Once a child, teen, or adult with Asperger’s or high functioning autism is diagnosed, the next question becomes, “What now?”
I’m going to outline some treatments for Aspergers and high functioning autism spectrum people.
photo credit: Niloy on Flickr
The list of treatments I am referring to here comes from A Parent’s Guide to Asperger Syndrome and High-Functioning Autism, (2002), written by psychologists Sally Ozonoff, Gerldine Dawson, and James McParland.
Applied Behavior Analysis (ABA) is one of the better known and established modes of treatment. It can be used from pre-school to adulthood ages. It is most often delivered at home for younger children, by a trained professional team. It is very intensive, up to 30-40 hours per week, ideally for two years. Later, it can be used in school and other environments.
ABA uses clear objectives that are measured in terms of observed and definable behaviors. It then uses specific techniques to meet those goals, and ongoing collection of facts to assess how effective the interventions are.
The pro’s and con’s: It is costly, but allows many children with 2 years of intensive treatment to work well in a regular school without special support.
Treatment and Education of Autistic and related Communication-handicapped Children (TEACCH)
This treatment uses visual structure and organization of the environment and learning materials using visual, mechanical, and memory strengths to teach language, imitation, social and cognitive skills; and it can be taught one on one, or in groups. Again, this treatment for autism spectrum disorders can be utilized from preschool all the way to adulthood. It is mainly used at school, with home supplementation possible, by teachers and parents. The techniques are easily generalized into the work environment.
The pros and cons of this approach: TEACHH is often funded by public schools, but the outcomes are less well-studied than ABA. However, it improves behavior and learning, and reduces parental stress, increasing confidence.
Denver and Greenspan models.
Also known as Floor Time, these treatment mainly targets preschool children on the autism spectrum. These treatment approaches emphasize play, positive social relationships, child-centered control of interactions, and sharing emotions with others. The theory is based on entering the child’s world and letting the child control the interactions.
The strengths of this treatment is that it stresses fostering warmth, pleasure, and reciprocity in relationships much more than ABA or TEACCH. It’s less well studied than ABA, but appears to be particularly effective in increasing social and emotional skills.
Social Skills Groups.
This approach can be used with all ages, and can take place in a therapist’s office, clinic, or school, led by a therapist or teacher. Social skills groups focus on the development of conversational skills, body language, perspective taking, reading of others’ emotions, regulating emotions, and social problem-solving skills such as dealing with being teased or left out.
The benefits of social skills groups is that they teach skills and offer practice with peers; provide tools that translate to home training; and can be used through adulthood.
Educational support is usually accomplished with an IEP (Individualized Education Plan). It can be put into place all the way from preschool through college. These include accommodations to and modifications of the environment and of academic goals.
Educational support is negotiable with schools, and adaptable to individual needs. It’s important to remember that school educational support is mandated by federal laws.
Language-communication therapy, or speech therapy, can be a very helpful treatment for the autism spectrum. This treatment is provided by a speech-language pathologist, and can be helpful for individuals all the way from pre-school through adulthood. It can be provided in group settings or with pairs of children. The speech therapist works on training the individual in pragmatics of language, social communication, and abstract or complex language concepts.
Speech therapy is beneficial with social skills group options are not available, or when a child has more communication problems.
Functional behavior analysis. This treatment examines the function of disruptive or problem behaviors. When the ‘function’ of those behaviors is better understood, the therapist can then work with the person to learn other more ways to communicate. This is a beneficial treatment for children and adults because it reduces behavior problems and increases communication skills.
Medication. Medication is prescribed by a medical doctor, such as a child psychiatrist or neurologist, and is given usually daily by parents at home. Medication can be helpful for attention or activity level problems, depression, anxiety, or anger. It is not meant to change the core challenges of communication difficulties. Rather, it can help diminish some of the more difficult symptoms that come out of tryig to deal with an often confusing NT world.
While there is not a lot of research to determine its effectiveness, sensory integration therapy works to decrease sensory sensitivities, and helps the person develop coping skills and tolerance for new sensations. This type of treatment is usually provided at the office of an occupational therapist. The therapist can also give parents exercises to work with their child on at home. Most often, this therapy targets preschool and childhood ages. However, I recall reading about Temple Grandin designing her own body pressure device that greatly calmed her and helped her focus and concentrate.
Finally, individual therapy can be helpful to explore moods and emotional states, develop self-awareness and self-acceptance, and develop emotional intelligence . Individual psychotherapy is best for people with good insight. It may not generalize to group settings, and may need to be more directive and concrete.
This a summary of the more recognized forms of therapy and treatments for people on the autism spectrum. Did I leave any out? Comment below!
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