters to the specialised needs of an individual as soon as the diagnosis of autism is received. It is important to note that every child is different and therefore it becomes important to understand the unique needs of the children and provide them with the intervention strategy that will best cater to their needs. This will ensure the holistic development of the child and help them reach their full potential.
Autism is not “curable”. The treatments available for autism focus on helping individuals with autism to reduce their symptoms and function more efficiently in their daily lives. The treatments aim to support learning and development.
Early intervention strategies also work by aiming for the child to reach their development milestones on time without any delays.
There is no one-size-fits-all treatment for autism. Due to the diverse nature of the symptoms, individuals need to talk to a specialist and choose a treatment that suits their needs the best.
Current treatments for autism spectrum disorder (ASD) aim to alleviate symptoms that hinder everyday activities and overall well-being. Therefore, each treatment can involve different types of professionals and it can cater to the different needs that an individual has.
Interventions for autism begin as early as 2 to 3 years of age. Since this is a critical period of development for childhood, the rationale behind these early interventions is to aid the child in meeting their developmental milestones as well as enhance their daily life functioning.
Since the child’s brain is still developing and therefore has an increased level of plasticity (the brain’s ability to adapt to changes), the intervention strategies have a higher potential of being a success and leading to long-term effectiveness.
