Interventions & Treatments

For a comprehansive list and links to autism therapies, visit the main National Autistic Society website.

There is growing evidence from a number of small-scale studies that intervention in the life of a child with autism can make a difference to their language development and social behaviour. In recent years there have been many new intervention approaches in the field of autism, including dietary, drug, sensory, behavioural and educational. Some have been devised for the child with autism taking account of the triad of impairments while others have drawn on good practice from working with children with learning difficulties. Other programmes have their origins in a particular theory relating to autism.

The diversity of intervention programmes reflects not only the range of understanding that practitioners have of autism but also the diversity of responsiveness to intervention of the child with autism. As a result there is no single programme that will suit every child or every family situation. Many parents draw on aspects of more than one intervention programme and develop their own to suit the very specific needs of their child. The financial implications of the programmes have not been included but many are costly. Below is a brief outline of some of the best known intervention programmes.

Earlybird (NAS)

The Earlybird Programme is an early intervention programme aimed at parents of children with a recent diagnosis of ASD. The programme runs for three months with workshops, video sessions and home visits. The aim is to provide parents with information, understanding and strategies to understand and develop their child’s communication and to encourage appropriate behaviour. Up to six families at a time can participate in the programme. They are organised in geographical areas.

Gluten & Casein Free Diets

Casein and gluten free diets have been become popular in recent years. It is thought that large protein molecules may only be partially broken down in digestion in the child with autism. If the wall of the gut is unusually permeable then these incompletely broken down molecules (peptides) can pass through the intestine wall into the blood stream and into the brain. These molecules act a bit like morphine type substances. Removal of casein and gluten from the diet may be one way to remove these molecules from the digestive process. It is suggested that removal of these peptides can improve the child’s attentiveness and ability to learn.

Many parents combine both gluten and casein free diets, however this approach is still considered to be controversial. Medical advice should be sought before starting out on such a diet regime.

Growing Minds

Growing Minds incorporates what the founders believe is the best from Lovaas Programme (ABA – Applied Behavioural Analysis) and Son-Rise programme. It incorporates ABA principles and methods into a play based approach. Core goals are taught in a designated playroom by a number of volunteer therapists and then generalised into other environments. Growing Minds incorporates instruction time, where the adult is directing learning and intensive interaction approach where the adult follows the child’s lead. Complete assessment is carried out and a profile created from which an IEP (Individual Educational Plan) is developed for the child.

Hanen – More Than Words

The Hanen Programme ‘More Than Words’  is available across both North and South Lanarkshire. It is led by a Hanen trained Speech and Language Therapist who has been trained in the ‘More Than Words’ programme. It is a family-focused programme that gives parents of children with an Autistic Spectrum Disorder or other social communication difficulties tools to help their children communicate. It is an intensive home based intervention programme where parents attend a number of taught evening sessions with follow up video feedback. These individual feedback sessions of parents interacting with their children allow parents to ‘see’ what is helping to support their child’s communication skills. Parents are recognised as the most important people in their child’s life. In the ‘More Than Words’ programme, they will learn ways to develop their child’s communication and interaction using everyday routines and activities. Parents also have the opportunity to share ideas with one another. The programme usually runs for approximately 10 –12 weeks. There are usually rolling programmes in different areas of the Local Authority and parents can normally access groups out with their local area if there are places available.

HELP! (NAS)

The NAS Help! Programme is a parent-training programme which aims to provide practical advice, information and support to parents at the post-diagnostic stage. It is aimed at families of school age children, adolescents and adults. The programme consists of workshops covering a wide range of issues to enable parents the gain the confidence to care and plan for their child’s future. Each Help! Programme is offered to 10 sets of parents and carers. The course includes presentations, discussions, videos, group and individual tasks and case studies.

LOVAAS

The Lovaas Approach is based on Applied Behavioural Analysis (ABA), where behaviours are observed and measured and new behaviours are taught. The Lovaas programme aims to encourage appropriate behaviour by continual reinforcement of desired behaviour. The programme is designed to run in the family home with an intensive programme of up to 40 hours a week. A work area or room is usually set aside for the therapy sessions. Parents have to undertake training. A team consisting of parents, therapist and trained volunteers would run the programme.

