Autism Spectrum Therapy

Because Autism is a spectrum disorder, each individual has a unique set of strengths and weaknesses. Often a combination of autism therapies are used to manage and address a variety of conditions including social skills, restrictive or repetitive behaviors, sensory issues, as well as speech and gestures problems.
Autism-Spectrum-Therapy-ThearpyTribe
The most common autism therapies utilize positive reinforcement to encourage desired behaviors in children.

What is Autism?

Autism-Wheel-ThearpyTribe

Autism, also known as Autism Spectrum Disorder (ASD), refers to a range of conditions characterized by challenges with social skills, restricted or repetitive behaviors, speech, and nonverbal communication. More specifically, autism is a developmental disability that affects how a person communicates with and relates to other people.

Autism traits present differently in each individual, and many therapists use a wheel to illustrate ASD and explain treatment goals to clients and their family members.

What is a Spectrum Disorder?

A spectrum disorder refers to the level of functioning an individual has. In other words, if you have this disorder, you are either extremely high-functioning and can care for yourself or low-functioning, and will need constant care for the rest of your life. In 2013, the DSM-5 recategorized autism spectrum disorder (ASD) into three severity levels: level 1 (“requiring support”), level 2 (“requiring substantial support”), and level 3 (“requiring very substantial support”).

This change has necessitated a shift in vocabulary for mental health professionals. Those previously diagnosed with Asperger’s syndrome are now categorized as level 1 Autism Spectrum Disorder (ASD) and considered high-functioning autistic individuals. Despite this, individuals diagnosed prior to 2013 may continue to embrace the term Asperger’s as an important part of their identity. Others choose to describe themselves as autistic. Both are accepted, it’s just a matter of preference.

How Many Children Have an Autism?

Studies indicate that the rate of autism is on the rise. According to estimates from the CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network, approximately 1 in 36 children were identified with autism spectrum disorder (ASD) in 2020. Furthermore, autism appears to be present across all racial, ethnic, and socioeconomic groups. Lastly, autism 4x more common in males than in females. 

What are the Possible Causes of Autism?

Scientists are trying to understand why some people develop autism while others do not. A growing area of research focuses on the likelihood that both genetic and environmental factors play a role in its development. For instance, environmental factors such as exposure to harmful chemicals, maternal obesity, or oxygen deprivation during pregnancy may trigger a genetic mutation that leads to autism. However, these factors alone would not cause autism.

When Do Autism Symptoms Typically Arise?

Autism symptoms typically emerge by the age of 2, but they can also present earlier (around 18 months) or later. It is important to note that diagnosing autism at earlier ages can be challenging. For example, early symptoms of autism may be mistaken for normal personality traits or developmental delays.

Under the DSM-5-TR, individuals with ASD must show symptoms from early childhood, even if those symptoms are not recognized until later. The shift in guidelines from the DSM-4 advocates for the early diagnosis and early intervention. Since young children with autism often face developmental delays in motor skills, speech, and coordination, initiating autism therapy and behavioral interventions at an early stage increases their chances of mitigating problem behaviors, acquiring new skills, and enhancing their daily living into adulthood.

When a high level of care is required, parents can often feel overwhelmed. If a parent is unable to meet all of their child’s needs, families may find it beneficial to seek support from autism services. These services can include a home health aide, a developmental pediatrician, a pediatric neurologist, a clinical child psychologist or psychiatrist, an occupational therapist, an audiologist (a hearing specialist), a physical therapist, and/or a speech therapist, depending on the child’s specific needs.

What are the Treatment Options for Autism?

It’s important to understand that there is currently no cure for autism. That said, numerous therapeutic strategies can enhance the social skills, educational outcomes, and overall well-being of individuals with autism. The level of treatment required varies significantly from person to person. Some may require minimal intervention, if any, while those with more severe autism might need ongoing, comprehensive therapy and support throughout their lives.

Below is a list of treatment modalities commonly used to address autism. Often, a treatment plan will involve a combination of therapies and parent training tailored to the child’s needs on the autism spectrum:

Applied Behavior Analysis (ABA)

One of the most common autism treatment approaches (for children and adults) is Applied Behavioral Analysis (ABA). In fact, 46 states require health insurers to cover ABA training for autism and Asperger’s syndrome. This therapy approach uses a reward system to encourage positive behaviors as well as discourage negative behaviors. ABA utilizes positive reinforcement to teach and promote social skills, communication abilities, learning and academic skills, and self-care habits.

