Autism Treatment Guide
Autism spectrum disorder (ASD) is a developmental disability caused by multiple factors – much of which is yet unknown – but ultimately comes down to differences in brain chemistry.
These differences can affect many aspects of an individual’s development; therefore, those with ASD exhibit behaviors and social interactions that differ from what is commonly observed in the general population.
What is Autism Spectrum Disorder (ASD)?
ASD is considered a spectrum disorder because those who are diagnosed can range in their abilities and support needs, some needing much support while others may need very little or no support at all.
Signs and Symptoms of Autism
Autism is more often signified in behavior than in an individual’s physical appearance. According to the Centers for Disease Control and Prevention, ASD may consist of particular characteristics that affect social communication and interaction skills, restricted or repetitive behaviors or interests, and more:
Social Communication/Interaction Skills
- Avoids or doesn’t keep eye contact
- Doesn’t respond to name by nine months of age
- Doesn’t show facial expressions like happy, sad, angry, and surprised by 9 months of age
- Doesn’t play simple interactive games by 12 months of age
- Uses few or no gestures by 12 months of age (like waving goodbye)
- Doesn’t share interests/objects of interest with others by 15 months of age
- Doesn’t point to show you something interesting by 18 months of age
- Doesn’t notice when others are hurt or upset by 24 months of age
- Doesn’t notice other children and join them in play by 36 months of age
- Doesn’t pretend to be something else, like a teacher or superhero, during play by 48 months of age
- Doesn’t sing, dance, or act for you by 60 months of age
Restricted or Repetitive Behaviors/Interests
- Lines up toys or other objects and gets upset when the order is changed
- Echolalia: Repeats words or phrases over and over
- Plays with toys the same way every time
- Focuses on parts of objects (like the wheels of a toy car)
- Gets upset by minor changes
- Has obsessive interests
- Must follow certain routines
- Stimming: Flaps hands, rocks body, or spins self in circles
- Unusually reacts to the way things sound, smell, taste, look or feel
- Delayed language skills
- Delayed movement skills
- Delayed cognitive or learning skills
- Hyperactive, impulsive, and/or inattentive behavior
- Epilepsy or seizure disorder
- Unusual eating and sleeping habits
- Gastrointestinal issues (like constipation)
- Unusual mood, emotional reactions
- Anxiety, stress, or excessive worry
- Lack of fear or more fear than expected
At what age does autism appear?
Symptoms of autism can begin as early as within the first year of life and may last throughout their entire adulthood, though symptoms may improve as they grow older.
Can you outgrow autism?
Although autism is a developmental disability rooted in differences in brain chemistry, symptoms can improve over time as the individual grows and matures.
What causes autism?
Some diagnoses of autism can be linked to brain differences caused by certain genetic conditions, but that’s not always the case, and scientists believe there are likely other causes involved in impacting the natural development of a person.
Are you born with autism?
Individuals with autism are indeed born with the disability, but symptoms of autism won’t necessarily be immediate and may take time to develop to the point of being observable.
How is autism treated?
As there is no cure, treatments for autism are intended to reduce the severity of disruption that some symptoms may bring to an individual’s life and those around them.
Overview of Treatments for Autism
There are a diverse array of treatment angles for autism, given that there are many ways in which a person’s development and overall life are affected by ASD.
The major categories of treatment include
- Behavioral: behavior modification, notably through Applied Behavior Analysis (ABA) and its derivatives, including Discrete Trial Training (DTT) and Pivotal Response Training (PRT)
- Developmental: improvement of particular developmental skills, most commonly applied in Speech and Language Therapy
- Educational: educational reinforcement in school/classroom settings, including Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)
- Social-Relational: improvement of social and emotional bonding skills, including the Relationship Development Intervention (RDI) model
- Psychological: treatment of anxiety, depression, and other derivative mental health conditions, including Cognitive-Behavior Therapy (CBT)
- Complementary and Alternative: treatments that supplement traditional solutions, including:
- Special diets
- Herbal supplements
- Chiropractic care
- Animal therapy
- Arts therapy
- Relaxation therapies
Autism is a lifelong developmental disability that can present well into a person’s childhood or as early as under two years old. There are plenty of symptoms that those with autism exhibit that isn’t exclusive to autism, so it’s important to know what’s distinct about autism in children.
How do I know if my child is on the spectrum?
A professional is required to diagnose your child with autism, but there are signs you can watch out for as to whether or not you should consider taking your child to a specialist for a possible diagnosis.