Megavitamin Therapy

Megavitamin therapy claims to have had a 50% success rate in improving the speech and behaviour of people with autism. This was attained by giving a daily dose of 8mg of vitamin B6 and 4mg of magnesium per pound of body weight. Improvements in some cases were immediately noticeable. It is recommended by the therapists that a course of megavitamins should be given for at least six weeks for the full effect of the treatment to be seen. Some studies have shown that vitamin B6 and Magnesium can help to normalise brain waves, urine chemistry and immune system function in addition to improving speech and behaviour. The small scale studies have shown some promise however results have not been widely replicated. It is recommended that you consult your GP or Community Paediatrician before embarking on any dietary or drug intervention

PECS (Picture Exchange Communication System)

PECS is a structured approach aimed at developing early communication skills using pictures. The principle behind PECS is that the child or person with autism is the initiator of the communication; the adult does not prompt communication. Children are taught to exchange pictures for things they want in their environment, the pictures chosen are motivating and appropriate to the likes of the individual child. They initiate the interaction by approaching the adult and giving them the picture. This approach is showing promise as many of the children in the programme are showing signs of developing some level of speech.

Son-Rise Programme

Parents of a child with autism developed the Son-Rise programme. The programme makes the assumption that fear prevents a child with autism from communicating and interacting. Parents are encouraged to accept their child and what he / she does. They are encouraged to enter into their child’s world and to build a special bond that will become the foundation for their child’s learning. The parents are encouraged to become involved in their child’s ritualistic and repetitive behaviours to show their child that what he /she does is of interest to them. By engaging their child through dynamic interactive play communication and social skills can be taught. Account is made of the things that motivate the child and these are used to develop skill acquisition. It is a child centred approach.

TEACCH (Treatment and Education of Autistic and related Communication-handicapped Children)

The TEACCH approach was founded almost thirty years ago through the University of North Carolina. Its approach is used extensively throughout the USA and all over the world. The basic principles, which underline their approach, were based on developing an understanding of autism by observation of the child rather than through professional theories. This has led to two main strategies being developed to support the education of the child with autism. Improving skills by a structured teaching approach which uses picture cues and by modifying the environment to accommodate deficits experienced by the child with autism.

The Biomedical Approach

DAN! (Defeat Autism Now), A group of medical practitioners from around the world, have the joint belief that ASD are primarily medical disorders with the typical impairments recognised in autism being by-products of the physical illness. The DAN protocol is a system for identifying and treating what these doctors believe to be the metabolic / biochemical causes of autism and related disorders. The recommended treatments include dietary changes, supplementation, anti-fungal, probiotic and anti-viral treatments amongst others. Parents with varying degrees of involvement often endorse them. These emerging treatments are still experimental and highly controversial. Mainstream medical professionals have little knowledge or experience of them and are therefore often resistant to supporting such an approach.

Social Skill Development

For many young people with ASD understanding and being able to cope in social situations is very difficult. It is recognised that they need to be taught the skills that will enable them to participate in social situations. There are materials available which can be used to support the development of social skills and social understanding.

Social Stories

Carole Gray has written several books on her approach which uses ‘Social Stories’ to develop social understanding in young people with ASD particularly those with AS. The stories are written with the child or young person in the form of cartoons, line drawings or text as appropriate to the young person. The stories are short and personalised for each individual. The adult supporting them needs to take on board the child’s perspective of the situation in order to determine the focus of the social story.

Social stories aim to explain the ‘hows’ and some of the ‘whys’ of social situations. They aim to reinforce prior understanding of social situations and to provide strategies which will allow the young person to recognise and evaluate what is happening and how they should respond in real everyday social situations.

Training

Both The National Autistic Society and the Scottish Autism offer training opportunities to parents, carers and the range of professionals who may be supporting or working with children and young people with ASD.

Final Comment

As new theories and developments are made in the research into ASD new approaches to intervention are always forthcoming. Those included above are the more commonly known intervention approaches. Other approaches include Music Therapy, The Handle Approach, Homeopathic Approaches, Auditory Integration Training, Higashi, Dolphin Therapy and Secretin. It is recommended that parents should consult their GP or other health professional before embarking on a dietary or drug programme.