Autism Treatment: Options, Approaches, and Support
Amanda Unrau CCC-SLP
August 13, 2024
According to the CDC, about 1 in 36 children have been identified as having autism spectrum disorder (ASD). Although there is no cure for autism, early intervention and appropriate treatment can help lessen symptoms and improve functional skills. This article will share some approaches and tips that can help.
Behavioral and Developmental Approaches
Individuals with autism spectrum disorder often exhibit developmental delays and behavioral difficulties. Specific treatment approaches aim to change behaviors by reducing challenging behaviors and increasing positive appropriate behaviors. Other approaches take a child’s current developmental skills and build on their strengths in order to make progress. Below are a couple of examples of these approaches.
Applied Behavior Analysis (ABA)
Applied Behavior Analysis (ABA) is an autism treatment approach that is based on learning and behavior. The goal of ABA is to understand the way behavior works, how behavior is affected by the environment, and how learning happens. This information is applied to real life situations in order to increase helpful or positive behaviors and decrease harmful behaviors or those that impede learning.
Treatment goals of ABA can include communication and language, motor skills, social skills, academic skills, play, and self-care.
Three steps are used to understand and teach behavior: A-B-C.
- A – Antecedent: This is what occurs just before the target behavior. It may be internal or come from another person or the environment. For example, an antecedent can be a thought or emotion, a question or command, or a toy or sound.
- B – Behavior: The resulting behavior is the response or lack of response to the antecedent. It can be a verbal response or an action.
- C – Consequence: This comes right after the behavior and can consist of positive reinforcement to encourage the desired behavior or no reaction for inappropriate behaviors.
These steps are used to understand what causes specific behaviors and how different consequences may affect whether the behavior will happen again.
An example scenario could look like the following:
- Antecedent: A parent tells their child it is time to get their shoes on and go out to the car.
- Behavior: The child shouts, “No!” and refuses.
- Consequence: The teacher puts the shoes in front of their child and says, “Put these on.”
ABA can help the child learn a more appropriate way to behave in this situation.
The new scenario could end up looking like this:
- Antecedent: A parent tells their child it is time to go.
- Behavior: The child is reminded that they can ask, “Can I have 5 more minutes to play?”
- Consequence: The parent says, “Sure, you can have 5 more minutes! Then we will get ready to go.”
Floortime
Another option when considering autism and treatment is floortime, which is a relationship-based therapy. In this approach, the caregiver or therapist gets down to play with the child at their level, often on the floor. Floortime is at times used as an alternative to or in addition to ABA therapy.
A key component of Floortime is to follow the child’s lead and meet them where they are in order to build upon their strengths. Floortime focuses on emotional development, and other areas, such as speech, cognition, or motor skills are not directly addressed. The goal of Floortime is to help children with autism achieve six key milestones. The milestones are:
- Interest in the world around them and self-regulation
- Engagement in relationships
- Two-way communication
- Complex communication
- Emotional ideas
- Emotional thinking
An example of a Floortime interaction is as follows:
A child is pushing a toy car on the floor, so the adult pushes a car in the same way. In order to encourage the child to react or respond, the adult may put their car on top of the child’s car. The adult will continue to encourage higher and more complex levels of interaction by changing their interactions to meet the child’s areas of interest.
Therapeutic Interventions
There are a variety of therapeutic interventions available to children with autism. These interventions each target different skills, but as with most of the examples for autism and treatment that are presented in this article, each of these help individuals with autism socialize, make academic progress, and learn adaptive skills in order to function successfully in their everyday life. Therapies are rarely used as the only treatment approach and are most effective when combined with other therapies.
Occupational Therapy
Occupational therapy is one of the therapies commonly used as a treatment for autism disorder. The goal of occupational therapy is to improve an individual’s ability to complete their occupation. In the case of children with autism, occupational therapy helps individuals participate in activities of daily living, including homework, play, and hygiene.
Treatment goals of occupational therapy can address muscle tone, motor planning, sensory skills dysfunction, social skills, and imitative play skills.
Examples of academic goals may include: improving handwriting or using scissors correctly. Examples of daily living goals may include: zipping up clothing, tying shoes, or brushing teeth independently. Examples of functional play goals may include: swinging on swings independently or throwing and catching a ball.
Physical Therapy
Physical therapy is often used in conjunction with occupational therapy as a treatment of autism spectrum disorder. While occupational therapy helps to improve daily functional skills, physical therapy helps to improve physical movement and balance.