These signs include
- No response with a smile or happy expression by six months
- No mimicking sounds or facial expressions by nine months
- No babbling or cooing by 12 months
- No gesturing (such as pointing or waving) by 14 months
- No speaking single words by 16 months
- No make-believe or pretend play by 18 months
- No speaking two-word phrases by 24 months
- Loss of language or social skills at any age
If you and your child’s doctor notice any developmental delays relating to autism, you will then go to one of the following professionals for a diagnosis:
- Child Psychiatrist
- Child Psychologist
- Pediatric Neurologist
- Developmental Pediatrician
When do children with autism start speaking?
Neurotypical children tend to develop and produce their first words between 12 and 18 months old, whereas children with autism, on average, don’t develop language until the age of around 36 months.
How is autism diagnosed?
According to the CDC, the criteria required for diagnosing ASD is a child’s deficiency in three areas relating to social communication and interaction, plus two out of four types of restricted, repetitive behaviors.
Social Communication and Interaction
A child with ASD will typically exhibit deficits in:
- Social-Emotional Reciprocity
- Nonverbal Communicative Behaviors used for Social Interactions
- Developing, Maintaining, and Understanding Relationships
Restrictive, Repetitive Behaviors
Restrictive or repetitive behaviors typically observed in children with autism include:
- Simple motor stereotypes
- Lining up toys
- Flipping objects
- Idiosyncratic phrases
- Extreme distress at small changes
- Difficulties transitioning from one activity to another
- Rigid thinking patterns
- Greeting rituals
- Need for the same routes to be taken
- Need to eat the same food every day
- Strong attachment or preoccupation with unusual objects
- Excessively circumscribed
- Preservative interests
- Indifference to pain or temperature
- Adverse response to certain sounds or textures
- Excessive smelling or touching of certain objects
- Visual fascination with lights or movement
What are early interventions for autism?
Early intervention programs typically include
- Family Training
- Speech Therapy
- Hearing Impairment Services
- Physical Therapy
- Nutrition Services
According to the National Institutes of Health, “Research shows that early diagnosis of and interventions for autism are more likely to have major long-term positive effects on symptoms and later skills.”
On top of that, autism can be diagnosed very early in a child’s development, giving many of those with autism a great chance at overcoming many of the difficulties they may face throughout the rest of their lives, making it important for parents to be watchful and to take any signs or concerns they may observe in their child seriously.
How early can autism be treated?
ASD in children can be diagnosed as early as under two years of age, signified by developmental regression just before or at two years old.
What is the most effective early intervention for autism?
Applied Behavior Analysis (ABA)
One of the most notable treatments for people with autism, especially for early intervention, is ABA, “widely accepted among health care professionals and… used in many schools and treatments clinics.”
Different types of ABA treatment include
- Discrete Trial Training (DTT)
- Early Intensive Behavioral Intervention (EIBI)
- Pivotal Response Training (PRT)
- Verbal Behavior Intervention (VBI)
A teaching method that utilizes visual cues for skill training, such as procedurally breaking down more complicated tasks with a sequence of images symbolizing each step.
OT trains those with motor impairments with skills that enable independent living, including dressing themselves, eating food, hygiene, and social interaction.
Sensory Integration (SI) Therapy
Some children with autism experience hypersensitivity to certain sounds or textures; SI therapy helps children with autism handle sensory input such as sights, sounds, and smells.
Children with autism exhibit deficits in functional and social communication, as well as language use in social contexts.
Speech therapy develops the child’s communication skills, ranging from verbal communication to gestures or other visual cues. Sign language is implemented as an alternative mode of communication to verbal, whereas the Picture Exchange Communication System (PECS) “uses picture symbols to teach communication skills.”
Social Skills Interventions
Social skills interventions are informed by curriculum-based programming with measurable goals.
Examples of social skills interventions include
- Social Stories
- Social Skills Groups
- Facilitated Play Groups
Developmental, Individual Differences, Relationship-Based Approach (DIR)
DIR, also known as Floortime, focuses on
- Emotional development
- Relational development
- Handling sensory stimuli (sights, sounds, smells)
- Speech skills
- Cognitive skills
According to Autism Speaks, “Floortime is a relationship-based therapy for children with autism… [where] the parent gets down on the floor with the child to play and interact with the child at their level.”
What happens if autism isn’t treated?
Autism is a developmental disorder that permeates throughout the entire life of a child, bringing its own unique struggles and demands for specialized support from his or her community.
