It has been said that “it takes a village” to treat a child on the autism spectrum. Youth with autism often require many different types of therapies and medical specialists to meet all their needs and achieve the best outcomes. Below is a list of some of the therapies that are recommended by the Knapp Center. Please note, the Knapp Center only utilizes evidenced based treatments and makes recommendations for such treatments.
Applied Behavior Analysis:
It is largely recognized that ABA can alter the course of autism with improvements in cognition, language, socialization and adaptive functioning. ABA is data driven. It is a dynamic approach to changing behavior and building skills that is based on analysis of the data. ABA is used to eliminate the maladaptive behaviors associated with autism spectrum disorders (ASD), ADHD, learning disabilities, developmental delays and behavioral disorders. ABA is also used to increase desired adaptive behaviors through the use of reinforcement and prompting. ABA brings about comprehensive and enduring improvements in a wide range of skills for most individuals. Individual with ASD may have great difficulty learning the way their peers do in traditional environments, but can learn a great deal when given the right kind of instruction. Two primary teaching tools in ABA are prompting and reinforcement.
Psychotherapist or Psychologist:
As reported by Autism Speaks “epidemiological studies suggest that between 54 and 70 percent of people with autism also have one or more other mental health conditions (Simonoff 2008, Hofvander 2009, Croen 2015, Romero 2016).” Mental health co-morbidities of autism include anxiety, depression, attention deficit and hyperactivity disorder (ADHD), schizophrenia and bipolar disorder.
Thus, youth on the autism spectrum may benefit from individual therapy, specifically cognitive behavioral therapy. CBT has been shown to have a positive impact on a child’s functioning and handling distress through learning necessary emotional regulation skills to improve their lives. CBT is based on the assumption that how we think, affects how we feel, and in turn, affects how we behave. Through sessions, the therapist works together with the child to identify the relationships between unhealthy thinking patterns, disruptive behavior, and negative emotional responses in upsetting situations. The child can learn to monitor and change their thinking patterns in order to create a change in mood and behavior. Treatment also necessitates active participation of the child during the session with exercises for exploration and homework assignments in between sessions.
Speech and Language Therapy:
Speech and language therapy is a fundamental component of educational programming for children on the autism spectrum. Speech/Language Pathologists evaluate speech, language and communication abilities and develop goals and objectives to target each individual child’s unique speech, language and communication needs. Speech and language therapy can focus on developing expressive and receptive language skills, social interactions and pragmatics skills, voice and intonation, speech sound production (articulation) and augmentative and alternative means of communication. Augmentative and alternative means of communication can include sign language, picture exchange communication system, speech generating devices and menu boards. Family education and training should be included in speech and language therapy, as family involvement is crucial in generalizing the skills learned in therapy to the home and community environments.
Families should take note of their child’s IEP as to the type of speech being offered and how often it is offered. Individual speech therapy often addresses increasing vocabulary, improving expressive and receptive language whereas group speech is often helpful when addressing the pragmatics of language. This is the social aspect of language. Prior to entering group speech, the child needs to have adequate expressive speech or adequate use of an alternative means to communicate.
An occupational therapist examines the child’s occupations or every day activities in order to improve these occupations. These occupations include: activities of daily living (dressing, toileting, grooming, bathing, feeding, eating, and functional mobility), and fine motor activities, such as writing, coloring, and cutting. Occupational therapists may work with children within the school setting to achieve school-related goals and/or within a private or hospital-based setting. They may also work closely with speech-language pathologists and physical therapists to develop a coordinated plan of care. OT is an important part of the child’s treatment. Parents should be aware that OT sessions can focus on adaptive functioning, sensory functioning, or a combination thereof. Adaptive functioning includes those skills needed to live and work in the everyday world such as dressing and writing. Sensory might include increasing the child’s tolerance to sensory stimuli such as touching various textures. It is important that adaptive functioning is part of the treatment plan.
A physical therapist is trained to assess and treat a person with motor deficits. The areas that a physical therapist may address include: strength, coordination, posture, balance, motor planning and basic developmental motor skills. Physical therapists work on these areas with a person whose movement problems lead to functional limitations.
A physical therapy evaluation for a child with autism spectrum disorder might be prompted by observations of gross motor delays. In a young child one might see a delay in crawling, sitting, or walking. In an older child a physical therapy evaluation might be initiated for persistent toe walking, or consistent tripping or stumbling, or difficulty in getting up from the floor.
Families may want to seek a PT evaluation if they notice muscle stiffness or tightness, delay in obtaining motor milestones, poor balance, poor coordination, difficulty in moving through the environment, postural abnormalities, muscle weakness and/or pain.
After the PT evaluation, the therapist will determine if the impairments identified are able to be modified by physical therapy treatment. A home exercise program should also be introduced so that the family can carry over therapeutic concepts in the home and in the community (generalization).
Recreation and Leisure Activities:
Recreation and leisure activities are beneficial to all people, including those on the autism spectrum. The benefits of regular participation in recreation/leisure activities are numerous. In the social realm, individuals with ASD can meet new people and expand their interests by participating in group recreation. They learn vital social skills that otherwise do not come naturally to them, such as turn-taking, sportsmanship, following directions, and cooperation. Programs that include typical peer models can often help the person with ASD learn and imitate the activity more quickly. Becoming proficient at activities such as sports can increase acceptance by the peer group and improve the participant’s self-esteem and confidence. Recreation activities can help improve motor planning, balance, flexibility and strength. Movement- based activities can also help the body and brain stay alert and active. Regular physical activity can improve health via weight control, cardiovascular benefits, and may help to reduce stress, anxiety and physical tension in the individual with ASD. Everyone, including people with ASD, needs positive recreation and leisure experiences in their lives, so it is important to seek out these treatments.
Parent Support Groups:
Parents raising a child with autism have long recognized the need for support from other parents who have raised or are currently raising a child with autism. There is a number of support groups specifically designed for parents raising a child with autism spectrum disorders. Support groups allow parents to exchange concerns, feelings and ideas, as well as provide opportunities for education, support, and friendship with others who are dealing with similar joys and challenges of parenting children with special needs.
Siblings of children with ASD tend to grow up with a different life experience than their peers. Having a sibling with ASD can present both joys and challenges. Many siblings develop a unique bond with their brother or sister with ASD and develop an awareness and respect for others with disabilities. They also can learn to be more compassionate, patient and flexible people. Having a sibling with ASD, however, can also increase the child/adolescent’s stress resulting from a variety of factors. Siblings often witness family turmoil related to the identified child’s ASD challenges and can be exposed to their brother/sister’s unpredictable and sometimes aggressive behavior. Many siblings experience a host of feelings, including anger, jealousy over parental attention to their sibling, embarrassment related to sibling tantrums and unusual behaviors, and worry about both the day-to-day safety and happiness of their sibling as well as their own future care-taking role for that brother or sister. Many also experience a sense of loss over not having a “typical” sibling to play with and confide in. They can feel a sense of isolation and loneliness and many believe that they are “the only one” going through such an experience. Because of their unique life experience, siblings of children with ASD have needs that are different from their peers. It is critical that these children and adolescents are taught developmentally appropriate information about ASD and information specific to their own sibling. So activities such as sibling support groups, sibling recreational programs or even alone time with a parent can be effective ways to help siblings manage their feelings.
There are a variety of medical specialists that should be involved in the child’s treatment. This can range from psychiatrists, gastroenterologists, neurologists, developmental pediatricians, and more. Please see the Knapp Center Resource Page / Medical and Mental Health Conditions for more information,