Treatments for Autism

Autism cannot be cured. Thankfully, it can be treated. The earlier the diagnosis and the earlier an intervention program is set in place to support the child and the family – the better the prognosis.

The extreme desperation of parents and educators, combined with an embarrassing shortage of autism treatment research has lead, unfortunately, to the existence of plenty of quacks offering miraculous “groundbreaking” treatments for children with autism. Some of these methods may seem to work, some may prove to be quackery immediately.
So it’s important that if you are a parent to a child with autism, you choose the program that is right for your child, your family and your philosophy. To read more about autism treatment, visit this site.

Different therapy techniques and approaches target different aspects and “symptoms” of autism. The causes for autism in each individual are usually unknown, and therefore it is impossible to choose one single therapy method for a child. I strongly recommend using a combination of some of the following methods, and I think the emphasis should be on the educational approaches, with the usage of other methods to complement it. When it comes down to the daily life, what we do with our children is educating them 24/7. At home, at school, in the fields or on the street. If you have an educational therapy plan you will be able to heal your child at any given point in the day! This will make both of you feel much better.

Educational Approaches:

DIR- FLOORTIME

The philosophy of Floortime was developed by Dr. Stanley Greenspan and is designed for all children with any kind of disability or developmental delay. This is a developmental and humanistic oriented approach, that is geared towards developing the individual, rather than his or her skills.

The Floortime approach is meant to help the child fill in the missing gaps in their development and climb to the next step on the developmental ladder.

Floortime therapy is a very flexible and creative approach. It encourages all the individuals involved in the child life to spend (combined) 5 sessions a day of 10-30 minutes each of high-intensity emotional connectedness with the child, by following the child’s lead. The idea is that when you follow a child’s lead, you follow them to their world and in their true interest (this can be anything from spinning around the room, or even running away from the therapist/parent/caregiver). This is how the therapist (which in Floortime is really all the people involved in the child’s life: parents, siblings, teachers, etc.) unlocks the door to the child’s inner world, and creates a personal connection. Sounds too spiritual or flaky? Try it for yourself. As a mother to a toddler who had no interest in games, stories or toys whatsoever, this was the only way I could actually tap into her world and engage in a conversation with her (perhaps non-verbal, but there was an exchange of information involved!). It was fun. We used anything that interested her, from tickles to puppets, to make each circle of communication as long and pleasurable as possible.

One of the most important things that are usually lacking the most in individuals with autism is the ability to “share the moment”. In Floortime, the emotional energy created by sharing the moment with the child is used to learn new things and create more and more circles of communications, which are the missing milestone without which no communication can occur.

Also, when parents engaged in a Floortime session, both the parents and the child can release emotional tension, as this is a play-based, high-energy activity. It helps with the bonding and helps the caregivers as well as the child an opportunity to renew and rejuvenate themselves emotionally. I am terribly biased towards Floortime as a whole, and therefore I have installed a small article about it earlier.

Links related to Floortime:

Alternatives to Behaviourism

Floortime Overview and Strategies (a website of a parent to a child with Asperger’s Syndrom)

SOCIAL STORIES
Social stories are a method used mostly for autism, and it is meant to put order and logic into social interaction (which are usually a very chaotic phenomenon if you think about it). The social story is often accompanied by images – either photographs, drawings, or symbols (often PECs symbols).
Social stories simplify social situations, and tell the way in which the person should be acting in all the different scenarios. It can be anything from a bedtime routine, to how to play games, how to behave in the classroom or on the playground, to more sophisticated scenarios of threatening emotions and language challenges.
Here are a few examples:

Circle time:
It is circle time.
When it is time for circle, I go sit in a blue chair.
I sit with my feet on the floor and my hands to myself.
It doesn't matter who I sit next to. I will shake their hand and say good morning.
I help Mrs. G. at circle by listening...
Waiting my turn...
And sitting like a big kid in my chair.
I don't get angry when I don't get a turn because I will get a turn another day.
When circle is over, I wait until Mrs. G. tells me where to go.
I did great at circle today!

Dealing with difficult, unpleasant emotions:
Sometimes I feel angry.
All people feel angry at one time or another.
When I get angry I will find my teacher, Mommy, Daddy or another adult.
When I find them I will try to use words to tell them that I am angry.
I can say "I'm angry!" or "That makes me mad!"
It is okay to use words when I feel angry.
They will talk to me about what happened and about how I feel.
This might help me to feel better.
Wherever I am I can try to find someone to talk to about how I feel.