According to the Autism Research Institute, “Without appropriate support, children will not develop effective social skills and may speak or behave in ways that create challenges. Very few individuals recover completely from autism without any intervention.”
There is no singular treatment for autism, but rather an array of treatment options depending on the case and needs of the person being treated. Autism treatments help reduce life-inhibiting symptoms while exercising and supporting the development of their abilities.
According to the National Institutes of Health, “Research shows that early diagnosis and interventions, such as during preschool or before, are more likely to have major positive effects on symptoms and later skills.”
Can autism be treated without medication?
Yes, different therapy and behavior modification treatments are available at autism treatment centers around the country. Medication isn’t used to treat autism directly but to help manage co-occurring disorders and conditions such as ADHD.
Does autism get better with therapy?
Yes, research shows that autism does get better with therapy, and the earlier your child is diagnosed and begins treatment, the greater the effect of his or her therapy through the rest of their life.
Therapies for Autism
There are plenty of types of therapy to treat symptoms of autism depending on the particular developmental deficits of the person being treated.
Behavioral Management Therapy
Behavioral Therapy for autism focuses on reinforcing productive behaviors and reducing inhibiting behaviors. The most widely accepted form of this type of therapy is Applied Behavior Analysis (ABA).
Different types of ABA are used to treat autism, including
- Positive Behavioral and Support (PBS): PBS troubleshoots problematic behaviors by changing different variables of the child’s environment and teaching skills to reduce future occurrences.
- Pivotal Response Training (PRT): PRT hones in on pivotal skills like motivation and initiating communication.
- Early Intensive Behavioral Intervention (EIBI): EIBI provides patient-tailored behavioral modification instruction for young children.
- Discrete Trial Training (DTT): DTT teaches new skills via step-by-step processes and positive feedback.
Cognitive Behavior Therapy
CBT focuses on the relationship between thoughts, feelings, and behaviors and how thoughts that lead to negative feelings and behaviors can be examined and changed to produce more positive outcomes.
Educational and School-Based Therapies
The Individuals with Disabilities Education Act (IDEA) “is a law that makes available a free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children,” including early intervention services for those born with disabilities under the age of 2 years old.
Joint Attention Therapy
Joint Attention Therapy focuses on developing language learning and communication skills by exercising skills relating to “shared attention,” including pointing and coordinating attention between someone else and an object.
Developing a nutrition plan with a nutritionist helps ensure all important nutrients are being ingested, especially since some people with autism are selective eaters, making them more prone to being malnourished.
Occupational Therapists help those with autism learn how to do everyday tasks, develop personal care skills, and acquire tools that accommodate their needs.
Parent-Mediated Therapy empowers parents to learn therapy techniques that can be applied throughout the day within the comfort of their home, allowing for day-to-day consistency.
Physical Therapy involves building motor skills, strength, posture, and balance.
Social Skills Training
Social Skills Training helps children develop skills required to interact with others, including conversating, handling teasing, having a positive attitude in competitive contexts, and overall acceptable behavior when playing or socializing with others.
Speech-Language Therapy helps those with autism develop verbal and non-verbal communication skills, including correctly naming people and objects, improving speech skills, better word choice, and utilizing hand signals and even sign language.
The word “autism” originates from the Greek word “autos,” meaning “self.” The attention of those with autism tends to be hyperfocused on the self, “exist[ing] in a private world in which they have limited ability to successfully communicate and interact with others.”
Given that autism is a spectrum disorder, the social abilities among those with autism range widely, with some high functioning while others have more severely life-inhibiting symptoms, lasting well into adulthood.
What are social skills deficits?
As autism is a developmental disorder, some experience deficits in communication and social skills. The causes of these deficits aren’t necessarily the same, even among those with autism, as some deficits may be caused by “inherent neurological impairment” or simply a lack of being taught or given opportunities for skill acquisition.
People with autism can experience deficits in
- Initiating interactions or responding to others’ initiations
- Keeping eye contact
- Sharing enjoyment
- Reading non-verbal cues of others
- Considering another person’s perspective
Does a lack of social skills mean autism?
There are many causes for why some children and adults lack or have underdeveloped social skills, and autism is only one of the Pervasive Developmental Disorders (PDD) that inhibit a person’s development.
In other words, a person who lacks social skills doesn’t necessarily have autism.
How does autism affect communication skills?
