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Treatment
Ongoing rehabilitative therapy beginning early on in childhood is recommended for individuals diagnosed with autism. While there is no definite treatment for autism, there are a variety of proposed interventions for improving the overall quality of life for individuals with this developmental disorder. Each person is impacted differently by autism and may benefit from certain treatments or interventions more than others. Therefore, treatment must be tailored according to the individual’s unique strengths and weaknesses. Such interventions include educational therapies for improving learning and developmental deficiencies as well as medical therapeutics for enhancing health and overall well-being.
Educational Therapeutic Options
The implementation of educational interventions is aimed at helping autistic individuals to enhance their cognitive and verbal skills. This educational approach has the potential to improve dysfunctional behavior while developing adaptation skills [1]. Many early intervention education programs are currently available for elementary school aged children with autism including speech therapy, music therapy, and picture symbol discrimination.
Speech Therapy
Communication deficiency is one of the most commonly noted impairments in autistic individuals. Some common difficulties observed in people with autism include pronoun reversals, word substitution and reliance on echolalia. Speech therapy addresses a wide range of communication issues and consists of teaching basic spoken language and gestural communication to both verbal and non-verbal individuals. Once a person is diagnosed with autism, a certified speech pathologist plays an essential role. Therapists often employ alternative methods of communication for non-verbal people such as signing or typing, the use of sounds, as well as the use of picture boards. If begun at an early age, continual speech therapy may assist in the development of conversational skills, the articulation of words, and enhance verbal comprehension [2].
Music Therapy
Music therapy uses music making activities to help improve communication and social interaction. Since research indicates that music is processed across several regions of the brain including, using music as a therapeutic tool may encourage integrated processing of auditory stimuli[3][4].
Picture Exchange Communication System (PECS)
This popular communication system is an augmentative training program that uses pictures to improve speech development in non-verbal children with autism. The pictorial system addresses issues such as expressive communication skills by training children to associate pictures with their corresponding real item and eventually use these pictures to convey a request to a communicative partner. This activity initiates a communicative act in non-verbal children. PECS consists of six training phases:
Phase 1: The child is prompted to exchange a single picture for a desired item.
Phase 2: More distance is placed between the child and the communicative partner during this phase. The child is required to locate a desired picture item in a communication book and request the item by travelling to his/her partner.
Phase 3: The child is given multiple picture cards and must be able to differentiate between the picture symbols to select the preferred item.
Phase 4: At this stage, the child is expected to make a request by constructing a simple sentence by utilizing a sentence strip with the phrase “I want” followed by a picture that represents the desired item.
Phase 5: Students learn to answer questions such as “what do you want?”.
Phase 6: Children are trained to comment and respond to various kinds of questions.
Overall, this exercise is intended to train students to be able to convey their wants and desires to family and friends [5].
Medical and Alternative Interventions
While no medication can completely reverse the core deficits of autism, some medical interventions have been found to be effective at managing dysfunctional behavioral symptoms that often make it difficult for people with autism to function in a home, school or work setting. Medication and dietary alterations are often recommended to treat associated symptoms such as seizures, hyperactivity, and extreme mood swings.
Pharmacological Therapies
Disruptive symptoms including hyperactivity and severe tantrums may be reduced by three types of medications including antipsychotics, antiepileptics, and antihypertensives. While these drugs have been administered to people with autism for years, not enough research evidence exists to demonstrate their efficacy[6]. Among the three drug treatment options, antipsychotics have been determined to be the most effective in controlling violent and aggressive behaviors. Administration of antipsychotic drugs must be monitored and initiated in small dosages as safety risks may include drug-associated dyskinesias. Antiepileptics reduce brain activity in children with autism who also suffer from seizures. This medication can also regulate aggressive behaviors but may exhibit long-term dangerous health implications such as irreversible damage to the liver or bone marrow. Antihypertensives are designed to lower blood pressure and are often found to regulate violent tantrums in children. The use of each of these medical interventions requires continual monitoring and regular blood testing to control any serious side effects that may arise.
Chelation Therapy
Researchers hope that alternative treatments such as chelation will prove to be effective in the treatment of autism. Chelation therapy is a controversial treatment that involves the administration of chelating agents to remove any existing metals from the body. Some researchers believe that the mercury content of vaccines caused by the presence of thimerosal is responsible for the onset of autism[7]. The removal of mercury from the body is believed to reverse the deficits associated with the neurological disorder. There is no scientific evidence that proves that the implementation of chelation therapy is an effective autism treatment.
Dietary Interventions
The use of dietary interventions for individuals with autism is becoming increasingly popular. Altering a patient’s diet may improve negative behaviors often associated with this developmental disorder. Physicians often recommend the gluten-free and casein-free diet for patients with food sensitivities. The implementation of this diet is based on the theory that people with autism are more likely to exhibit allergies to certain foods. Some believe that processing foods containing gluten and casein may intensify autistic symptoms [8]. While many families have noted improvements in gastrointestinal problems and autism-related symptoms, the effectiveness of this dietary intervention has not yet been scientifically confirmed in randomized clinical trials.
References
- ↑ Moore T, Symons, F. 2009. “Adherence to Behavioral and Medical Treatment Recommendations by Parents of Children with Autism Spectrum Disorders”. Journal of Autism & Developmental Disorders, 39(8):1173-1184.
- ↑ Demaine K, Norton A, Schlaug G, Wan C, Zipse L. 2010. “From music making to speaking: Engaging the mirror neuron system in autism.” Brain Research Bulletin. 82: 161-168
- ↑ Wigram T, Gold C. 2005 “Music therapy in the assessment and treatment of autistic spectrum disorder: clinical application and research evidence.” Child: Care, Health and Development. 32(5): 535-42
- ↑ Lim HA. 2010 “Effect of developmental speech and language training through music on speech production in children with autism spectrum disorders.” Journal of Music Therapy. 47(1):2-26
- ↑ Flippin M, Reszka S, Watson L. “Effectiveness of the Picture Exchange Communication System (PECS) on Communication and Speech for Children with Autism Spectrum Disorder: A Meta-Analysis. American Journal of Speech-Language Pathology.
- ↑ Malone R, Waheed A. 2009 “The Role of Antipsychotics in the Management of Behavioral Symptoms in Children and Adolescents with Autism”. Drugs. 69(5):535-548.
- ↑ Levy S, Hyman S. 2005. “Novel Treatments for Autistic Spectrum Disorders”. Mental Retardation and Developmental Disabilities Research Reviews. 11:131-142.
- ↑ Cornish E. 2002. “Gluten and casein free diets in autism: a study of the effects on food choice and nutrition”. Journal of Human Nutrition and Dietetics. 15(4):261-269.