This is a social story that can help an autistic person understand how to react to figures of speech. Most individuals with autism find figures of speech, puns and jokes to be very puzzling and have hard time understanding them Social stories can help.
Often, people say things that mean something different that the words might normally mean.
Sometimes, people say, "Save your breath."
They usually say this to someone who is arguing a point.
"Save your breath" means that you can stop arguing, because your arguments are not going to change the other person's mind.
If any of you have read the book “The Curious Incident of the Dog in the Night-Time”, you may have noticed that many parts of the book are written in this style of social stories. Social stories help reduce the stress that rises from very complex social interactions that are often overwhelming to a person with autism.

Related links:

Polyxo.com - an excellent resource for autism; all the social stories here are from there.
The Gray Centre for Social Learning and Understanding

PECS TRAINING
This is a tool that is used in many settings with children and adults that have speech and language challenges. A set of primitive images are used to represent each word. The pictures are either laminated or are used in a more high-tech manner (i.e. on a PalmPilot or a computer), and the person uses the pictures to communicate.
The pictures are often used to illustrate the child’s daily schedule, and the child will communicate their wants and needs by bringing a picture and exchanging it for the object or activity they want. The pictures can also be placed next to each other to form sentences.

PECS training is not meant to replace language. It is meant to reinforce the learning of language by making the process of language and exchange of communication a more concrete and tangible process. In fact, PECs training have proven to be extremely helpful in promoting literacy - learning reading and writing; because each word is printed on the cards, and so the child is visually exposed to the written words.

BEHAVIOIURAL THERAPY: APPLIED BEHAVIOURAL ANALYSIS (ABA)
Applied Behaviour Analysis is a method that teaches new skills as well as correct inappropriate or unwanted behaviour. This is done by using reinforcements: the wanted or “correct” behaviour is rewarded (either by a simple treat in early phases, or by praise, etc.).

These are very expensive therapies when done “by the book”, as they usually require 40-50 hours a week of one-to-one work with the therapist, at least in the early stages of intervention. This method is often integrated into the classrooms to teach very specific skills and tasks, i.e.: number recognition, learning safety rules, etc.

This method is the one that has been tested and researched more than any other approach, because it is so empirical, measurable. However, this does not mean that it is the only one that works. Lack of research funding should not be the indicator for which methods work or don’t work.
ABA Related links:

History of ABA

ABA Resources

Association of Behavioural Therapy International

PHYSICAL and MEDICAL INTERVENTION

BIOMEDICINE
Often, children with autism will present behaviorus that clearly indicate a chemical imbalance in their nervous system (for instance: interruption in the dopamine and serotonin system may cause Obsessive Compulsive Disorder, repetitive behaviours, ticks, etc.). If these behaviours are so extreme that they interfere negatively with the individual’s ability to live their lives, it may be a good idea to think of drug treatment. Don’t get too scared when you read the pamphlets for the drugs – they are often prescribed for anxiety, obsessive compulsive disorder and curiously enough schizophrenia.

Treatment with medication should be taken very seriously and really should be the last resort. Especially with young children. A psychiatrist that is too prescription happy may not be cautious enough. It’s of utmost importance that drugs be introduced gradually, and very very slowly, to reduce if not eliminate side effects altogether. To start gradually, child psychiatrist would prescribe minute doses in suspension or liquid, which allows for full control of the dosage and how slow it is introduced to the nervous system.

DIETARY INTERVENTIONS
Some individuals with autism have food allergies or sensitivities. Some parents and professionals noticed a significant improvement with their children when certain suspicious proteins where eliminated from their diet (primarily gluten, which is founding wheat, and kazaine, which is found in milk).

Other report improvement when certain supplements were given to the child. There is still not enough research done in this area to recommend dietary intervention to all children with autism though. Parents should be careful not to make dramatic changes in the child’t diet without consulting with their pediatritian and a nutritionist.

SENSORY INTEGRATION and “SENSORY DIET”
As I explained earlier, many of the phenomenon of autism are related to the inability of the nervous system to regulate itself. Make sure you hire an Occupational Therapist that specializes in autism and sensory integration. There are also some Sensory Integration clinics, that provide unusual sensations that are focused and targeted in order to help the child learn to organize their nervous system. Tactile activities such as foot-painting with slimy paint, bouncing on trampolines, wearing a cocoon bag from spandex which creates unusual pressure on the skin, the head and the joints, spinning and more. Some activities can be taken into the classroom or the gym, and be performed on a daily basis. Some children need sensory breaks. The WIllberer’s Protocol can be also performed almost anywhere and helps the child to reorganize their system and de-sensitize to the sensations that irritates them (this includes brushing the arms, legs and back with a surgical brush – through the clothes of course – followed by systematic joint compression).