According to the National Institute on Deafness and Other Communication Disorders, some patterns commonly found in children with autism include
- Repetitive or Rigid Language: Sometimes, children with autism who can speak say things that don’t mean anything or relate to conversations at hand or even continuously repeat words spoken by those around them – also known as echolalia.
- Narrow Interests, Exceptional Abilities: Some children with autism can speak on and on in monologue about something that engages their interest but is unable to have a dialogue with others. But the power of their interest can go well beyond a monologue – in fact, “Approximately 10 percent of children with ASD show “savant” skills, or extremely high abilities in specific areas, such as memorization, calendar calculation, music, or math.”
- Uneven Language Development: Some children with autism develop speech and language skills, although they fall short of typical age expectations, and their skills tend to progress unevenly. For example, some children with autism can read words before age five but still don’t comprehend what they’ve read.
- Poor Nonverbal Conversation Skills: Many children with autism are unable to use gestures in their communication with others, such as pointing at something to communicate further what they’re saying, often leading to frustration as they can’t communicate their feelings, thoughts, or needs.
Can a person with Autism learn social skills?
People with autism can learn social skills with the help of specialists, including speech-language pathologists trained to treat those with disorders relating to voice, speech, and language.
These specialists “will perform a comprehensive evaluation of the child’s ability to communicate and will design an appropriate treatment program.”
There are plenty of adults who have autism and have yet to be diagnosed by a medical professional. Despite having gone without treatment, many have coped and acclimated well as they’ve grown throughout their adulthood, managing and working with their symptoms to achieve independence and success. But even for those who have managed well, especially those with more severe symptoms, lack of treatment and support for autism makes navigating the challenges of their condition more difficult than necessary.
Having a better understanding of yourself and the funding and support available will greatly benefit you, your relationships, and your pursuit of your goals.
What does autism look like in adults?
Signs of autism in adults can range from communication skills and social interactions to restricted, repetitive behaviors and sensory processing.
Signs of autism can include
- Difficulty joining conversations
- Non-speaking or flat, monotone when speaking
- Lack of relating to the thoughts and feelings of others
- Repetitive language
- Difficulty reading body language or social cues
- Dominating conversations with an overload of information
- Difficulty engaging in two-way conversations
- Taking figures of speech literally
- Difficulty maintaining eye contact
- Blunt assessments of others
- Difficulty acquiring and maintaining friendships or relationships
- Making unusual facial expressions
- Anxious or upset when a consistent routine is disrupted
- Surprises are upsetting
- Difficulty regulating emotional reactions
- Bothered by rearranged positions by someone else
- Daily repetitive rituals and behaviors
- Hyperfocus on specific interests or hobbies
- Difficulty multitasking
- Hypersensitivity or non-response to sensory stimuli
- Lone-wolf lifestyle
What does high-functioning autism look like in adults?
For some adults, high-functioning autism proves to have positive effects on one’s life and may include
- Mastery over studies or career
- Uncommonly detail-oriented
- Immense care or empathy for people and animals
- Enjoys living and working independently
What difficulties do adults with autism have?
Difficulties adults with autism face cover the whole range of human experience and development, including
- Difficulty getting and sustaining a job or education
- Difficulty initiating or sustaining relationships
- History of neuro-developmental disorders or psychiatric difficulties
Do people with autism have empathy?
Yes, people with autism have empathy. In fact, some of those with autism may develop stronger empathy for people and animals than the average neurotypical person.
Can people with autism live alone?
People with autism can certainly live alone, but that depends on the impact ASD has had on the overall development of their independent living skills. Even with deficits in fundamental skills, those with autism can still live with qualified independence with support programs that develop an individual’s ability to live as independently as possible.
Independent living skills include:
- Financial responsibility/budgeting
Can people with autism drive?
People with autism can develop the ability to drive, and there are no laws prohibiting anyone with autism from acquiring a driver’s license and operating a motor vehicle.
But safety is of utmost importance, and those with autism may face more difficulties when handling challenges on the road; therefore, it’s good to exercise certain skills before getting involved in driving, including motor coordination, pre-planning, adaptability to change, focus, multitasking, and prioritization.
Do adults with autism have meltdowns?
People with autism of all ages can experience meltdowns – “an intense response to an overwhelming situation.”
A meltdown can be expressed verbally or physically, including
Does autism worsen with age?
A person’s autism doesn’t change or worsen over time, but if untreated, the symptoms of autism can become more and more inhibiting the longer treatment is neglected, making it more difficult for them to maintain relationships, a career, live independently, etc.
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