Child and Adolescent Psychiatry Consulting

There is no single “best treatment” package for all children with ASD, but most experts agree:

• early intervention is important
• most individuals with ASD respond well to highly structured, specialized programs.

Before you make decisions on your child’s treatment, you will want to gather information about the various options available. Learn as much as you can, look at all the options, and make your decision on your child’s treatment based on your child’s needs. You may want to visit public schools in your area to see the type of program they offer to special needs children.

Guidelines used by the Autism Society of America include the following questions parents can ask about potential treatments:

• Will the treatment result in harm to my child?
• How will failure of the treatment affect my child and family?
• Has the treatment been validated scientifically?
• Are there assessment procedures specified?
• How will the treatment be integrated into my child’s current program? (Do not become so infatuated with a given treatment that functional curriculum, vocational life, and social skills are ignored)

The National Institute of Mental Health suggests a list of questions parents can ask when planning for their child:

• How successful has the program been for other children?
• How many children have gone on to placement in a regular school and how have they performed?
• Do staff members have training and experience in working with children and adolescents with autism?
• How are activities planned and organized?
• Are there predictable daily schedules and routines?
• How much individual attention will my child receive?
• How is progress measured? Will my child’s behavior be closely observed and recorded?
• Will my child be given tasks and rewards that are personally motivating?
• Is the environment designed to minimize distractions?
• Will the program prepare me to continue the therapy at home?
• What is the cost, time commitment, and location of the program?

An effective treatment program will:

• build on the child’s interests
• offer a predictable schedule
• teach tasks as a series of simple steps
• actively engage the child’s attention in highly structured activities
• provide regular reinforcement of behavior.

Parents

• should be involved, as their participation is a major factor in treatment success.
• can work with teachers and therapists to identify the behaviors to be changed and the skills to be taught.
• are the child’s earliest teachers–more programs are beginning to train parents to continue the therapy at home.

Early intervention:

As soon as a child’s disability has been identified, instruction should begin.Effective programs will teach early communication and social interaction skills.

In children younger than 3 years, appropriate interventions usually take place in the home or a child care center:

• Interventions target specific deficits in learning, language, imitation, attention, motivation, compliance, and initiative of interaction.
• Included are behavioral methods, communication, occupational and physical therapy along with social play interventions.
• Often the day will begin with a physical activity to help develop coordination and body awareness; children string beads, piece puzzles together, paint, and participate in other motor skills activities.
• At snack time the teacher encourages social interaction and models how to use language to ask for more juice.
• The children learn by doing.
• Students, behavioral therapists, and parents who have received extensive training work with the children
• Positive reinforcement is used to teach the children.

In Children older than 3 years , interventions usually include school-based, individualized, special education.

• The child may be in a segregated class with other autistic children or in an integrated class with children without disabilities for at least part of the day.
• Different methods may be utilized, but all interventions should provide a structure that will help the children learn social skills and functional communication.
• In these programs, teachers often involve the parents, giving useful advice in how to help their child use the skills or behaviors learned at school when they are at home.

In elementary school, the child should receive help in any skill area that is delayed and, at the same time, be encouraged to grow in his or her areas of strength. Ideally, the curriculum should be adapted to the individual child’s needs. Many schools today have an inclusion program in which the child is in a regular classroom for most of the day, with special instruction for a part of the day. This instruction should include such skills as learning how to act in social situations and in making friends. Although higher-functioning children may be able to handle academic work, they too need help to organize tasks and avoid distractions.

During middle and high school years, instruction will begin to address such practical matters as work, community living, and recreational activities. This should include work experience, using public transportation, and learning skills that will be important in community living.

All through your child’s school years, you will want to be an active participant in his or her education program. Collaboration between parents and educators is essential in evaluating your child’s progress.

Adolescence

• Like all children, children with ASD  need help in dealing with their sexual development.
• Some behaviors may improve during the teenage years and some may worsen
• Increased aggressive behavior may be one way some teens express their newfound tension and confusion.
• The teenage years are also a time when children become more socially sensitive.
  • Teens with autism may become painfully aware that they are different from their peers.
  • They may notice that they lack friends, or aren’d dating or do not have the same plans for a career.
  • For some youth with ASD, these realizations motivate them to learn new behaviors and acquire better social skills.