Early Intensive Behavioral Intervention, also known as EIBI, is a type of Applied Behavior Analysis (ABA) tailored for children younger than five years old. This approach involves personalized teaching that can take place in the home or a clinical environment. The National Research Council advises that children with Autism Spectrum Disorder (ASD) should receive a minimum of 25 hours per week of focused interaction.

Cognitive-Behavioral Therapy (CBT)

Another approach commonly used in the treatment of autism is Cognitive-Behavioral Therapy (CBT). This modality is often referred to as “talk therapy,” indicating that sessions are geared toward helping autistic individuals connect feelings, thoughts, and behaviors together. The goal of this therapy is to help these individuals recognize negative thoughts and feelings that are possibly triggering unhealthy and destructive behaviors.

A 2010 study on autism and cognitive-behavioral therapy found that CBT may indeed help autistic individuals better manage their conditions by lowering their stress levels. Results also suggested that CBT may help autistic individuals identify other people’s emotions, so they can interact with them better.

Occupational Therapy (OT)

Occupational therapy (OT) is also used to treat individuals with autism. This approach concentrates on teaching children and adults with autism the skills they need to function effectively in daily life. An occupational therapist can help improve a child’s or adult’s fine motor skills, handwriting abilities, and self-care practices. Additionally, this professional can teach adults skills for independent living, such as paying bills, cooking, working, grocery shopping, cleaning, and budgeting.

Sensory Integration Therapy (SIT)

For individuals with sensory issues (sight, sound, and/or smell), sensory integration therapy (SIT) is often recommended. A specially trained occupational therapist can help individuals with to balance or minimize distractions, enabling the individual to learn healthy skills and behaviors. Some of the methods and techniques employed during these therapy sessions include drawing in the sand, jumping rope, and meditating.

Speech Therapy

People with autism often experience difficulties with speech. Consequently, speech therapy is frequently recommended. Speech therapists assist individuals with autism in improving their clarity of speech by teaching them enhanced verbal skills. This form of therapy is typically conducted by an occupational therapist or a speech-language pathologist.

The objective of this therapy is to assist adults and children in enhancing their speech, including its rate and rhythm, and in utilizing words correctly. Additionally, it aims to aid both children and adults with speech difficulties in more effectively expressing their thoughts, opinions, beliefs, and emotions.

Social Skills Training (SST)

Social skills training (SST) is a method for helping individuals with autism, particularly children, to develop the necessary skills for proper interaction with others. For some, socializing can be extremely challenging, thereby limiting their ability to make and maintain friendships and engage in romantic relationships. Therefore, social skills trainers instruct individuals with autism on how to initiate and sustain conversations, understand humor, and interpret emotional cues or non-verbal gestures.

Note: This training is typically recommended for children; however, it has also proven effective for teens and young adults.

Medications

Another treatment sometimes used for autism is medication. Currently, there are no medications specifically designed to treat autism; however, there are a variety of medications that may alleviate certain symptoms or associated with autism.

Medications used to help manage autism include: Antipsychotics, Anti-anxiety meds, Antidepressants, Stimulants, Anticonvulsants

Alternative Treatments

Although not as popular as more traditional treatments for autism, alternative therapies may be beneficial for some individuals with autism when used in conjunction with their prescribed treatment plans. However, it is important to understand that studies supporting these treatments are severely limited at this time. The few studies that have been conducted on autism and alternative therapies remain inconclusive regarding their effectiveness. More so, a couple of studies have found that alternative treatments sometimes used for autism like chelation therapy (the removal of metals from the body), may actually do more harm than good. Consult your physician before substituting or adding alternative treatments to an autism maintenance regimen.

Alternative treatments sometimes used to manage autism symptoms include: Specialized Diets (i.e Gluten-Free and/or Casein-Free), Weighted Blankets, Melatonin Supplements, Vitamin C, Omega-3, Dimethylglycine, Vitamin B6 with Magnesium, Oxytocin, CBD oil.

Massage Therapy

Another alternative treatment that has skyrocketed in popularity in the last few years is massage therapy. In fact, one review found that massages can relieve symptoms, like stress, anxiety, and sensory issues. Many people, who struggle with autism, attest to the benefits of massage therapy, however, there is little-to-no scientific evidence to back this theory up on a larger scale. Also, it’s important to understand that some people with autism do not like to be touched, so this type of therapy would not be suitable for these individuals.