The goals of physical therapy are to develop stronger muscles and movement skills, increase strength and flexibility, improve posture and coordination, and improve the skills needed to roll, sit, crawl, walk, run, and jump. Physical therapy can help with functional skills, play skills, fine and gross motor skills, strength and coordination, and social skills.
Physical therapy treatment goals may include accessing playground equipment, interacting with others on a team sport, walking up and down stairs, throwing and catching a ball as part of a group activity, and improving hand-eye coordination for sports.
Speech Therapy
Another common therapy for autism spectrum disorder is speech therapy. Speech therapy for individuals with autism focuses on improving their communication skills, intelligibility of speech, understanding of language, and social interactions.
Speech therapy treatment goals for individuals with autism may include taking turns in conversation, using communication supports, transitioning from one activity or setting to another, expanding interests and trying new activities, advocating for their needs, problem solving in social settings, improving tone or rhythm of speech, understanding nonliteral language, improving production of speech sounds, and improving reading and writing skills.
Sensory Integration Therapy
Most individuals with autism spectrum disorder have sensory issues. Those with ASD may have sensory processing disorder (SPD), characterized by hyporeactivity or hyperreactivity to sensory stimuli, which can make it hard for them to function in daily life. Sensory integration therapy is an autism treatment that helps individuals participate in daily life better by regulating their reactions to sensory input.
Sensory integration therapy is a specific treatment approach of occupational therapy. It is provided by occupational therapists with specific training in this area. The goal is to help individuals become more functional in their daily lives.
Specific goals for treatment will vary for each individual. Examples include helping a child adjust to bright lights or loud noises, tolerating various smells, touching different textures, etc. Specific activities may include swinging, playing in a ball pit, brushing, or other sensory activities.
Educational Interventions
Educational interventions are interventions that help support children with autism in the educational setting. They can help improve social and education outcomes and ensure that individuals with autism receive the best education possible that is unique to their specific strengths and difficulties.
Individualized Education Program (IEP)
One education intervention is an Individualized Education Program (IEP). IEPs are federally regulated documents that are written for any child who qualifies as having a disability in the school setting. In order to qualify for an IEP, a student is evaluated in the areas of concern. Once a child is eligible for an IEP, areas of need are outlined and services and goals are added to the IEP to target these areas. IEP goals for a student with autism may include academic skills, social skills, motor skills, communication, and behavior. IEPs can also include accommodations or modifications that allow the student to better access and participate in the academic environment. This plan is reviewed and updated annually and the child is reevaluated every three years. Updates and reevaluations can happen more often if needed.
504 Plan
A 504 Plan is for students who don’t qualify for an IEP because their needs are less severe and they require less support. Students who qualify for a 504 still require help in order to succeed in the academic environment. While an IEP includes specific services/therapy and goals, a 504 Plan is more broad and includes basic accommodations and modifications to the curriculum. Examples of accommodations that may be found in a 504 Plan include visual aids, extra time, reduced distractions, flexible seating, a predictable schedule, and positive reinforcement.
Assistive Technology
Assistive technology (AT) for autism includes a variety of tools that can support and enhance certain abilities or allow individuals to do things they couldn’t do before. Assistive technology can be used to help with the following areas: sensory integration, communication, reading, writing, and math, telling time, social skills, managing schedules, safety, and activities of daily living such as self-care and household chores. Most assistive technology can be paired with other ASD treatment in order to boost the effects. Examples of assistive technology for ASD include picture boards, apps, AAC (Augmentative and Alternative Communication) devices, and robots.
Types of Assistive Technology
Assistive technology can be low-tech, mid-tech, or high-tech. Low-tech AT does not require electricity. Examples include picture boards, fidgets, weighted vests or blankets, sensory tools, and color-coded schedules. Mid-tech AD uses electricity, but is affordable and easy to operate. Examples include videos that teach social skills, timers, battery-operated sensory toys, calculators, sound-blocking headphones, and watches with alarms. High-tech AT is more costly and can require more training in order to operate. Examples include speech-to-text software and AAC devices that help individuals communicate.
Forbrain
Another example of assistive technology is Forbrain. Forbrain is an auditory stimulation device that individuals wear to help hear themselves better. Using Forbrain can help improve speech clarity, voice quality and rhythm, attention, and memory.
According to the Forbrain website, Brenda stated that her son with nonverbal autism has experienced many benefits since using Forbrain. After using Forbrain for 6 weeks, there were major improvements in his confidence, enunciation, and reading skills. His speech became more intelligible. Brenda reported that it feels like her son is a completely new kid.
