What About Alternative Remedies
There are countless alternative options that people try. However, there isnt much conclusive research backing up these methods, and its unclear whether theyre effective. Some of them, such as chelation therapy, may also do more harm than good.
Still, autism is a wide-ranging condition that causes a variety of symptoms. Just because something doesnt work for one person doesnt mean it wont help another. Work closely with a doctor when looking into alternative options. A good doctor can help you navigate the research surrounding these options and avoid potentially risky methods that arent backed by science.
Potential alternative options requiring more conclusive research include:
- gluten-free, casein-free diet
Comparison Of Ncaep And Nsp Ebps
NCAEP and the National Standards Project published reports of their systematic reviews of the literature and identification of evidence-based practices. Nineteen of the NCAEP EBPs were also identified as established interventions in the NSP report Five of the NCAEP EBPs were identified as emerging interventions . NCAEP identified four EBPs that were not included in the NSP previous report and NSP identified Language Training as an established intervention, whereas it was not included in the current NCAEP report. NSP also included Comprehensive Behavioral Treatment for Young Children, and NCAEP did not consider comprehensive treatment models in the current review. In summary, there continues to be a substantial overlap in EBPs identified by these two independent reviews.
To print out the NCAEP NSP Comparison table, download the table here and open using Adobe Reader.
How Is Tms Used For Autism
Depending on where an individual lies on the spectrum of autism, certain parts of the brain may be targeted to address their unique symptoms. The medial prefrontal cortex , for example, is thought to play a role in how one understands the mental state of others. One ASD patient receiving TMS therapy on this part of the brain reported that eye contact was less uncomfortable and that social situations were more natural.
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Behavior And Communication Approaches
According to reports by the American Academy of Pediatrics and the National Research Council, behavior and communication approaches that help children with ASD are those that provide structure, direction, and organization for the child in addition to family participation .
Applied Behavior Analysis A notable treatment approach for people with ASD is called applied behavior analysis . ABA has become widely accepted among healthcare professionals and used in many schools and treatment clinics. ABA encourages positive behaviors and discourages negative behaviors to improve a variety of skills. The childs progress is tracked and measured.
There are different types of ABA. Here are some examples:
- Discrete Trial Training DTT is a style of teaching that uses a series of trials to teach each step of a desired behavior or response. Lessons are broken down into their simplest parts, and positive reinforcement is used to reward correct answers and behaviors. Incorrect answers are ignored.
- Early Intensive Behavioral Intervention This is a type of ABA for very young children with ASD, usually younger than 5 and often younger than 3. EIBI uses a highly structured teaching approach to build positive behaviors and reduce unwanted behaviors . EIBI takes place in a one-on-one adult-to-child environment under the supervision of a trained professional.
- Early Start Denver Model
There are other therapies that can be part of a complete treatment program for a child with ASD:
What Are Some New Treatments For Autism
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Research by Medavarapu, et al. , provides a comprehensive insight into biological therapies that have been proven to be effective and those that dont have proven benefits. Treatments with proven benefits include symptomatic treatments such as psychopharmacology agents risperidone and aripiprazole. Non-biological treatments with promising results include Applied Behavioral Analysis which includes discrete trial training , early intensive behavioral intervention , verbal behavioral intervention , pivotal response training . Other non biological treatments with benefits include the TEACCH method, picture exchange communication system , responsive teaching .
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Autism Spectrum Disorders Defined
Autism spectrum disorder refers to a range of disorders of brain development. Commonly known as autism, these conditions are characterized by difficulties in social skills, both verbal and nonverbal communication, repetitious movements, delayed child development and other unique strengths and challenges. In the phrase autism spectrum disorder, spectrum refers to the variation in presentation of symptoms and assets of each individual with autism.
Also see: What Was It Called Before Autism?
