Sunday, January 11, 2009

Treatment and Therapy (sample and fact taken on cdc website)

No two people with ASDs are exactly alike. So, each person with an ASD needs a treatment program to meet his or her individual needs and the needs of his or her family. While there is not yet a cure for ASDs, early, intensive treatment can help children with the disorder reach their full potential. Acting early can make a big difference! For guidance on choosing a treatment program.

It is important to remember that children with ASDs can get sick or injured just like children without ASDs. Regular medical and dental exams should be part of a child’s intervention plan. Often it is hard to tell if a child’s behavior is related to the ASD or is caused by a separate health condition. For instance, head banging could be a symptom of the ASD, or it could be a sign that the child is having headaches. In those cases, a thorough physical exam is needed.

Even if your child has not been diagnosed with an ASD, he or she may be eligible for early intervention services. The Individuals with Disabilities Education Act (IDEA) says that children under the age of 3 who are at risk of having substantial developmental delays may be eligible for services. These services are provided through an early intervention system in your state. Through this system, you can ask for an evaluation. To learn more about early intervention, click here National Dissemination Center for Children with Disabilities.

  1. Behavioral and Educational Interventions
  2. Complementary and Alternative Medicine
  3. Dietary Changes
  4. Medications
  5. Additional Treatment Resources

Behavioral and Educational Interventions
According to the American Academy of Pediatrics, educational interventions thought to help children with ASDs are those that provide structure, direction, and organization for the child. These interventions must be individualized to the child and take into account his or her overall developmental status and specific strengths and needs. To learn more about these treatments and interventions, including specific strategies used by physicians to treat ASDs, refer to the American Academy of Pediatrics’ report on diagnosing and managing ASDs.

The National Institute of Mental Health says that psychosocial and behavioral interventions are key parts of comprehensive treatment programs for children with autism. Some of the most common interventions include:

  • Applied behavior analysis (ABA)
    • Discrete trial training (DTT)
    • Early intensive behavioral intervention (EIBI)
    • Incidental teaching
    • Pivotal response training (PRT)
    • Verbal behavior intervention (VBI)
  • Developmental, individual differences, relationship-based approach (DIR also called Floortime)
  • Relationship development intervention (RDI)
  • Treatment and education of autistic and communication- related handicapped children (TEAACH)

Therapies often used with those listed previously:

  • Occupational therapy
  • Sensory integration therapy
  • Speech therapy
  • The Picture Exchange Communication System (PECS)

For more information:

Complementary and Alternative Medicine
There is no known cure for autism. To relieve the symptoms of autism, some parents and providers may use treatments that are outside of what is typically recommended by their pediatrician. These types of treatments are known as complementary and alternative treatments or CAM. They may include special diets, chelation (a treatment to remove heavy metals like lead from the body), biologicals (e.g., secretin), or body-based systems (like deep pressure).

NIH’s National Center for Complementary and Alternative Medicine (NCCAM) defines CAM as a group of different medical and health care systems, practices, and products that are not part of conventional medicine. NCCAM divides complementary and alternative treatments into five categories:

  • Alternative medical systems (e.g., homeopathy or Chinese medicine)
  • Mind-body interventions (e.g., meditation, dance therapy, auditory integration)
  • Biologically based therapies (e.g., using herbs, foods, and vitamins)
  • Manipulative and body-based methods (e.g., deep pressure, craniosacral therapy)
  • Energy therapies (e.g., reiki, electromagnetic fields, etc.)

There have been efforts to develop a protocol for biomedical interventions for ASD. There are anecdotal reports of success with individual children; however, before this approach can be recommended as a standard treatment, more research is needed on the safety and effectiveness of the various treatments for a variety of people with ASD.

To learn more about CAM therapies, go to the NCCAM Get the Facts webpage.

These types of treatments are very controversial. Current research shows that as many as one third of children with autism may have tried complementary or alternative medicine treatments, and up to 10% may be using a potentially dangerous treatment.Before starting such a treatment, check it out carefully, and talk to your child’s health care professional.

Dietary Changes

If you are thinking about changing your child’s diet, talk to his or her health care professional first. Or talk with a nutritionist to be sure your child is getting the essential nutrients he or she needs.

Many biomedical interventions call for changes in diet. Such changes include removing certain types of foods from a child’s diet and using vitamin or mineral supplements. Dietary treatments are based on the idea that food allergies cause symptoms of autism or that the lack of a specific vitamin or mineral may cause some autistic symptoms. Some parents feel that changes in their child’s diet may make a difference in how the child feels or acts.

The National Institute of Mental Health, part of NIH, does studies to test how well various biomedical interventions work.

No medication can cure ASDs or treat the core symptoms that make up the disorder—that is, communication, social, and repetitive or unusual behaviors. But medications can help with some of the symptoms of autism in some people. For instance, medication might help with a person’s high energy levels, inability to focus, depression, or seizures. Also, the U.S. Food and Drug Administration has approved the use of risperidone (an antipsychotic drug) to treat 5- to 16-year-old children with ASDs who have severe tantrums, aggression, and self-injurious behavior.

Medications may not affect a person with an ASD in the same way they would affect another person. So, it is important to work with a health care professional who has experience treating people with ASDs. Also, parents must watch their child’s progress and reactions while he or she is taking a medication to be sure that the side effects of the treatment do not outweigh the benefits.

Here the link to find out more about medications and ASDs on the National Institute of Mental Health autism website.

Additional Treatment Resources

The Autism Treatment Network (ATN) seeks to create standards of medical treatment that will be made broadly available to physicians, researchers, parents, policy makers, and others who want to improve the care of individuals with autism. ATN is also developing a shared national medical database to record the results of treatments and studies at any of their five established regional treatment centers.

[1] Gupta, Vidya Bhushan. Complementary and Alternative Medicine. New York Medical College and Columbia University, 2004. Pediatric Habilitation, volume 12.

[2] National Center for Complimentary and Alternative Medicine Accessed 2006.

[3] Levy, S. Journal of Developmental and Behavioral Pediatrics, December 2003; vol 24: pp 418-423. News release, Health Behavior News Service.