Treating autism

Best Practices

Because eclectic models can vary widely, and cannot be validated by research as we build them for each individual person, they can greatly enhanced by, and their outcomes may even be dependent upon, the use of these universal best Autism practices for successful results. These guidelines also allow the Autism community to have some principles we can have consensus on, even as we may agree to disagree on the specific models we may choose from in a person-focused, family-centered, and community based model approach.
 
The following are the ten universal best-practice features that have been shown to provide a common foundation to all successful intervention programs:

  • Emphasis on earliest possible screening, diagnosis, eligibility for Autism services evaluations and ongoing assessment in the immediate implementation of appropriate effective Autism interventions.
  • Programs are tailored to the needs of each individual with specific adaptations that match the person's spectrum profile, age, stage of development, and emergent potentials.
  • Highly structured and skill-oriented teaching and treatment programs.
  • Frequent informal reassessment and systematic data-based tracking of skill growth and related plan review and revisions.
  • Use individual motivational strategies and systems (behavioral model motivators are more extrinsic in nature, and developmental model motivators are more intrinsic in nature. Most programs will utilize a certain combination).
  • Teaching areas are structured, organized and distraction-free environments which incorporate intensive one-to-one and small group sessions. Activities and routines are flexible yet predictable. Time spent waiting is kept to a minimum.
  • Provide multiple settings and consistency of methodology across time and spaces, in at least three and up to six settings, for promoting skills generalization.
  • All personnel are well-trained and continuously evaluated for competence and consistency in application of the intervention model used- optimally a family-centered choice with life-span planning.
  • Comprehensive home programming and parent training within a team approach that seeks to use the family’s talent in a co-treatment mode.
  • Intervention strategies are maintained full-day and year-round from preschool through adulthood, as provided by our family and respite-care providers and our public and private services and programs.

Treatment Options: Approaches for Treating Autism Spectrum Disorders

Because of the nature of autism and the many combinations symptoms that may be present, there is no known single approach that has been shown to take away all symptoms of autism. Various types of therapies are available, including behavior training, speech/language therapy, sensory integration training, vision therapy, music therapy, auditory training, medications and dietary interventions.

Studies and personal accounts have shown that individuals with autism respond well to a highly structured, specialized education and behavior training program that is tailored to the individual needs of the person. A comprehensive approach should explore the Childs’ needs in communication, social skills development, sensory and behaviors. All programs should be explored thoroughly to assess cost, effectiveness, outcomes, and safety of your child. The most effective programs are the ones that can be worked into your families’ routine and delivered in a consistent and coordinated manner.

It is important to develop “life skills” for children with autism. Tasks that enhance independence, give more opportunity for personal choice and allow more freedom in the community are especially valuable. Learning to cross streets safely, ask for assistance, knowing contact names and phones numbers, along with other critical skills should be taught at the earliest age possible. To be effective, any approach should be flexible in nature, rely on positive reinforcement, be re-evaluated on a regular basis and provide a smooth transition from home to school to community environments.

A good program will also incorporate training and support systems for the caregivers. Rarely can a family, teacher, or other caregiver provide effective habilitation for a person with autism unless offered consultation or in-service training by a specialist knowledgeable about the disability. No single treatment approach can take away all the traits of autism for everyone, but many behaviors can be positively changed with appropriate intervention. Sometimes the resulting changes are so significant the person appears to no longer have autism. However, the majority of children and adults will continue to show some characteristics of the disorder to some degree throughout their lives.

Many treatment options are available. The following links provide some examples in several categories (listed in alphabetical order):

  • Bio Medical
  • Communication
  • Complimentary
  • Skill Based
  • Social/Relationships

Principles for evaluating treatment of autism:

  • Approach any new treatment with hopeful skepticism.
  • Remember that the goal of any treatment should be to help the person with autism become a fully functioning member of society.
  • Beware of any program or technique that is touted as effective or desirable for every person with autism.
  • Beware of any program that thwarts individualization and potentially results in harmful program decisions.
  • Be aware that any treatment represents one of several options for a person with autism.
  • Be aware that treatment should always depend on individual assessment information that points to it as an appropriate choice for a particular child.
  • Be aware that no new treatment should be implemented until its proponents can specify assessment procedures necessary to determine whether it will be appropriate for an individual with autism.
  • Be aware that debate over use of various techniques are often reduced to superficial arguments over who is right, moral and ethical and who is a true advocate for the children. This can lead to results that are directly opposite to those intended.
  • Be aware that new treatments often have not been validated scientifically.

Questions to ask regarding specific treatments:

  • Will the treatment result in harm to the child?
  • How will failure of the treatment affect my child and family?
  • Has the treatment been validated scientifically?
  • Do specified assessment procedures exist?
  • How will the treatment be integrated into the child's current program?
  • Be aware that treatment should always depend on individual assessment information that points to it as an appropriate choice for a particular child.

Related publications:

  • A meta-analysis of educational interventions text: “Educating Children with Autism” published by the National Research Council. National Academy Press. Washington D.C. at: www.nap.edu
  • "Principles for Evaluating Autism Treatments", Adapted from guidelines created by Dr. B. J. Freeman
  • “Options to Meet the Challenges of Autism,” Autism Society of America