Autism Intervention Programs

In recent years, other non-biological treatments, such as the Picture Exchange Communication System (PECS), the TEACCH method, and the Responsive Teaching (RT) method, have become viable options for individuals with autism to manage their unique needs. 

Picture Exchange Communication System (PECS)

Picture Exchange Communication System (PECS)can help people with autism, who have little-to-no ability to verbally communicate, express their wants, needs, thoughts, feelings, and opinions through pictures. Through the use of PECS, individuals with autism can engage with others by presenting pictures that represent their wants or needs. They are also able to express their emotions or thoughts without relying on verbal communication. For instance, a child with autism may utilize PECS to request an item or to communicate an idea or message by indicating symbols, words, images, or illustrations on a picture card. One of the primary advantages of PECS is its versatility, allowing it to be implemented both at home and in educational settings.

The TEACCH Method

The TEACCH Method stands for Treatment and Education of Autistic and related Communication-handicapped CHildren. The TEACCH method was developed in the 1960s by Dr. Eric Schopler and Dr. Robert Reichler, professors at the University of North Carolina, as a treatment for pediatric autism.

The TEACCH method offers a “structured teaching” or “regulated” approach to visual learning. The TEACCH method can be extremely beneficial for individuals with autism because it recognizes the traits, behaviors, and challenges that some people, especially children, struggle with on a daily basis. This recognition makes it easier for doctors to customize treatments for these individuals. This is achieved by providing accommodations for individuals with autism, such as modifying the environment and offering alternative forms of communication, enabling them to express themselves. Another advantage of the TEACCH method is that it can be utilized independently or in conjunction with other treatments, such as Cognitive Behavioral Therapy (CBT), Sensory Integration Therapy (SIT), Applied Behavior Analysis (ABA) therapy, medications, self-help tools, and so on.

Responsive Teaching (RT) Early Intervention Program

An autistic child’s environment plays a crucial role in his or her development. Thus, this space should be warm and inviting. Parents and teachers are considered “responsive adults,” and as such, they play an essential role in the learning environment.

Responsive Teaching, also sometimes referred to as Relationship-Focused Interventions (RFI), involves teaching parents how to support their autistic children in healthy ways. This environment should include the autistic child’s home, public spaces, daycares, classrooms, and other areas that they frequent regularly. Responsive teaching should also incorporate daily or classroom schedules and learning materials within these environments. This approach to autism treatment is designed for children under the age of 7; however, it is sometimes utilized to treat children older than this age.

In 2007, Responsive Treatment emerged as a therapy for young children with autism, particularly for those experiencing developmental delays. The objective of RT is to assist parents in becoming more attuned to and responsive to their autistic children’s cognitive processes, communication, and social and emotional skills during interactions. Thus, responsive learning environments should be modified to address and accommodate an autistic child’s developmental levels, interests, skills, communication mode(s), and needs.

Ultimately, researchers suggest that a learning environment can encourage healthy relationships and positive behaviors in children with autism. Studies have also found that Responsive Teaching has positive effects on child learning and development. However, further research is needed to definitely determine the overall effects of this treatment for autism.

Pivotal Response Training (PRT)

Pivotal Response Training (PRT), a comprehensive intervention model, was developed by Dr. Robert Koegel and Dr. Lynn Koegel to incorporate a more holistic or “natural” approach to Applied Behavior Analysis (ABA). PRT is a notable autism treatment because it is not only “child-led” but also reinforces positive behaviors with clear and natural stimuli. According to the Koegel Autism Center at the Gevirtz School, Pivotal Response Treatment (PRT) should be considered a ‘go-to’ treatment for Autism Spectrum Disorder (ASD). This is primarily because it targets key developmental areas that are known to support a child’s ability to develop a wide range of aptitudes or skills.”

The primary objective of Pivotal Response Treatment (PRT) is to concentrate on crucial areas of a child’s development, including motivation, responsiveness to cues, self-regulation, and social interactions. The prevailing view is that improvement in these domains can support a child across a range of emotional, behavioral, and social contexts, and that the skills acquired in these areas may benefit them throughout their lifetime.

