DESENSITIZATION

Systematic desensitization is a type of behavioral therapy that can be used to help children or adults with autism and Asperger's syndrome effectively overcome phobias and other anxiety disorders. It is based on the behavioral techniques involved in Applied Behavior Analysis and the Lovaas program.

To begin the process of systematic desensitization in a clinical setting, the individual is usually first taught relaxation skills in order to control fear and anxiety responses to specific phobias. These are then used to react towards and overcome situations in an established hierarchy of fears. The goal of this process is that an individual will learn to cope and overcome the fear in each step of the hierarchy, which will lead to overcoming the last step of the fear in the hierarchy. Systematic desensitization is sometimes called graduated exposure therapy. However, in a home-based situation, relaxation skills will not normally be required unless there is a high degree of anxiety or fear from the child.

An example of desensitization would be introducing new foods to a child on the autism spectrum who has problems with the smell, taste and texture of certain foods. Its gradual introduction can help the child to become desensitized to the smell, look and texture of an unfamiliar food. The first step would be to try a food that has the best chance of suiting your child's preferences. It may just sit on a plate near theirs for several nights. The next few dinners, it may be placed on their plate but with no expectation made of the child to eat it. Next, the family may try the new food and show their enjoyment. With gradual introduction no negative effects from exposure, the child will usually try the new food eventually.

Clinical Procedure of desensitization

Specific phobias are one class of mental illness often treated through the cognitive-behavioral process of systematic desensitization. When individuals possess irrational fears of an object, such as height, dogs, snakes, and close spaces, they tend to avoid it. Since escaping from the phobic object reduces their anxiety, the individual’s behavior to reduce fear is reinforced through negative reinforcement, a concept defined in classical conditioning.

The goal of desensitization is to overcome this avoidance pattern by gradually exposing individuals to the phobic object until it can be tolerated. This will be challenging for the individual at first to deal with the fear, but gradually, most will overcome this fear. In classical and operant conditioning terms the elicitation of the fear response is extinguished to the stimulus (or class of stimuli).

Coping Strategies

In a clinical setting the therapist teaches the individual some cognitive strategies prior to exposure to cope with anxiety. This is necessary because it provides the individual with a means of controlling their fear, rather than letting it build until it becomes unbearable. Relaxation training, such as meditation, is one type of coping strategy. Individuals who have serious anxiety that leads to breathing problems, might be taught to focus on their breathing or to think about happy situations.

Another means of relaxation is cognitive reappraisal of imagined outcomes. The therapist might encourage subjects to examine what they imagine happening when exposed to the phobic object, allowing them to recognize their catastrophic visions and contrast them with the actual outcome. For example, a individual with a snake phobia might realize that they imagine any snake they encounter would coil itself around their neck and strangle them, when this would not actually occur. These individuals need to see that not all snakes are large and that most snakes are completely harmless so that they can get over their fear. Research at the University of Pennsylvania has demonstrated the effectiveness of this technique in helping subjects reduce similar animal phobias.

Progressive Exposure

The second component of systematic desensitization is gradual exposure to the feared object. Continuing with the snake example, the therapist would begin by asking their individual to develop a fear hierarchy, listing the relative unpleasantness of various types of exposure. For example, seeing a picture of a snake in a newspaper might be rated 5 of 100, while having several live snakes crawling on one’s neck would be the most fearful experience possible. Once the individual had practiced their relaxation technique, the therapist would then present them with the photograph, and help them calm down. They would then present increasingly unpleasant situations: a poster of a snake, a small snake in a box in the other room, a snake in a clear box in view, touching the snake, etc. At each step in the progression, the individual is desensitized to the phobia through the use of the coping technique. They realize that nothing bad happens to them, and the fear gradually extinguishes.

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This autism fact sheet is licensed under the GNU Free Documentation. It is derivative of a Desensitization article at http://en.wikipedia.org