COMPLEMENTARY THERAPIES: MUSIC THERAPY, ART THERAPY, ANIMAL THERAPY
These are wonderful opportunities for the child to be exposed to a different environment and experience that is nourishing for their soul and also enhances interaction with the therapist (or the animals), increases self esteem. Using non-verbal means for communication can be quite a relief for the child, and provides them with other tools for releasing tension. Singing can help develop the oral muscles and improve language skills, and listening to music helps develop listening and communicating skills. Swimming with dolphins and therapeutic horseback riding, for instance, help develop muscles, coordination and skills that wouldn’t get much attention otherwise.

A few tips and warning about recruiting people to work with your child:

Funding for autism therapy varies between countries, states, provinces, districts and cities. There is one thing in common everywhere though: there are always limited resources, both financial wise and manpower wise. If you are fortunate enough to live in a country that funds autism, and have a budget to work with – use it wisely. Here are a few tips:

1) Use whatever resources you have to the max. Get the professional (and expensive) therapists and consultants to be in constant communications with all the caregivers and educators involved in your child’s life. Get the daycare teachers to do as many one-on-one sessions as possible with your child (be it a Floortime session, an ABA session, a Sensory Integration session). These can be really short sessions, as long as they are frequent and meaningful.

2) Spend as little money as possible (if at all) on any consultant that actually behaves like a consultant. You need to get advice from people that know your child enough to truly recommend anything valuable. Consultants that see your child once a month or less are usually useless, unless they are amazing experts in their field. You would probably be able to tell pretty fast though…

3) Work as a team. Treat your therapy professionals as a team, and make them feel good about being in your team. Team meetings are excellent, as long as they don’t happen too frequently. Once a month is a good timing. More than two months apart might be too little especially in the first years. Bring some treats to the team meeting too ;)

4) Be the team leader. The parents know what’s best for their child, and they should be the ones who make the big decisions on what’s important to work on.

5) Make sure your therapy and educational team is always in fluent communication with you and preferably also with one another. The more you open the channels of communication, the better treatment your child will get. Joint sessions can be one of the most rewarding experiences for both the therapists and your child. They will create an environment of collaboration for your child and more importantly – provide continuity between one session to another. Practice makes perfect…

The people you choose to work with your child on a daily basis are going to have a significant impact on your child life. So be sure that you and your child like them and feel comfortable and safe around them, regardless of how impressive their education and qualifications are.

Quite recently, in British Columbia anyways, funding for autism has increased and became more reasonable. This is a blessing as well as a curse. There aren’t that many therapists experience or trained for treating autism, and unfortunately there are a few that are attracted to the job because of the new funding more than the work itself. Obviously, you want the person working with your child to be passionate about helping them

Some parents and therapists could be as passionate about their treatment philosophy as if it was a fundamentalist religion. I am none such fundamentalists, and I don’t believe that there is one single way to treat autism. which uses the most effective techniques for each specific child, in a particular situation and settings. I am going to do my best to steer away from such controversies, and I will simply outline a few of the most commonly practiced methods, which are used in schools and in most early intervention programs.

I personally believe that an eclectic approach that includes the methods that are most suitable for the child’s needs is ideal. I have my own personal bias towards Floortime, as it was a very rewarding experience to me and prove to work for my child; But I wouldn’t go as far as rejecting any other therapy just because this is what worked for my child. ABA is very effective for children with severe autism. It may help for teaching the child preliminary tools that are needed for the next step. I am a practical woman (and I bleive most parents have to learn to be practical after being in the business long enough), and I think you should pick and choose what’s best for your child, in each and every particular situation. For instance, a child may respond well to the playful and stimulating interactions of the Floortime approach, yet need a structured ABA session to learn her math and typing; She may also need a “sensory diet” to help her regulate her nervous system, social stories before difficult events (such as visiting the dentist or getting her hair done), and may even end up needing the help of drugs to regulate her obsessive-compulsive behaviorus once the hormones starts kicking in around puberty…