Treatments for Autism Spectrum Disorders

Parents can often be overwhelmed with information about possible interventions for Autism Spectrum Disorders.  It is important to remember that because ASD is a spectrum disorder, children may have a wide range of abilities and challenges. An intervention that works for one child may not necessarily work for another.  So watch out for people or groups who claim to be able to "cure" all children with ASD or who offer costly treatments.  Some parents feel that their children have benefited from these various therapies, but ask questions and talk to other parents and professionals. (For example, find out how long the treatment has been around, if is it individualized and based on assessment of the child, what types of studies have been done to support it, how much research support there is for it compared with other treatments, and what type of training is needed to practice it).

If the professional you are consulting strongly recommends a specific program or treatment, be aware that others will recommend another just as strongly. Also, many programs are made up from parts of several methods.  Inform yourself as much as possible.  Ultimately you know your child best and should play a role in evaluating which approaches are most effective.

Autism Community Training (B.C.) has compiled information on their website which parents can use to assess the qualifications of professionals.

The page below provides an overview of some of the more common treatments and interventions for informational purposes only.  There are also links to websites where you can learn more about each type of therapy.  We strongly recommend that you follow up by consulting a licensed professional in order to decide the best treatment plan for your child.

Treatments - Description and Resources

There are several different models of interventions for ASD.  Many of the educational and communication approaches focus on replacing dysfunctional behaviours and developing specific skills.  There are also other interventions such as biomedical or dietary treatments. The effectiveness of some approaches has been supported by scientific research.  Other newer or alternative therapies may not have been scientifically evaluated but have been reported to have produced benefits for some individuals.

Behavioural approaches
ABA - TEACCH

Developmental approaches
DIR/Floortime - RDI

Other approaches
PECS - SCERTS - Sensory Integration

Biomedical and Dietary Interventions
SCD - GFCF

Applied Behavioural Analysis (ABA)
ABA uses a variety of assessment and intervention methods in order to change behaviour and teach skills.  ABA interventions involve breaking a task down into small steps and teaching each of those steps to the child. ABA is not necessarily intensive nor is it restricted to autism or to young children.  It can be used in a broad range of situations by a variety of individuals.

Discrete Trial Teaching (DTT) is a teaching method that was pioneered by Lovaas in the 1960s and can be used in ABA programs.  Children are presented with a brief instruction or question and given a “prompt” (a clue or the answer) to help them answer correctly and receive a reward.  If they get the wrong answer, they are provided with the correct one. Data is collected and progress is evaluated on an ongoing basis.

Intensive Behaviour Intervention (IBI) or Early Intensive Behavioural Intervention (EIBI) is a general term which to describe behavioural therapies that are intensive. One-on-one therapy is provided by trained therapists.  This method is frequently used with young children.

The following article presents a history and an overview of ABA:
”The History of Applied Behaviour Analysis: It’s not just Discrete Trial Teaching”,
by Alexandra Rothstein, M.A., B.C.B.A.

“… Over the past 30 years, there have been several thousand studies published documenting the effectiveness of applied behavior analysis (ABA) across a wide range of populations (children and adult with mental illness, developmental disabilities and learning disorders, animals, geriatric patients, addicts), settings (schools, homes, institutions, group homes, hospitals, organizations and businesses), and behaviors (language, social, academic, leisure and functional life skills, aggression, self-injury, oppositional and stereotypical behaviors)…  More recently, ABA became most popular with the implementation of its principles being applied to children with autism. The field of ABA refers to a range of strategies based on research of how behavior is learned and modified. Discrete trial teaching is just one of the many teaching methodologies under the umbrella of ABA...”
Read complete article
Courtesy of Alexandra Rothstein, M.A., B.C.B.A., a Board certified Behaviour Analyst who offers private consultation for children with ASD, social skills groups and workshops in the Montreal area. Visit her web site: http://www.alexandrarothstein.com/

ABA Resources
Canadian resources:

ABACUS
Autism Ontario, 1179A King Street West, Suite 004, Toronto, ON  M6K 3C5
Tel.: (416) 246-9592 ext. 232
Fax: (416) 246-9417
http://www.abacuslist.ca/
A listing of Autism ABA Providers serving Ontario, provided by Autism Ontario.

