April is Autism Awareness Month

Healthy Tip Tuesday is brought to you by Trinity Hospital Twin City

The following information is courtesy of the Centers for Disease Control and Prevention.

These interventions may reduce symptoms, improve cognitive ability and daily living skills, and maximize the ability of the child to function and participate in the community ^[1-6].

The differences in how ASD affects each person means that people with ASD have unique strengths and challenges in social communication, behavior, and cognitive ability. Therefore, treatment plans are usually multidisciplinary, may involve parent-mediated interventions, and target the child’s individual needs.

Behavioral intervention strategies have focused on social communication skill development—particularly at young ages when the child would naturally be gaining these skills—and reduction of restricted interests and repetitive and challenging behaviors. For some children, occupational and speech therapy may be helpful, as could social skills training and medication in older children. The best treatment or intervention can vary depending on an individual’s age, strengths, challenges, and differences ^[7].

It is also important to remember that children with ASD can get sick or injured just like children without ASD. Regular medical and dental exams should be part of a child’s treatment plan. Often it is hard to tell if a child’s behavior is related to the ASD or is caused by a separate health condition. For instance, head banging could be a symptom of ASD, or it could be a sign the child is having headaches or earaches. In those cases, a thorough physical examination is needed. Monitoring healthy development means not only paying attention to symptoms related to ASD, but also to the child’s physical and mental health.

Not much is known about the best interventions for older children and adults with ASD. There has been some research on social skills groups for older children, but there is not enough evidence to show that these are effective ^[8]. Additional research is needed to evaluate interventions designed to improve outcomes in adulthood. In addition, services are important to help individuals with ASD complete their education or job training, find employment, secure housing and transportation, take care of their health, improve daily functioning, and participate as fully as possible in their communities ^[9].

Types of Treatments

There are many types of treatments available. These include applied behavior analysis, social skills training, occupational therapy, physical therapy, sensory integration therapy, and the use of assistive technology.

The types of treatments generally can be broken down into the following categories:

• Behavior and Communication Approaches
• Dietary Approaches
• Medication
• Complementary and Alternative Medicine

Behavior and Communication Approaches

According to reports by the American Academy of Pediatrics and the National Research Council, behavior and communication approaches that help children with ASD are those that provide structure, direction, and organization for the child in addition to family participation ^[10].

Applied Behavior Analysis (ABA)
A notable treatment approach for people with ASD is called applied behavior analysis (ABA). ABA has become widely accepted among healthcare professionals and used in many schools and treatment clinics. ABA encourages positive behaviors and discourages negative behaviors to improve a variety of skills. The child’s progress is tracked and measured.

There are different types of ABA. Here are some examples:

• Discrete Trial Training (DTT)
  DTT is a style of teaching that uses a series of trials to teach each step of a desired behavior or response. Lessons are broken down into their simplest parts, and positive reinforcement is used to reward correct answers and behaviors. Incorrect answers are ignored.
• Early Intensive Behavioral Intervention (EIBI)
  This is a type of ABA for very young children with ASD, usually younger than 5 and often younger than 3. EIBI uses a highly structured teaching approach to build positive behaviors (such as social communication) and reduce unwanted behaviors (such as tantrums, aggression, and self-injury). EIBI takes place in a one-on-one adult-to-child environment under the supervision of a trained professional.
• Early Start Denver Model (ESDM)

This is a type of ABA for children with ASD between the ages of 12-48 months. Through ESDM, parents and therapists use play and joint activities to help children advance their social, language, and cognitive skills.

• Pivotal Response Training (PRT)
  PRT aims to increase a child’s motivation to learn, monitor their own behavior, and initiate communication with others. Positive changes in these behaviors are believed to have widespread effects on other behaviors.
• Verbal Behavior Intervention (VBI)
  VBI is a type of ABA that focuses on teaching verbal skills.

There are other therapies that can be part of a complete treatment program for a child with ASD:

Assistive Technology
Assistive technology, including devices such as communication boards and electronic tablets, can help people with ASD communicate and interact with others. For example, the Picture Exchange Communication System (PECS) uses picture symbols to teach communication skills. The person is taught to use picture symbols to ask and answer questions and have a conversation. Other individuals may use a tablet as a speech-generating or communication device.

Developmental, Individual Differences, Relationship-Based Approach (also called “Floortime”)
Floortime focuses on emotional and relational development (feelings and relationships with caregivers). It also focuses on how the child deals with sights, sounds, and smells.

Treatment and Education of Autistic and related Communication-handicapped CHildren (TEACCH)external icon
TEACCH uses visual cues to teach skills. For example, picture cards can help teach a child how to get dressed by breaking information down into small steps.

Occupational Therapy
Occupational therapy teaches skills that help the person live as independently as possible. Skills may include dressing, eating, bathing, and relating to people.

Social Skills Training
Social skills training teaches children the skills they need to interact with others, including conversation and problem-solving skills.

Speech Therapy
Speech therapy helps to improve the person’s communication skills. Some people are able to learn verbal communication skills. For others, using gestures or picture boards is more realistic.

Visit the Autism Speaksexternal icon, Autism Societyexternal icon, or National Center for Child Health and Human Developmentexternal icon website to read more about these therapies.