TIPS FOR SELECTING SUITABLE
by Barry K. Morris B.ScWk
interventions 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.
Intervention should be Autism-specific
The therapy should be designed for children with
Autism Spectrum Disorders. If it focuses specifically on your
child's particular condition (ie. Autism
or Asperger's) so much
the better. The therapists should also take time to observe and
assess your child, then discuss the theory behind the therapy, how
it is works, and its suitability in your child's case.
An experienced therapist will acknowledge and
respect your role as a parent. You know your child best and your
involvement should be emphasized. The therapy should also provide
parents with strategies to implement in the home environment. Ideally
a therapy should give you practical approaches to use in general
common elements of effective interventions
There is a broad range of interventions styles
available, so a number of studies have looked for the common elements
in these interventions regardless of the particular style chosen
(Dawson and Osterling 1997). The effectiveness of interventions
does not seem to rely so much on the particular styles chosen, but
how well they are adapted to suit the needs and strengths of the
child and family as a whole.
The most effective interventions address the following
• Attention and concentration
• Appropriate social interaction
• Ability to imitate other people
• Language skills
• Appropriate play.
As Autism Spectrum Disorders affect a child
in many ways, effective interventions usually have a stress on a
multidisciplinary approach, with the possible involvement of occupational
therapists, speech therapists, teachers, psychologists, physiotherapists,
and of course, the parents. In the same spirit, a variety of interventions
may be used together to better address the needs of the individual
Parents are actively involved
The most effective interventions involve the parents
heavily in learning to consistently apply the intervention in their
child' life. Experienced therapists should be aware of the difficulties
faced by parents and be able to support them as issues arise.
Intensive supportive and structured teaching environment
The teaching environment focuses on the need for
routine and enabling the child to predict what will happen next.
The environment is also highly supportive and aims to generalize
strategies learnt from one context to another. The number of hours
devoted each week to interventions are important too. This can vary
from a suggested minimum of 15 hours per week (Dawson and Osterling
1997) to the 40 hours per week or more of intensive Applied
Proactive approach to challenging behaviors
There is a proactive approach to challenging
behaviors by identifying and minimizing the triggers for behavior,
and looking for what the child is trying to communicate through
the behavior. There is also an emphasis on a structured environment,
holding the child's interest and using positive
reinforcement to encourage appropriate behavior.
The most effective interventions are increasingly
stressing the need to encourage choice, independence and a focus
on the child's control of what happens during intervention.
Support for transition to school
The start of schooling
is a difficult time for children on the autism spectrum and the
most effective interventions encourage independence in a child that
makes this transition easier. Extra support is provided during this
transition and the intervention therapists should work with parents
to find the most suitable school available for their child.
Visual cues for communication
A common characteristic of children on the autism spectrum is a difficulty with verbal language. Augmentative
communication uses strategies such as the Picture Exchange Communication
System, interactive story boards and social
stories to develop communication skills.
Encourage interaction with other children
Effective interventions stress the need for a
child on the autism spectrum to engage in social interaction and
play with other children to develop appropriate communication and
Self-stimulating behaviors, rituals and obsessions
An emphasis is needed on why these behaviors occur.
Interventions should seek to minimize these behaviors when inappropriate,
but at the same time realize that as pleasurable activities they
can be used as positive reinforcement and managing stressful situations.
Some people claim miraculous benefits or cures
for children on the autism spectrum. Remember that each child has a diverse range of issues
from being on the autism spectrum and will respond to various
interventions in various ways. There are also less reputable services
providing 'cures' on the Internet that seek to exploit every parents
desire to see their child develop as normally as possible.
Some children improve substantially even without
therapy, so it is very difficult to know when therapy has definitely
made the difference. In other cases, a therapy may work so well
for one child it will appear as if it has 'cured' the Autism, but
may only have moderate to little effect for most other children.
approach uses objective rigorous testing to look at large groups
of children under a therapy, and have a 'control group' of children
not under the therapy. Unfortunately this approach has not been
applied to many new therapies so far. The next best option is to
look for general agreement on an intervention's effectiveness from
Autism associations, researchers, journals and respected books on
the autism spectrum. When a therapy is quite new, you may need
to rely on anecdotal evidence from wide range of parents who have
used the therapy. Try not to be swayed by one or two parents who
had huge success. You are looking for a substantial number of parents
who consistently report benefits. Talk to parents in support groups,
get into autism
forums and talk with Autism associations about your findings.
In your research, ask when the intervention style was developed,
how widely it is used and its evaluation from autism specialists.
Unfortunately, therapies are often very expensive. Some parents
look at creating their own home-based budget
intervention program. Your local Autism association should be
able to inform you on subsidies, government treatments and other
where to start?
Given the controversies, debates, lack of research
and variations on the autism spectrum, making general suggestions
on choosing interventions is difficult. However, there is a fairly
broad consensus that the first step is assessment by an experienced
pediatrician or team to see in which areas your child needs support.
In most cases, the next step is implementing a
behavioral program such as Applied
Behavior Analysis which is the most rigorously tested intervention
method to date. When there are sensory
problems, some form of sensory
integration therapy will prove useful. Communication
issues can be dealt with using a variety of interventions, some
of which include Applied Behavior Analysis and Social
Finally, many parents look at biomedical
interventions such as restrictive diets and vitamins, although
evidence for these is still mostly anecdotal in nature with little
research done to date. There is no one approach here that helps
all children across the autism spectrum - however some parents
find that a particular biomedical intervention can have a positive
effect. When this occurs, there is usually debate over whether the
biomedical intervention is actually treating the Autism Spectrum Disorder, or simply one of the many comorbid
to read a fact sheet about avoiding exploitation by less ethical
Click here for the full
range of Asperger's and Autism fact sheets at www.autism-help.org
This autism fact sheet is produced by autism-help.org under GNU