ABA Educational Resources Ltd.
185 Vanguard Rd, Concord, Ontario L4K 5G9
Tel.: (905) 597-0140
Fax: (905) 303-3568
http://www.abaresources.com/
This site, run by a parent, is devoted to providing ABA resource materials and information.

ABA Learning Centre
100- 21320 Gordon Way, Richmond, B.C. V6W 1J8
Tel: 604-232-4122
Fax: 604-232-9515
http://www.abacentre.ca/
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ABA Learning Centre provides a wide range of services to families of children and youth with autism spectrum disorders and other complex developmental disabilities.

U.S. & International resources:

Association for Behaviour Analysis (ABA) International
1219 South Park Street, Kalamazoo MI 49001
Tel: (269) 492-9310
Fax:(269) 492-9316
http://www.abainternational.org/
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The Association for Behavior Analysis International (ABA International) is a nonprofit professional membership organization with the mission to develop, enhance, and support the growth and vitality of behavior analysis through research, education, and practice.

Behavior Analyst Certification Board
A non-profit corporation established to meet professional credentialing needs identified by behavior analysts, governments, and consumers of behavior analysis services. The BACB’s mission is to develop, promote, and implement a national and international certification program for behavior analyst practitioners.
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Website: http://www.bacb.com/

Cambridge Center for Behavioral Studies
http://www.behavior.org/autism/
336 Baker Ave., Concord, MA 01742
The Cambridge Center’s mission is to advance the scientific study of behavior and its application to the solution of practical problems.  The website offers information for professionals and parents on various treatments for ASD.

TEACCH Program (Treatment and Education of Autistic and Related Communication Handicapped Children)
Developed in the early 1970's by Eric Schopler, the TEACCH approach focuses on the person with autism and the development of a program around this person's skills, interests, and needs.  TEACCH emphasizes individualized assessment and adopting appropriate adaptations.

TEACCH Resources
TEACCH Autism Program,
Department of Psychiatry, University of North Carolina
Tel.: (919) 966-2174
Fax: (919) 966-4127
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http://www.teacch.com/

Floortime
The DIR (Developmental, Individual-Difference, Relationship-Based)/Floortime model was developed by Stanley Greenspan.  It is a treatment method and a philosophy for interaction with children (and adults as well). Floortime focuses on helping children master the building blocks of relating, communicating and thinking, at the child’s current developmental level.

Floortime Resources

The Floortime Foundation
4938 Hampden Lane, Suite 229, Bethseda, MD 20814
http://www.floortime.org/
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Relationship Development Intervention (RDI)
RDI is a parent-based intervention program, developed by Dr. Steven Gutstein. The program coaches parents and others to teach the motivation for and skills of Experience Sharing Interaction within the family environment in a day-to-day approach.   The methods have been developed for people of all ages, including teenagers and adults.
RDI Resources
Connections Center
4120 Bellaire Boulevard, Houston, Texas 77025
Phone: (713) 838-1362
Fax: (713) 838-1447
Director: Dr. Steven Gutstein
http://www.rdiconnect.com/default.asp
The Connections Center has evolved into the home of the RDI Program© and serves as a consultation and training center for professionals and families on an international scale.

Picture Exchange Communication System (PECS)
The Picture Exchange Communication System (PECS) was developed in 1985 as an augmentative training program to help children and adults with autism and other communication deficits to initiate communication.  It uses ABA-based methods to teach the person to exchange a picture for something they want, like an item or an activity.  PECS does not require complex or expensive materials. It was created with educators, resident care providers and families in mind, and so it is readily used in a variety of settings.   The materials can be purchased, or they can be made at home using images from newspapers, magazines or other books.

PECS Resources
Pyramid Educational Consultants of Canada, Inc.
2274 Lawrence Avenue Suite B, Etobicoke, Ontario M9P 2A6
Tel.: (416) 546-PECS (7327)
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http://www.pecs-canada.com/
Home website of Pyramid Educational Consultants, a U.S.-based company offering PECS-related resources and training.

