Treatment for Autism
A Multidisciplinary Treatment Approach:
As parents, you may frantically look for all possible treatment options for your child. Your search may give you several options which may further confuse you or create more doubts. With help from your developmental pediatrician, you may be able to identify the problems in your child and decide about the early intervention plan. Early identification has increased in importance, as many studies have found that children with ASDs who receive services prior to 48 months of age make greater improvements than those who enter treatment programs after 48 months of age. Management in autism calls for a Multi-disciplinary holistic approach. You will probably be referred to a psychologist, an occupational therapist, speech and language pathologist, dietician etc. Each of the above professionals will target different aspects in the treatment of your child. It is important to understand that intervention is not exclusive i.e., there are several aspects that may overlap.
Until now there are no medicines available to cure autism. All the medicines provide only symptomatic relief. However, treatment of symptoms is very important as it is the distressing symptoms that limit the quality of life of people with autism, their families and caregivers. If the symptoms are severe and difficult to manage or; have the potential for self harm or; pose a threat to surroundings/people or; cause major familial distress or; affecting daily functioning or schooling, then use of medicines should be considered. There are various medications being used for control of diverse symptoms in autism. Once the symptoms are controlled with medications, there is a better scope for benefit from multidisciplinary interventions like Occupational therapy, psychological therapy, speech therapy, vocational training, etc. Medications should be used as a tool to improve the productivity of the child and quality of life of the family. In combination with various therapies it can serve as an effective modality in the overall management of autism.
Applied Behaviour Analysis:
Applied Behaviour Analysis (ABA therapy) is a generic term used widely for scientific method of behavior modification. ABA therapy is based on the principle that influencing a response is associated with a particular behaviour which may cause the behaviour to be shaped and controlled. ABA is a mixture of psychological and educational techniques which are tailored to the needs of each individual child and to alter their behaviours. ABA involves the use of behavioural methods to measure the behaviour, teach functional skills and evaluate progress.
ABA therapy techniques have been proven in many studies as the method of choice for treating deficits in the behaviours of children with Autism spectrum disorders at any level. ABA therapy approaches such Pivotal Response Treatment (PRT), Picture Exchange Communication System (PECS), Self-Management, and a range of social skills training techniques are all critical in teaching children with autism. Ultimately, the goal is to find a way of motivating the child and using a number of different strategies and positive reinforcement techniques to ensure that the sessions are enjoyable and productive.
In ABA therapy programs, and particularly in PRT, the intent is to increase and generalize skills in language, play and socialization, while decreasing behaviours that interfere with learning. The results can be profound. Many children with autism who have ritualistic or self-injurious behaviours reduce or eliminate these behaviours.
Benefits of Applied Behaviour Analysis:
• Promotes generalization of skills to untaught areas.
• Increases motivation.
• Enjoyed by the child, therapist and parents.
• Useful for managing behaviours and teaching new ones
• Reduces undesirable behaviours
• Promotes better and more functional communication
Occupational therapists traditionally focus on teaching activities of daily living (ADL) like eating, bathing, grooming, dressing etc. More specifically in autism, occupational therapists with expertise in Sensory/Motor Integration and Skill training, work on optimizing sensory processes, altering behaviors and training for developing gross and fine motor skills, communication, play and social skills. Children on the autism spectrum may benefit from occupational therapy, both at home and at school. The goal is to help them live independent and meaningful lives.
Performance of age appropriate meaningful activities depend on the interaction between the people (includes individual's physical, cognitive or emotional ability), the environment (accessibility, structure, safety, and availability of supports to carry out activity) and the nature of the activity itself (complexity, repetitions, size and texture of objects etc.) Occupational therapists address barriers in each of the above to enhance functional performance and modify behaviors. By adapting the tasks and environments as well as working with the families on how to teach new skills, occupational therapists can make a difference in the family's day to day life.
Usually, the first thing a parent says to a professional dealing with autism is "My child does not have speech. Please teach him to talk." In the desperation to see your child verbalize with words and sentences, you fail to connect with him/her. Thus you are unable to notice all the other means of communication. Whether expression comes through spoken language, or picture cards, a communication device, gestures or sign language; it is all communication. Each child has something to say to us. It is our responsibility to listen in a way that ensures that they are heard and understood.