Relationship Development Intervention (RDI)

Relationship Development Intervention (RDI) is a parent-led approach that focuses on helping children develop their social skills, think flexibly, understand different perspectives, and learn to engage with others and form close relationships. This is a relatively new approach in the field of autism, but has shown promise in reducing autistic symptoms and increasing social emotional functioning. Preliminary studies show that the quality of parent-child interaction significantly improves outcomes.

Hiring an Autism Therapist

A family member with Autism can put a heavy strain on romantic relationships, familial relationships, and friendships. It can also affect the self-esteem and self-confidence of the person with autism. Fortunately, a qualified autism therapist can help the child or adult change “abnormal” behaviors, potentially moving him or her up the spectrum by increasing their every day functioning and independence. 

Keep in mind, autism can take a while to fully present, so having a specialist who can help you and your child better understand the condition, and guide you both through the treatment process is extremely important.  Autism therapy is a highly specialized field, so extensive knowledge and experience can make a huge difference during the treatment process.

Moreover, due to the complexity and time-consuming nature of the treatments, it’s necessary to find a doctor that will really listen to your loved one’s concerns, questions, and fears. The good news is that with proper treatment, those suffering from autism spectrum disorders can gain a sense of “normalcy.” In addition, many are able to go on to live independently.

Search TherapyTribe, therapist directory to find a qualified therapist in your area or online in your state that can help diagnose and manage autism and Asperger’s syndrome.



Post-Pandemic Update on Individuals with ASD

In 2019, the coronavirus (COVID-19) became a worldwide pandemic, essentially shutting down the world with unprecedented job loss, and mandated social distancing and lockdowns. The seclusion, fear, paranoia, and misinformation caused a tremendous amount of stress and anxiety for the general population, however, people on the autism spectrum fared much worse. COVID-19 disrupted everyone’s daily routines, but it was especially problematic for people with autism or Asperger’s syndrome. 

People, who struggle with ASD, already have a hard time adapting to changes in their normal rituals and routines, so when COVID hit and a lot of adaptive services and therapies came to a halt, many of these individuals felt confused, scared, anxious, and lost. And, while the social-distancing was deemed a “plus” for people with ASD, because many people with these conditions struggle in social situations, and have a hard time making eye contact, being touched (i.e. hugged), and socializing with peers. 

However, the lockdowns and lack of services appeared to hurt these individuals, and the hysteria, paranoia, misinformation, etc., only heightened their stress and anxiety, making their ASD behaviors more pronounced. COVID-related lockdowns also lead to restricted access to grocery stores, which was challenging for people with ADHD, who tend to be “picky eaters” and will only eat certain foods that were no longer available or available in scarce quantities at the time. This also caused extreme stress worsening ASD behaviors. 

Many adults with autism were deemed “non-existential” workers, which led to mass layoffs and high unemployment rates. This meant that many of these individuals lost their jobs and were forced to stay home with nothing to occupy their time. Being unable to follow their normal routines, caused many adults with ASD to experience extreme stress, angst, depression, and increased ASD behaviors. The same could be said for children with ASD that were forced to miss school. Being away from the people they were used to seeing was upsetting to people with ASD. 

Studies found that children with ASD misbehaved more when they were kept away from familiar people. To help ease the stress and anxiety that people with ASD felt because of the pandemic and restrictions, therapists and other mental and developmental health specialists, began ramping up their telehealth services. 

Researchers found that telehealth services that focused on movement were especially beneficial for children with ASD during the pandemic. Although this was not the same as face-to-face interactions, could disrupt daily routines and rituals, and could limit therapeutic exercises and activities, it was able to provide familiarity, comfort, and interactions, which benefited these individuals. 

Augmented reality (virtual reality) also helped people, especially children, with ASD during the pandemic. Augmented reality (AR) merges the digital world with the real world. More specifically, it links images, audio, and text (digital information) with the real world, through glasses, headphones, and other audio/visual devices. According to a 2020 study, AR helped people with autism and Asperger’s better understand the world around them by connecting the physical world with the digital one. 

AR helps people with ASD learn the meaning of facial expressions (facial emotions), and non-verbal cues. It also helps people on the spectrum practice their social skills, increase their vocabularies, encourage imaginative play, and improve motivation, learning, attention, focus, and fine motor skills. It can even teach people with ASD how to learn new tasks. During the pandemic, AR helped people with ASD feel connected to the rest of the world.  

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