Early intervention is key to optimal outcomes for kids on the autism spectrum. There's little doubt that young people with Asperger’s (AS) and High-Functioning Autism (HFA) who undergo therapy at an early age, be it behavioral or developmental, do better than kids who don't. And there's certainly no good reason for parents to wait to provide such therapy. Even a little progress is far better than none, especially when that progress comes in the form of new social skills that allow the special needs youngster to “fit-in” with his or her peer-group. While early intervention is extremely important, intervention at any age can be helpful.
Even if your youngster has not been diagnosed with AS or HFA, he may be eligible for early intervention treatment services. The Individuals with Disabilities Education Act states that kids under the age of 3 who are at risk of having developmental delays may be eligible for services. In the U.S., these services are offered through an early intervention system in each State. Through this system, parents can ask for an evaluation. Also, treatment for particular symptoms (e.g., speech therapy for language delays) often does not need to wait for a formal diagnosis.
The first five years of life are crucial to a child’s development and growth. To intervene before age five can help the AS or HFA youngster learn new social and communication skills at a time when she is most able to grasp them. In addition, she can unlearn problematic behaviors before they become deep-rooted. Kids on the autism spectrum who are younger are usually easier to teach because they have less time to develop unwanted behaviors before they become habit. For example:
- Speech therapy works best with younger kids. Correcting errors in speech early on can be easier than waiting years later after the youngster has already become used to certain mouth movements and pronunciations.
- It is easier to implement new dietary interventions with a younger boy or girl before long-term food preferences are entrenched. A preschool child, while having some food preferences of course, can often be convinced to change her diet with repeated introductions to new foods. This is essential since many therapeutic interventions address possible food allergies (e.g., gluten, casein).
- It is much easier to teach a 4-year-old not to tantrum as compared to a 7-year-old.
There are many different types of therapies available (e.g., vitamin therapy, sensory integration therapy, physical therapy, occupational therapy, speech therapy, music therapy, facilitated communication, discrete trial training, auditory training, anti-yeast therapy, etc.). The different types of therapies can generally be broken down into four categories:
- Dietary Interventions
- Complementary and Alternative Medicine
- Behavior and Communication Interventions
Medication— While there are no medications that can “cure” AS or HFA, or even treat the main symptoms, there are medications that can help most children with related symptoms (e.g., hyperactivity, inability to focus, anxiety, depression, seizures, etc.). (Click here for more information.)
Dietary Interventions— Many biomedical interventions call for changes in the child’s diet (e.g., removing certain types of foods, using vitamin or mineral supplements, etc.). Dietary therapies are based on the idea that the lack of certain supplements and/or food allergies cause (or worsen) symptoms of AS and HFA. (Click here for more information.)
Complementary and Alternative Therapies— To relieve the symptoms of AS and HFA, some moms and dads use therapies that are outside of what is typically recommended by their doctor (e.g., special diets, treatment to remove heavy metals like lead from the body, biologicals, deep pressure, etc.). (Click here for more information.)
Behavior and Communication Interventions— Behavior and communication methods that help kids with AS and HFA are those that provide structure, direction, and organization for the youngster in addition to family participation. A notable treatment method for these special needs children is called Applied Behavior Analysis (ABA). ABA has become widely accepted among mental health professionals and is used in many schools and treatment facilities. ABA discourages negative behaviors and encourages positive behaviors in order to improve a variety of skills. There are different types of ABA (click here for more information), for example:
- Verbal Behavior Intervention (VBI) is a type of ABA that focuses on teaching verbal skills.
- Pivotal Response Training (PRT) aims to increase the AS or HFA youngster’s motivation to learn, monitor her own behavior, and initiate communication with others.
- Early Intensive Behavioral Intervention (EIBI) is a type of ABA for younger kids on the autism spectrum (below the age of 5).
- Discrete Trial Training (DTT) is a type of therapy that uses a series of trials to teach each step of a desired behavior or response. Lessons are broken down into their simplest parts, and positive reinforcement is used to reward correct answers and behaviors while incorrect answers are ignored.
Additional Therapies— Other therapies that can be part of a complete treatment program for a youngster with AS or HFA include the following:
- The Picture Exchange Communication System (PECS) uses picture symbols to teach communication skills. The child is taught to use picture symbols to ask and answer questions and have a conversation.
- TEACCH uses visual cues to teach certain skills (e.g., picture cards can help teach a youngster how to get dressed by breaking information down into small steps).
- Speech therapy helps to improve the child’s communication skills.
- Sensory integration therapy helps the child deal with sensory information. The therapy aids the AS or HFA youngster who is troubled by certain tastes, smells, sounds, or does not like to be touched.
- Occupational therapy teaches skills that help the AS or HFA adult live as independently as possible.
- FLOORTIME focuses on emotional and relational development (e.g., feelings, relationships with parents/teachers/peers). It also focuses on how the youngster deals with sensory overload.
What about moms and dads whose kids on the spectrum weren’t identified soon enough for early intervention?
Many kids with AS and HFA are indeed “high-functioning” enough that they are not identified until they enter elementary school. It is only as they get older and their classmates surpass them socially and behaviorally that problems become noticeable. Not every youngster shows signs of autism before the age of 6, or the signs are so few and far between that they are missed. The higher-functioning youngster can compensate for his deficits, and peers may just pass him off as being odd or “quirky.” The entire pattern of behavior has to be evaluated, and unless the youngster is having issues that significantly disrupt his daily functioning at home or school, no “red flags” pop up.
Parents should not blame themselves in this case. Simply begin the process of seeking help when you discover the need for it. Later intervention is certainly better than no intervention. Rather than dwelling on what wasn’t done or what you “should have noticed,” focus on what can be done now. With the right intervention, older kids with AS and HFA (since they are high-functioning) can catch up rather quickly in most cases.
Teaching Social Skills and Emotion Management