The notion that autism is a spectrum of disorders is a relatively new phenomenon. Before 2013, autism spectrum disorders, such as Aspergers syndrome and Kanners syndrome, were thought of as distinct disorder classes with independent treatments. In the latest revision of the Diagnostic and Statistical Manual of Mental Disorders in 2013, the American Psychiatric Association combined subcategories of autism and related conditions into one unified category with different characteristics and severity. Autism is now understood to be on a continuum with overlapping symptomology, caused by a multitude of complex genetic and environmental factors. This progression of the classification and etiology mirrors that of evolving treatment approaches for individuals with autism. Treatments have changed in the last century due to changing theoretical conceptions, new philosophies, and research advances in the field, ranging from biochemical to social and behavioral methods.
Aba First Came On The Scene In A Very Different Time
Applied Behavior Analysis is different from other methods because its focused on just one thing: Changing a persons behavior. There have been many peer-reviewed studies over the years that prove the effectiveness of ABA. Its been around for decades and had great success in the autism community.
But just like many things in life, ABA has its champions and its contenders. When it was first named by Dr. O. Ivar Lovaas almost a half century ago, it was also a time when electroconvulsive shock therapy was still in use, the human genetic code was sci fi, and kids with autism were often institutionalized. Today EST has been eliminated, the human genetic code has been cracked, and toddlers are no longer sent to live in asylums.
The Rise of Pseudoscience Cures
Because ABA was founded so long ago, some may consider the basis of the science to be outdated, and its methods antiquated. They opt instead for current pseudoscience claims and cures. According to physicist Robert Park, pseudoscience is represented by claims that are supposedly made from well-established scientific evidence. Often, however, the evidence can be misinterpreted, misunderstood, or completely missing altogether.
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Why Is There So Little Known About Asd And These Treatments
The research reviewed for this guide showed that some treatments can make specific improvements in the way a child thinks or acts. But researchers do not have enough information to know whether one type of treatment works better than any other. For most treatments, researchers also do not know which treatments will work best for specific children. For example, research does not show whether a program usually works best for older or younger children, or for children with severe or less severe ASD.
This does not mean that a treatment, therapy, or program will not be helpful for your child. It only means that researchers do not have enough information to say so with strong confidence.
Researchers are still studying these treatments and therapies. Check with your doctor or a support group to find out about new research on the programs and treatments in this guide and about new options.
Alternative Therapies And Supports
Alternative therapies and supports for autistic children include a broad range of therapies that mainstream health and autism professionals dont use. This is because theres little or no evidence to say that these alternative therapies work. Considerable evidence shows that some of these therapies have no effect for example, secretin. Evidence also shows that other therapies have risks for example, chelation.
Another common concern about these therapies and supports even those that do no direct harm is that they use time, energy and sometimes money that families could otherwise spend on established therapies that have been shown to work.
Examples of alternative therapies and supports include:
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Types Of Autism Treatment Available
When it comes to early autism treatment options, there are a dizzying variety of therapies and approaches. Some autism therapies focus on reducing problematic behaviors and building communication and social skills, while others deal with sensory integration problems, motor skills, emotional issues, and food sensitivities.
With so many choices, it is extremely important to do your research, talk to autism treatment experts, and ask questions. But keep in mind that you dont have to choose just one type of therapy. The goal of autism treatment should be to treat your childs unique array of symptoms and needs. This often requires a combined treatment approach that incorporates several different types of therapy.
Common autism treatments include behavior therapy, speech-language therapy, play-based therapy, physical therapy, occupational therapy, and nutritional therapy. But keep in mind that the routine is important and the program should be designed in a way that can be sustained. You should think about what skills and behaviors are most essential and treat those first. It may not be possible to tackle everything at once.
Benefits Of Early Accurate Diagnosis
An early, accurate diagnosis of ASD can help families and caregivers access appropriate services, provide a common language across interdisciplinary teams, and establish a framework to help families and caregivers understand the child’s difficulties. Any diagnosis of ASDâparticularly of young childrenâis periodically reviewed by members of the interdisciplinary team because diagnostic categories and conclusions may change as the child develops.
The identification of early behavioral indicators can help families and caregivers obtain appropriate diagnostic referrals and access early intervention services, even before a definitive diagnosis is made . Furthermore, early intervention can improve long-term outcomes for many children . A number of researchers have been reporting the benefits of providing intervention to at-risk infants that targets pre-linguistic communication .
