Medical Treatment, Behavioural Training and Specialised Therapies

There is no standard medicine for the treatment of autism. The American Academy of Pediatrics (AAP) suggests targeting the main one or two problem behaviors when considering medicines.

Medicines have a limited role in improving symptoms of autism. But some may help prevent self-injury and other behaviors that are causing difficulty. Medicines may also take a child to a functional level at which he or she can benefit from other treatments.

Many different biomedical treatments are used in autism. The most widely used are medications to treat seizures and behavioral and emotional problems associated with autism. Many different biomedical treatments are used in autism. The most widely used are medications to treat seizures and behavioral and emotional problems associated with autism.

What Are Autism Medications?

Autism Medication does not treat the underlying neurologic but is given to help manage behavioral manifestations of the disorder, such as hyperactivity, impulsivity, attention difficulties, and anxiety. In most cases, medication is given to lessen these problems so that the person can receive maximum benefit from behavioral and educational approaches. Medications used in autism are psychoactive, meaning they affect the brain. Those used most often include the Antipsychotic drugs: which  reduce hyperactivity, repetitive behaviors, withdrawal, and aggression in some people with autism and include The newer, atypical antipsychotics, which have replaced the older, traditional antipsychotics, with  more side effects. Antidepressants like Selective serotonin reuptake inhibitors (SSRIs) commonly used to treat people with depression, obsessive compulsive disorder (OCD), and/or anxiety. In some people with autism, these drugs reduce repetitive behaviors, depression, irritability, tantrums, and aggression.  Stimulants used to treat attention-deficit/hyperactivity disorder (ADHD) may help some people with autism. These drugs work by increasing the person’s ability to concentrate and pay attention and by reducing impulsivity and hyperactivity.

Very few of these drugs have been tested in scientific studies in individuals with autism.

  • Moreover, issues related to dosage (especially important in children), monitoring, and interactions with other drugs and foods are concerns, as are short- and long-term side effects.
  • Many of these medications have side effects such as sleepiness (sedation) or trouble sleeping (insomnia), weight loss or weight gain.
  • Infrequently, dependence may develop with some of these drugs
  • These medications should be prescribed only by a medical professional experienced in treating persons with autism.

AUTISM THERAPIES

Intensive, sustained special education programs and behavior therapy early in life can help children with ASD acquire self-care, social, and job skills, and often can improve functioning, and decrease symptom severity and maladaptive behaviors; claims that intervention by around age three years is crucial are not substantiated.Behavioral training teaches people of all ages who have autism how to communicate appropriately. This type of training can reduce behavior problems and improve adaptation skills.

Behavioral Training

Behavioral training and management uses positive reinforcement, self-help, and social skills training to improve behavior and communication. Many types of treatments have been developed, including Applied Behavioral Analysis (ABA), Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH),developmental models, structured teaching, speech and language therapy, social skills therapy, and occupational therapy. The specific program should be chosen according to the child’s needs.

Educational intervention methods can take place at home, at school, or at a center devoted to autism treatment; they can be done by parents, teachers, speech and language therapists, and occupational therapists.

Applied Behavior Analysis (ABA) is the applied research field of the science of behavior analysis, and it underpins a wide range of techniques used to treat autism and many other behaviors and diagnoses, including those who are patients in rehab or who need to have their behavior changed. ABA-based interventions focus on teaching tasks one-on-one using the behaviorist principles of stimulus, response and reward, and on reliable measurement and objective evaluation of observed behavior. There is wide variation in the professional practice of behavior analysis and among the assessments and interventions used in school-based ABA programs.

Speech therapy and Social skills therapy

The inability to communicate, verbally or non-verbally, is a core deficit in Autism. They require intensive intervention to learn how to communicate their intent. Interventions that attempt to improve communication are commonly conducted by speech and language therapists, and work on joint attention, communicative intent, and alternative or augmentative and alternative communication (AAC) methods such as visual methods, for example visual schedules.

Social skills treatment attempts to increase social and communicative skills of autistic individuals, addressing a core deficit of autism. A wide range of intervention approaches is available, including modeling and reinforcement, adult and peer mediation strategies, peer tutoring, social games and stories, self-management, pivotal response therapy, video modeling, direct instruction, visual cuing, Circle of Friends and social-skills groups.

There are many other programs like Animal-assisted therapy, music therapy and many others

Occupational therapy

Children with autism and attention deficit hyperactivity disorder (ADHD) tend to exhibit significantly different patterns of sensory processing to their peers and to children with other special educational needs (SEN).

Occupational therapists work to promote, maintain, and develop the skills needed by students to be functional in a school setting and beyond.  Active participation in life promotes:

  • learning
  • self-esteem
  • self-confidence
  • independence
  • social interaction.

Occupational therapists use a holistic approach in planning programmes. They take into account the physical, social, emotional, sensory and cognitive abilities and needs of students.In the case of autism, an occupational therapist works to develop skills for handwriting, fine motor skills and daily living skills. However, the most essential role is also to assess and target the child’s sensory processing disorders. This is beneficial to remove barriers to learning and help the students become calmer and more focused.

Therapies which can be prescribed by occupational therapist are:

 A sensory diet/lifestyle 

A sensory diet/lifestyle is a specifically designed daily activity plan. It aims to infuse sensory activities throughout the child’s waking day in order to improve focus, attention and ensure the child is feeling “just right” (regulated) throughout the day. A sensory diet/lifestyle helps the child’s nervous system to feel better organised and therefore assists the child’s attention and performance.It actually helps  to restructure a student’s nervous system over time so that he is better able to tolerate sensations and situations he finds challenging/distracting, to regulate their alertness and increase attention span, etc.

Sensory circuits                                                                 

Sensory circuit: a sensory–motor activity programme which helps children achieve a “ready to learn” state. Sensory circuits are a series of activities designed specifically to wake up all the senses. They are a great way to energise or settle children into the day.  

  • alerting activities (e.g. spinning, bouncing on a gym ball, skipping, star jumps) to stimulate the body’s central nervous system in preparation for learning
  •  organising activities (e.g. balancing on a wobble board, log rolling, juggling etc.) which demand brain and body to work together
  • calming activities (heavy muscle work and deep pressure e.g. wall pushes, push ups, using weights) to give an awareness of their body in space and increases the ability to self-regulate sensory input.

 

References:

Myers SM, et al. (2007, reaffirmed 2010). American Academy of Pediatrics clinical
report: Management of children with autism spectrum disorders. Pediatrics, 
120(5): 1162–1182.
www.emedicinehealth.com 
Medical Author: Roxanne Dryden-Edwards, MD Medical Editor: Melissa Conrad Stöppler,
MD, Chief Medical Editor
www.network.autism.org.uk
Occupational therapist Corinna Laurie