Fact sheet on early intervention for Autism, an Autism Spectrum Disorder

AN INTRODUCTION TO EARLY INTERVENTION

There is a broad range of therapies for Autism Spectrum Disorders such as Autism and Asperger's syndrome, but the effectiveness of each varies dramatically from child to child. Progress on medical and behavior modification remedies has been hindered significantly by disagreements over the nature and causes of Autism Spectrum Disorders, and by a relative lack of effective therapies thus far recognized by medical authorities. The situation is further complicated by parents who have found a particular treatment effective, and may advocate this as a cure-all for Autism, Aspergers syndrome, and other Autism Spectrum Disorders.

While there is no cure for Autism Spectrum Disorders, research indicates that intensive educational and behavioural interventions can have a major effect when started as early as possible (ie. two years of age and on).

why early intervention is crucial for autisTIC SPECTRUM DISORDERS

If a child experiences a developmental delay, this can compound over time. The principle of early intervention is to provide appropriate therapies to minimize these delays and maximize their chances of reaching normal milestones in development.

The focus of early intervention coordinates therapies to:

• Build better communication and social interaction skills

• Manage obsessive, repetitive and challenging behaviors

• develop activities of daily living skills (hygiene, dressing, eating, toileting etc.)

• Improve physical coordination

• Teaching joint attention skills, play, and imitation skills
• Manage sensory issues.

why evidence-based treatment is important

There are many types of interventions available for Autism Spectrum Disorders, ranging from those with solid research backing their effectiveness, others relying on anecdotal evidence, to those deliberately exploiting vulnerable parents. Evidence-based treatment is based on rigorous research to ensure the effectiveness of a treatment or intervention is free from the various biases that beset medical research. The strongest evidence for therapeutic interventions is provided by randomized, double-blind, placebo-controlled trials involving a homogeneous patient population and medical condition. Although still fallible if not conducted properly, it is the highest standard of proof that currently exists.

Currently the most effective evidence-based treatments are behavioral interventions such as Applied Behavior Analysis, the Lovaas Program and Intensive Behavioral Interventions. It should be noted though that these interventions may still not suit all families due to the expense, intensity and expertise required.

It should be noted that a lack of rigorous research does not mean an intervention is ineffective. For example, small studies have shown that developmental interventions such as Relationship Development Intervention, Floortime and the Developmental Social-Pragmatic model provide benefits but more research is required. Other interventions have had little or no independent research done, but may rely on word-of-mouth by parents, or at worst, deliberately misleading advertising that exploits vulnerable parents by aiming to 'cure' Autism. Careful research is needed to investigate many of the more recent interventions.

Typical interventions for Autism spectrum disorders

A typical Autism or Asperger's syndrome intervention program may include:
• Social skills training for more successful interaction with others
• Cognitive behavioral therapy for managing emotions, obsessions and repetitive routines
• Medication, for co-existing conditions such as depression and anxiety
• Occupational/physical therapy for sensory integration and motor coordination problems
• Specialized speech therapy, to learn the “give and take” in normal conversation
• Parent training and support, to teach parents behavioral techniques to use at home.

Some parents explore biomedical interventions with anecdotal evidence suggesting some find improvements in various symptoms.

Many studies have been done on early behavioral interventions. Most of these are single case with one to five participants. The single case studies are usually about controlling non-core autistic problem-behaviors like self-injury, aggression, noncompliance, stereotypes, or spontaneous language. Packaged interventions are designed to treat the entire syndrome e and have been found to be somewhat effective.

Unintended side effects of medication as an intervention have largely been ignored in the literature about intervention programs for children or adults with Autism, and there are claims that some interventions are not ethical and do more harm than good. As with all types of early intervention, it pays to research first then monitor the results to see if medication is helping or not. Click here for tips on selecting early intervention approaches.

Therapies for Autism Spectrum Disorders are continually developing, and can present a bewildering array of approaches, costs, benefits and waiting lists to parents who may still be reeling from the impact of their child being diagnosed. Although parents may feel a sense of urgency to find therapies quickly, in the long term it is advisable to put time, research and discussion into your choice. For more information, go to the Early intervention page.

When interventions are too expensive

Do some research through books, the Internet and Autism associations on the therapy, to see when it was developed, how widely it is used and its evaluation from Autism specialists. Unfortunately, therapies are often very expensive, bur remember the most expensive ones may not be the best one for your child anyway. Your local Autism association should be able to inform you on subsidies, government treatments and other options available. While therapy by specialists can make a huge difference, it is the ongoing therapy provided by parents in the home which will make the most impact. For more information, go to the Guide to low cost intervention program page.

a list of early interventions

This website provides information on some of the well known interventions. Please note this is not an exhaustive list, and inclusion of an intervention does not guarantee its effectiveness.

alternative approaches to Autism interventions

Economist Thomas Sowell, author of The Einstein Syndrome, is a major opponent of any form of ‘early intervention’ for children with certain characteristics (whom he considers wrongly labeled autistic), i.e. those who appear to be intelligent, are able to understand spoken language, and have several engineers or musicians as close family members.

An approach for dealing with Autism which involves reducing stressful situations, and not trying to force the autistic child to change into someone he is not, is proposed in The Self-Help Guide for Special Kids and Their Parents by Joan Matthews and James Williams. James Williams is an autistic child who, with his mother’s help, recounts much of his experiences through examples of possible problems encountered by parents of autistic children. The approach recommends, for example, not forcing the child into a mainstreamed schooling situation too early; trying to understand the problems caused by hypersensitivity and adapting to them; allowing the child to cope with stress by stimming; helping the child develop left-brain thinking; and so on.

The Institutes for The Achievement of Human Potential, established in 1955, is a nonprofit organization dedicated to improving the health and development of children who have some form of brain injury, including children diagnosed with Autism. The IAHP claims that many children show improvement with a home program consisting of a healthy diet, clean air, and respiratory programs, without the need for medication. The IAHP publishes the results of its treatment for over 1700 children on its website.

Click here for the full range of Asperger's and Autism fact sheets at www.autism-help.org
Click here to read a personal story about early intervention
This autism fact sheet is licensed under the GNU Free Documentation. It is derivative of an Autism and Asperger's syndrome-related articles at http://en.wikipedia.org

Early interventions biomedical interventions are crucial to maximizing the development of children with an Autism Spectrum Disorder

AN INTRODUCTION TO EARLY INTERVENTION

why early intervention is crucial for autisTIC SPECTRUM DISORDERS

why evidence-based treatment is important

Typical interventions for Autism spectrum disorders

When interventions are too expensive

a list of early interventions

Behavioral interventions

Developmental interventions

Combined interventions

Sensory integration interventions

Biomedical interventions

alternative approaches to Autism interventions