Picture Card Communication
Tel.: (613) 825-4803
http://www.picturecardcommunication.com/
The website of a Canadian parent of a 23 year old son with autism who created personalized/individualized visual resources and educational materials.

SCERTS
The SCERTS™ Model (Social Communication, Emotional Regulation and Transactional Support) was developed out of 25 years of research and clinical/educational practice by Dr. Barry Prizant and a multidisciplinary team of professionals.  It combines functional language therapy, social skill development through Greenspan’s floor-time approach, sensory integration therapy, and support to the family. It focuses on the core deficits of ASD and is a comprehensive model that can be applied in a variety of settings for children with a range of abilities.

SCERTS Resources
SCERTS™ Model Website:
http://www.scerts.com/

Childhood Communication Services (Prizant website)
Barry M. Prizant, Ph.D., CCC-SLP
2024 Broad Street, Cranston, RI 02905
Barry Prizant Website
 

Sensory Integration
There are also therapies that focus on differences in processing sensory information, although to date, their effectiveness has not been supported by scientific literature.
Many children with ASD have some form of sensory difficulty, making it difficult for them to process information. Children can be over or under stimulated by light, sound, movement or touch. Different approaches are being used to deal with these sensory differences. Sensory Integration therapy aims to promote sensory integration by facilitating the ability to process sensory input.  Elements of Sensory Integration are often incorporated into a variety of interventions. An Occupational Therapist is the professional most frequently trained in dealing with sensory differences.

Sensory Integration International (Ayres Clinic)
http://www.sensoryint.com/faq.html

Sensory Integration International is a non-profit organization that promotes education, research and treatment related to sensory integration disorders. Website presents a detailed description of sensory integration dysfunction.

Temple Grandin
http://www.grandin.com/inc/intro-squeeze.html
Dr. Temple Grandin, Ph.D., who herself has autism, developed a "squeeze machine", a device that delivers deep touch pressure to help an individual learn to tolerate touching and to reduce anxiety and nervousness.

Biomedical and dietary interventions

There are anecdotal reports of benefits in regulating behaviour and enhancing overall progress in some children with ASD through modifications in diet.  To date, the effectiveness of these approaches has not been scientifically demonstrated. 

For information on some specific diets, visit the following sites:
 
Specific Carbohydrate Diet (SCD)
http://www.scdiet.org/
The SCD Web Library was founded in 1996.  It is an edited compilation of communications from on-line discussion groups of people who are experiencing good results from dietary adjustments.  It also has links to books, CDs and other resources.

Gluten and Casein Free diet:

Fondation Québécoise de la Maladie Coeliaque
http://www.fqmc.org/
French-Canadian website with information on Celiac disease.

Gluten Free-Casein Free Support Group
http://www.gfcfdiet.com/
The Official GFCF Diet Support Group Website on the Gluten free-Casein free diet with information on its use in people with ASD.

Autism Network for Dietary Intervention (ANDI)
http://www.autismndi.com/
Tel: 609-737-8985
Fax : 609-737-8453
Offers information and support to families using the gluten and casein free diet.

For comparisons and opinions on diet, biomedical and other treatment options:

Autism Research Institute
http://www.autismwebsite.com/ari/index.htm
Features some articles on special diets and biomedical supplements, as well as a study of parent ratings of behavioral effects of biomedical interventions.

Autism Watch
Autism Watch provides general information on Autism and has the goal of providing a scientific perspective on its many aspects.  It is linked with Quackwatch.com, the site of a nonprofit corporation whose purpose is to combat health-related frauds, myths, fads, fallacies, and misconduct.
http://www.autism-watch.org/
http://www.quackwatch.com/

Association for Science in Autism Treatments
http://www.asatonline.org/resources/autismtreatments.htm#applied
A U.S. website that provides general information, such as descriptions of various psychological, educational and therapeutic interventions with a brief summary of associated research, as well as a description of types of service providers.