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Other Psychopharmacologic Agent Treatments
Stimulants
Stimulants are treatments or drugs that stimulate or excite the brain or central nervous system . Double-blind placebo-controlled trials have conducted studies for stimulants believed to have benefits in ASD these stimulants include: SSRIs, methylphenidate, and alpha-adrenergic agonists.
Typically, stimulants have been found to be effective in increasing alertness and mood, wakefulness, increase in speech and motor activity, and also decreasing appetite.
- SSRIs
Selective serotonin reuptake inhibitors are the most common types of treatments used in treatment symptoms such as impulsivity, anxiety, and repetitive behaviors among autistic children. The reason behind this is that, according to research, it counters the low serotonin levels found in some ASD patients. According to the review by Medavarapu, et al. , SSRIs were found to be effective in young children with autism as seen in a double-blind two-way crossover trial.
The main limitation is that ASD therapy with SSRIs differs in results across every child. Additionally, it is not possible to firmly choose one SSRI over another to treat any symptom associated with autism.
- Methylphenidate
Some side effects include decreased appetite, tics, irritability, stomach pain or discomfort, and increased heart rate. It is difficult to confirm whether this stimulant is an effective treatment as more research still needs to be conducted on the treatment in relation to its efficacy in ASD.
- Alpha-adrenergic agonists
Treatment Modes And Modalities
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Treatment modes and modalities are technologies or other support systems that the SLP can use in conjunction with, or during implementation of, various treatments. For example, the SLP can use video-based instruction in peer-mediated interventions to address social skills and other target behaviors.
A number of treatment modes and modalities are described below. When selecting a mode or modality, the SLP considers the intervention goal and the individual’s developmental stage. For example, a mode or modality that is appropriate for an individual who is at the emerging language stage may not be appropriate for an individual who is at the prelinguistic stage. The list below is not exhaustive, and inclusion does not imply an endorsement from ASHA.
An AAC system is an integrated group of componentsâincluding symbols, selection techniques, and strategiesâused to enhance communication. AAC uses a variety of techniques and toolsâincluding picture communication systems, line drawings, photographs, video clips, speech-generating devices , tangible objects, manual signs, gestures, and finger spellingâto help the individual express thoughts, ideas, wants, needs, and feelings. AAC can be used to supplement existing expressive verbal communication or with individuals who are unsuccessful at learning expressive verbal communication.
Activity Schedule and Visual Supports
Computer-Based Instruction
Video-Based Instruction
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Timeline: Major Historical Developments In The Treatment Of Autism
- 1911 Eugen Bleuler first uses the term autism to describe symptoms of schizophrenia
- 1920s Electroconvulsive therapy first used to treat symptoms of autism
- 1920s Emergence of dietary restrictions for autism treatment
- 1943 Leo Kanner first characterizes autism as a social and emotional disorder
- 1944 Hans Asperger publishes article on autism as a communication disorder in children
- 1950s Bruno Bettelheim coins the refrigerator mother theory
- 1950s Parentectomy is common treatment approach for autism
- 1970s Temple Grandin develops a squeeze machine for children with autism
- 1970s Shock therapy and aversive punishment mainstream autism treatment approach
- 1970s Guy Bérard develops auditory integration training for autism treatment
- 1977 Susan Folstein and Michael Rutter publish first twin study on autism
- 1970s Pharmaceutical treatments for autism become main treatment method
- 1980 Infantile autism is its own category in DSM-III
- 1987 Autism is expanded in DSM including diagnostic criteria
- 1987 Ivar Lovass develops intensive behavioral therapy for children with autism
- 1997 Emergency of special education programs for children with autism
- 2013 Autism spectrum disorders classified in DSM-V
Breakdown Of The Proven Biological Treatments
If youve ever wondered how biological treatments are approved, the answer is biological treatment methods are tested through clinical trials. The most common and best type of clinical trial is thought to be double-blind placebo-controlled trials in this form of trial two key factors are important and adhered to: firstly, the participants are either administered a placebo or the test drug. The participants are divided into two groups and half is administered the placebo and half the other the drug. Secondly, neither the researcher nor the participants know what is being administered.