Diet and Nutrition:
Often the nutritional status in children with autism remains compromised. This is mainly because of their inability to swallow and digest many foods. Many of them have food preferences due to their sensory problems, which causes a deficit in the intake of nutrients. The common physical symptoms of children with autism often include diarrhea, constipation, bloating and gastrointestinal (GI) pain, frequent infections, sleeping challenges and inflammation/pain. For many children with autism, when things go awry in the "gut," negative behavioral changes and cognitive problems occur or are exacerbated. For many, food intolerances, imbalanced biochemistry and digestive problems are at the core of these symptoms. These weaknesses in physiological functioning can be directly tied to biochemical processes that are affected by diet-the absence of required nutrients and/or the presence of offending substances. For many children, altering food choices and adding supplementation affects these processes, promotes healing and can improve autism symptoms.
The most specialized diet commonly prescribed for children with autism and proved to be successful is the Gluten free and Casein free diet (GFCF- diet). Gluten and glutenlike proteins are found in wheat and other grains, including oats, rye, barley, bulgar, durum, kamut and spelt, and foods made from those grains. They are also found in food starches, semolina, couscous, malt, some vinegars, soy sauce, teriyaki sauce, flavorings, and artificial colors and hydrolyzed vegetable proteins.
Casein is a protein found in milk and foods containing milk, such as cheese, cream, butter, yogurt, ice cream, whey and even some brands of margarine. It also may be added to non-milk products such as soy cheese and hot dogs in the form of caseinate.
Every human body reacts differently to different food substances. Hence it is essential to follow a diet prescribed specifically by a qualified Nutritionist. This prescription will be based on all the information gathered about the child.
Yoga is an emerging and promising therapy for children with autism. Yoga improves sensory processing and enhances one's sense of personal space, improves gross motor skills and the ability to transition from one activity to another. It helps develops self esteem, improves communication and relationship skills. In contrast to other therapies, Yoga helps these children calm themselves, rather than relying on someone else to provide comfort. After a child has learnt the various poses, breathing practices, and visualizations, he can accomplish this by himself/herself or with a parent.
Yoga is a mind-body practice in Complementary and Alternative Medicine (CAM) with origins in ancient Indian philosophy. The various styles of yoga used for health purposes typically combine physical postures, breathing techniques and meditation or relaxation. Practicing yoga yourself as a parent or teacher will help you deal with the stresses in your life. Caring for a child with autism is a challenge and the journey can be smoothened with the practice of yoga.
One of the major characteristics of autism spectrum disorders is difficulty with verbal and social communication. It is seen that in some cases, people with autism are literally non-verbal i.e. they are absolutely unable to use speech for communication. In the other cases of autism, persons have a hard time processing language and turning it into smooth, easy conversations. Children with autism also have tough time understanding faces, expressions and body language.
Many individuals with autism have an extraordinary ability to think visually i.e. “in pictures." Many can put that ability to good use, eg. In processing memories, recording images and visual information, and expressing ideas through drawings or other artistic media. Art is a form of expression that requires little or no verbal interaction which could open doors of communication for a child with autism.
Research pertaining to the impact of art therapy on individuals with autism is somewhat sketchy. However, listed below are a few positive results of art therapy:
• Improves the ability to imagine and think symbolically
• Increases the ability to recognize and respond to facial expressions
• Increases the ability to manage sensory issues (problems with stickiness, messy activities etc.)
• Improves fine motor skills
• Improves social skills
Not all qualified art therapists, however, have specific experience in working with people on the autism spectrum. While extensive experience may not be critical, it is very important that the therapist you choose understands the specific issues, challenges and strengths associated with autism, and more particularly your child. Art therapy in groups can have additional benefits of improving interaction skills and communication. The usefulness of art therapy is not only limited to children but has been established for people of all ages, including adults.