Alternative Treatments
Besides the above mentioned treatment approaches for ASD, there are other options that may be considered as a complementary approach to other types of therapy:
Music Therapy
In music therapy, musical experiences are used to target specific therapy goals. A music therapist will provide therapy based on goals and objectives developed after an initial assessment of the client’s strengths and weaknesses. The therapist focuses on the child’s creative talents instead of trying to fix problem areas.
Music therapy can help improve personal expression, communication, social interactions, focus, stress management, physical coordination, behavior, motor skills, and cognition. It can also help individuals with sensory sensitivities cope with different sounds. Music therapy is not the same thing as music instruction or music lessons, but could be a good choice for a child who demonstrates a strong interest or talent in this area.
Art Therapy
Another alternative to more traditional types of treatment for autism disorder is art therapy. Art therapy uses different types of art as a way to express oneself and communicate and to promote mental and emotional development. Art therapy can be a great choice for children with autism who have weak verbal communication and social skills. It allows individuals to explore and express themselves through art.
Some of the benefits of art therapy can include improved communication skills, regulated emotions, improved sensory integration, development of identity, and development of social skills. Art therapy can also help children channel challenging behaviors into a creative outlet. For example, a child who has a compulsive habit of shredding paper can be taught how to use that habit to create beautiful collages.
Using Forbrain to Help with Autism
As mentioned above, Forbrain can be used as a complementary tool to any other autism treatment approach. Forbrain is an auditory stimulation headset that utilizes the auditory feedback loop. It helps keep the brain alert, which improves focus during tasks such as specific therapy activities. This can help improve outcomes in treatment. Since Forbrain allows the individual to hear better, they can more clearly understand and produce speech sounds. Both of these skills can also help with social interactions, another area that children with autism struggle with.
Final Words
There are many treatment approaches available to individuals with autism. While many children with autism struggle with similar skills, each individual will have unique strengths and weaknesses and need a treatment program specifically designed for them. This will often entail a variety of approaches used together. Parents, educators, and healthcare professionals should consider the goals of each treatment approach to find the best fit for their child, student, or client with ASD. Use the information shared above to choose a behavioral or development approach, a therapeutic intervention, educational interventions, and/or assistive technology.
References
ASHA. (Accessed 2024, July 18). Autism (Autism Spectrum Disorder). American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/Autism/
Autism Center for Kids. (Accessed 2024, July 22). The Therapeutic Canvas: Exploring Art Therapy for Autistic Children. Autism Center for Kids. https://autismcenterforkids.com/art-therapy-for-autistic-children/
Autism Speaks. (Accessed 2024, July 18). Applied Behavior Analysis (ABA). Autism Speaks. https://www.autismspeaks.org/applied-behavior-analysis
Autism Speaks. (Accessed 2024, July 21). Floortime. Autism Speaks. https://www.autismspeaks.org/dir-floortime
Centers for Disease Control. (2024, January 25). Data and Statistics on Autism Spectrum Disorder. U.S. Centers for Disease Control and Prevention. Retrieved from here.
Gong, Amy. (2023, August 4). Physical Therapy for Autistic Children: What to Know. Beaming Health. https://beaminghealth.com/article/physical-therapy-for-autistic-children-what-to-know
Hanson, Jennifer. (Accessed 2024, July 20). 504 Plan for Autism. Special Education Journey. https://special-education-journey.com/504-plan-for-autism/
Lacour, Kate. (Accessed 2024, July 22). The Value of Art Therapy for Those on the Autism Spectrum. The Art of Autism. https://the-art-of-autism.com/the-value-of-art-therapy-for-those-on-the-autism-spectrum/
LaMoreux, Karen. (2022, January 20). How Music Therapy Can Tune the Autistic Brain. Psych Central. https://psychcentral.com/autism/music-therapy-for-autism
Rudy, Lisa Jo. (2023, November 8). Assistive Technology for Autism: Tools that Help with Communication, Learning, and More. VeryWell Health. https://www.verywellhealth.com/assistive-technology-for-autism-5076159
Rudy, Lisa Jo. (2023, August 15). Occupational Therapy for Autism. VeryWell Health. https://www.verywellhealth.com/occupational-therapy-for-autism-4783594
Rudy, Lisa Jo. (2024, May 12). Sensory Integration Therapy and Autism. VeryWell Health. https://www.verywellhealth.com/sensory-integration-therapy-and-autism-260509
Amanda Unrau
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