Each person in the groups is given a code that the computer registers and that code is assigned a trial treatment randomly. After a period, the participants return for a follow up and the computer registers the results according to each participants code. Fun fact: the placebo group is known as the control group and the group receiving the actual drug is known as the treatment group. In addition, participants have to be within the same population group i.e. age group, some trials specify same gender, or ethnicity etc.
Clinical trials can take years, if not decades to be approved by the Food and Drug Administration agency . With that said, lets look at some of the new biological treatments that have proven benefits for the treatment of ASD symptoms.
Psychopharmacologic agents
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Behavioural Therapies And Supports
Behavioural therapies and supports for autistic children use specialised, structured techniques to help children learn new behaviours and skills. These therapies and supports are generally referred to as Applied Behaviour Analysis approaches.
Many of these therapies and supports use specialised behaviour techniques along with other strategies. And different therapies and supports use the techniques in different ways. For example, Discrete Trial Training works on childrens behaviour by breaking behaviour skills down into steps. It looks different from the Early Start Denver Model, which builds behaviour techniques into childrens play.
Research has shown that ABA approaches work. But theres also some controversy about ABA. Some members of the autism community feel that ABA sometimes aims to stop behaviours like flapping or stimming, which can be calming or enjoyable for autistic people.
Examples of behavioural therapies and supports include:
Treatment Considerations: Asha’s Position
Several treatment options and approaches lack scientific evidence of validity and are not endorsed by ASHA. They are Auditory Integration Training , Facilitated Communication , and Rapid Prompting Method . Below are brief descriptions of these treatments, along with ASHA’s position on each. Click on the hyperlinks provided to read ASHA’s full position statements.
Auditory Integration Training
Auditory Integration Training is a type of sensory integration treatment that involves exercising the middle ear muscles and auditory nervous system to treat a variety of auditory and nonauditory disorders, including auditory processing problems, dyslexia, learning disabilities, attention-deficit disorders, and ASD. The treatment typically involves listening to specially filtered and modulated music for two 30-minute sessions per day for 10 consecutive days. The objective is to reduce distortions in hearing and hypersensitivity to specific frequencies so that the individual will be able to perceive soundsâincluding speechâin a normal fashion.
According to ASHA’s position statement titled, Auditory Integration Training, “The 2002 ASHA Work Group on AIT, after reviewing empirical research in the area to date, concludes that AIT has not met scientific standards for efficacy that would justify its practice by audiologists and speech-language pathologists” .
Facilitated Communication
Rapid Prompting Method
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Reference And Suggested Readings
The Missouri Autism Guidelines Initiative. Autism Spectrum Disorders: Guide to Evidence-based Interventions: a 2012 Consensus Publication. The Missouri Autism Guidelines Initiative. www.autismguidelines.dmh.mo.gov. Accessed June 5, 2917.
Zwaigenbaum L, Bauman ML, Choueiri R, et al. Early intervention for children with autism spectrum disorder under 3 years of age: recommendations for practice and research. Pediatrics. 2015 136 Suppl 1:S60-S81.
Makrygianni MK, Reed P. A meta-analytic review of the effectiveness of behavioural early intervention programs for children with autistic spectrum disorders. Research in Autism Spectrum Disorders. 2010 4 577-593.
The Lovaas Model. The Lovaas Institute website. . Accessed June 5, 2017.
Dawson G, Rogers S, Munson J, et al. Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics. 2010:125:e17-e23.
Arnold LE, Vitiello B, McDougle C, et al. Parent-defined target symptoms respond to risperidone in RUPP autism study: customer approach to clinical trials. J Am Acad Child Adolesc Psychiatry. 2003 42:1443-1450.
McCracken JT, McGough J, Shah B, et al. Risperidone in children with autism and serious behavioral problems. N Engl J Med. 2002 347:314-321
Myers SM, Johnson CP. Management of children with autism spectrum disorders. Pediatrics. 2007 120:1162-1182.