Normally, children prefer the company of other children rather than being alone. However, for children or adults with autism, the same natural activities become a difficult task. Children with autism use toys in a very inappropriate manner; for example tasting, banging or spinning them. Their play behaviors are also very repetitive. They often lack the ability to pretend play (e.g. dressing up a doll, or pretending to be a teacher) or imitate others. They usually have difficulty initiating or engaging themselves in play activities. Even if they do so, it may be the repetitive use of a toy in an inappropriate manner. They may simply line up toys in front of them, in different patterns. They need to be taught about both, the "desire to play" and "the skills" needed to do so.
Children with autism not only need appropriate toys to play with, but also need to be taught 'how to play'. Parents need to get down on the floor and actively teach their autistic child the "right" way to play with a toy. This concept is well adopted in a treatment technique called "Floortime". As its name suggests, Floortime encourages parents to engage children literally at their level - by getting on the floor to play. Overall, Floortime aims to help children reach the developmental milestones crucial for emotional and intellectual growth.
Music is an ancient form of communication, common to all human cultures. It requires no verbal abilities, and it can be adapted to meet the needs and tastes of absolutely everyone. Music therapy is a well-established technique of using musical interaction to help individuals with a wide range of cognitive (thinking, understanding, attention and concentration abilities) and emotional challenges to improve their ability to function. By interacting with adults and children on the autism spectrum, musical therapists can help build skills, lower anxiety, and even develop new communication strategies. Music therapy has become an increasingly popular treatment option for autism.
It's important to note that music therapy is NOT the same as musical instruction. If your aim is to have your child build vocal or instrumental skills, you'll need to find an instructor instead of or in addition to a music therapist.
The National Autistic Society (UK) claims that "music can stimulate and develop more meaningful and playful communication in people with autism. Research has shown positive effects, however there is a need for extensive research.
Music therapy is conducted by professional therapists who are experienced in playing musical instruments and who have the experience of catering to the needs of children with autism. It is very important that therapy session should be conducted by a trained and an experienced musical therapist. A professional who specializes in autism can suggest different treatment for autistic's that can have a significant positive effect on their behavior.
Dance therapy works on increasing the range of movement, cognition, decision making and self-esteem. It also deals with the ability to cope with change and stress. The experience of dance can help a child with autism open up to the possibility of connecting to others. Social interaction is very difficult for a child with autism to achieve and when a child with autism is encouraged to dance to rhythms and mirror the therapist's moves, it leads to the satisfaction of belonging to a group.
The combination of music and dance helps the brain to reorganize itself. During dance, the child processes music, learns new movements, performs movements to that music, and then repeats it a couple of times. The processes of hearing, listening, processing, executing and repetition enable a child's brain to forge new pathways, engaging both the right and left side of the brain.
A dance therapist works to increase the child's self-awareness through expressive movements. They try to draw the attention of the child to the feeling of the bodily senses that are created as a result of dance therapy. Dance therapy is believed to release muscular tension in the body i.e. emotional or physical as it increases the flow of energy in the body. It is important that a therapist having the experience of working with children with autism conducts this innovative therapy for your child.
Animal-assisted therapy can vary from something as simple as bringing a pet into the home like a pet dog or a cat to something as structured as programs that offer horseback riding or swimming with dolphins. Interacting with animals can help children with autism to develop physically and improve their strength, coordination, and physical abilities. Most importantly the relationship formed with animals can help autistic children have a better sense of well-being, more self-confidence and can offer transferable skills of empathy and relating to others.
What are the benefits of owning, an animal at home?
Owning a pet at home can help children with autism in the following ways:
• Helps to overcome sensory defensiveness.
• Helps the child to relax and maintain a better state of mind.
• Helps the child learn about unconditional love.
• Building and maintaining social skills
• Increasing attention span.
• Enhancing problem-solving skills.
• Allowing a mirror for negative behaviors. Animals do not like loud screaming or tantrums, and will often shy away from them. If the child wants to spend time with the animal, he will begin to change his behavior.
However, it is very important to keep in mind that the child does not suffer from any allergies that could be caused or aggravated due to contact with animals.