孤独症自闭症Treatment and Intervention for Autism

Treatment and Intervention Services for Autism Spectrum

Disorder

Current treatments for autism spectrum disorder (ASD) seek to

reduce symptoms that interfere with daily functioning and

quality of life.1 ASD affects each person differently, meaning

that people with ASD have unique strengths and challenges

and different treatment needs.1 Therefore, treatment plans

usually involve multiple professionals and are catered toward

the individual.

Treatments can be given in education, health, community, or

home settings, or a combination of settings. It is important

that providers communicate with each other and the person

with ASD and their family to ensure that treatment goals and

progress are meeting expectations.

As individuals with ASD exit from high school and grow into

adulthood, additional services can help improve health and

daily functioning, and facilitate social and community

engagement. For some, supports to continue education,

complete job training, find employment, and secure housing

and transportation may be needed.

Types of Treatments

There are many types of treatments available. These

treatments generally can be broken down into the following

categories, although some treatments involve more than one

approach:

Behavioral

Developmental

Educational

Social-Relational

Pharmacological

Psychological

Complementary and Alternative

Behavioral Approaches

Behavioral approaches focus on changing behaviors by

understanding what happens before and after the behavior.

Behavioral approaches have the most evidence for treating

symptoms of ASD. They have become widely accepted among

educators and healthcare professionals and are used in many

schools and treatment clinics. A notable behavioral treatment

for people with ASD is called Applied Behavior Analysis (ABA).

ABA encourages desired behaviors and discourages undesired

behaviors to improve a variety of skills. Progress is tracked and

measured.

Two ABA teaching styles are Discrete Trial Training (DTT) and

Pivotal Response Training (PRT).

DTT uses step-by-step instructions to teach a desired

behavior or response. Lessons are broken down into their

simplest parts, and desired answers and behaviors are

rewarded. Undesired answers and behaviors are ignored.

PRT takes place in a natural setting rather than clinic

setting. The goal of PRT is to improve a few “pivotal skills”

that will help the person learn many other skills. One example

of a pivotal skill is to initiate communication with others.

Developmental Approaches

Developmental approaches focus on improving specific

developmental skills, such as language skills or physical skills,

or a broader range of interconnected developmental abilities.

Developmental approaches are often combined with

behavioral approaches.

The most common developmental therapy for people with

ASD is Speech and Language Therapy. Speech and Language

Therapy helps to improve the person’s understanding and use

of speech and language. Some people with ASD communicate

verbally. Others may communicate through the use of signs,

gestures, pictures, or an electronic communication device.

Occupational Therapy teaches skills that help the person live

as independently as possible. Skills may include dressing,

eating, bathing, and relating to people. Occupational therapy

can also include:

Sensory Integration Therapy to help improve responses to

sensory input that may be restrictive or overwhelming.

Physical Therapy can help improve physical skills, such as

fine movements of the fingers or larger movements of the

trunk and body.

The Early Start Denver Model (ESDM) is a broad

developmental approach based on the principles of Applied

Behavior Analysis. It is used with children 12-48 months of age.

Parents and therapists use play, social exchanges, and shared

attention in natural settings to improve language, social, and

learning skills.

Educational Approaches

Educational treatments are given in a classroom setting. One

type of educational approach is the Treatment and Education

of Autistic and Related Communication-Handicapped Children

(TEACCH) approach. TEACCH is based on the idea that people

with autism thrive on consistency and visual learning. It

provides teachers with ways to adjust the classroom structure

and improve academic and other outcomes. For example,

daily routines can be written or drawn and placed in clear sight.

Boundaries can be set around learning stations. Verbal

instructions can be complimented with visual instructions or

physical demonstrations.

Social-Relational Approaches

Social-relational treatments focus on improving social skills

and building emotional bonds. Some social-relational

approaches involve parents or peer mentors. The

Developmental, Individual Differences, Relationship-Based

model (also called “Floor time”) encourages parents and

therapists to follow the interests of the individual to expand

opportunities for communication.

The Relationship Development Intervention (RDI) model

involves activities that increase motivation, interest, and

abilities to participate in shared social interactions.

Social Stories provide simple descriptions of what to

expect in a social situation.

Social Skills Groups provide opportunities for people with

ASD to practice social skills in a structured environment.

Pharmacological Approaches

There are no medications that treat the core symptoms of ASD.

Some medications treat co-occurring symptoms that can help

people with ASD function better. For example, medication

might help manage high energy levels, inability to focus, or

self-harming behavior, such as head banging or hand biting.

Medication can also help manage co-occurring psychological

conditions, such as anxiety or depression, in addition to

medical conditions such as seizures, sleep problems, or

stomach or other gastrointestinal problems.

It is important to work with a doctor who has experience in

treating people with ASD when considering the use of

medication. This applies to both prescription medication and

over-the-counter medication. Individuals, families, and

doctors must work together to monitor progress and reactions

to be sure that negative side effects of the medication do not

outweigh the benefits.

Psychological Approaches

Psychological approaches can help people with ASD cope with

anxiety, depression, and other mental health issues.

Cognitive-Behavior Therapy (CBT) is one psychological

approach that focuses on learning the connections between

thoughts, feelings, and behaviors. During CBT, a therapist and

the individual work together to identify goals and then change

how the person thinks about a situation to change how they

react to the situation.

Complementary and Alternative Treatments

Some individuals and parents use treatments that do not fit

into any of the other categories. These treatments are known

as Complementary and Alternative treatments.

Complementary and alternative treatments are often used to

supplement more traditional approaches. They might include

special diets, herbal supplements, chiropractic care, animal

therapy, arts therapy, mindfulness, or relaxation therapies.

Individuals and families should always talk to their doctor

before starting a complementary and alternative treatment.

There may be other treatments available for individuals with

ASD. Talk to a doctor or healthcare provider to learn more.