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Best Treatment Options for Aspergers and HFA

"What are some of the better treatment options for children on the autism spectrum?"

While there is no cure for Aspergers or High Functioning Autism (HFA), treating it early with proper school-based programs and medical care can (a) greatly reduce symptoms and (b) increase your youngster's ability to grow and learn new skills.

Early Intervention—

Research has shown that intensive behavioral therapy during the toddler or preschool years can significantly improve cognitive and language skills in young kids with Aspergers and HFA. There is no single best treatment for all kids, but the American Academy of Pediatrics recently noted common features of effective early intervention programs. These include:
  1. Encouraging activities that include typically developing kids, as long as such activities help meet a specific learning goal
  2. Guiding the youngster in adapting learned skills to new situations and settings and maintaining learned skills
  3. Having small classes to allow each youngster to have one-on-one time with the therapist or teacher and small group learning activities
  4. Having special training for moms and dads and family
  5. Measuring and recording each youngster's progress and adjusting the intervention program as needed
  6. Providing a high degree of structure, routine, and visual cues, such as posted activity schedules and clearly defined boundaries, to reduce distractions
  7. Providing focused and challenging learning activities at the proper developmental level for the youngster for at least 25 hours per week and 12 months per year
  8. Starting as soon as a youngster has been diagnosed with Aspergers
  9. Using a curriculum that focuses on:
  • Cognitive skills, such as pretend play or seeing someone else's point of view- Language and communication
  • Research-based methods to reduce challenging behaviors, such as aggression and tantrums
  • Self-help and daily living skills, such as dressing and grooming
  • Social skills, such as joint attention (looking at other people to draw attention to something interesting and share in experiencing it)
  • Typical school-readiness skills, such as letter recognition and counting

One type of a widely accepted treatment is Applied Behavior Analysis (ABA). The goals of ABA are to shape and reinforce new behaviors, such as learning to speak and play, and reduce undesirable ones. ABA, which can involve intensive, one-on-one child-teacher interaction for up to 40 hours a week, has inspired the development of similar interventions that aim to help children with Aspergers and HFA reach their full potential. ABA-based interventions include:
  • Pivotal Response Training: Aims at identifying pivotal skills, such as initiation and self-management that affect a broad range of behavioral responses. This intervention incorporates parent and family education aimed at providing skills that enable the youngster to function in inclusive settings.
  • Verbal Behavior: Focuses on teaching language using a sequenced curriculum that guides kids from simple verbal behaviors (echoing) to more functional communication skills through techniques such as errorless teaching and prompting.

Other types of early interventions include:
  • TEACCH (Treatment and Education of Autistic and related Communication handicapped Kids): Emphasizes adapting the youngster's physical environment and using visual cues (e.g., having classroom materials clearly marked and located so that students can access them independently). Using individualized plans for each student, TEACCH builds on the youngster's strengths and emerging skills.
  • Interpersonal Synchrony: Targets social development and imitation skills, and focuses on teaching kids how to establish and maintain engagement with others.
  • Developmental, Individual Difference, Relationship-based (DIR) / Floortime Model: Aims to build healthy and meaningful relationships and abilities by following the natural emotions and interests of the youngster. One particular example is the Early Start Denver Model, which fosters improvements in communication, thinking, language, and other social skills and seeks to reduce atypical behaviors. Using developmental and relationship-based approaches, this therapy can be delivered in natural settings such as the home or pre-school.

For kids younger than age 3, these interventions usually take place at home or in a childcare center. Because moms and dads are a youngster's earliest educators, more programs are beginning to train moms and dads to continue the therapy at home.

Children on the autism spectrum may benefit from some type of social skills training program. While these programs need more research, they generally seek to increase and improve skills necessary for creating positive social interactions and avoiding negative responses. For example, Children’s Friendship Training focuses on improving kid's conversation and interaction skills and teaches them how to make friends, be a good sport, and respond appropriately to teasing.

Working With Schools—

Start by speaking with your youngster's teacher, school counselor, or the school's student support team to begin an evaluation. Each state has a Parent Training and Information Center and a Protection and Advocacy Agency that can help you get an evaluation. A team of professionals conducts the evaluation using a variety of tools and measures. The evaluation will look at all areas related to your youngster's abilities and needs.

Once your youngster has been evaluated, he has several options, depending on the specific needs. If your youngster needs special education services and is eligible under the Individuals with Disabilities Education Act (IDEA), the school district (or the government agency administering the program) must develop an individualized education plan, or IEP specifically for your youngster within 30 days.

IDEA provides free screenings and early intervention services to kids from birth to age 3. IDEA also provides special education and related services from ages 3 to 21. Information is available from the U.S. Department of Education.

If your youngster is not eligible for special education services (not all kids on the spectrum are eligible) he can still get free public education suited to his or her needs, which is available to all public-school kids with disabilities under Section 504 of the Rehabilitation Act of 1973, regardless of the type or severity of the disability.

The U.S. Department of Education's Office for Civil Rights enforces Section 504 in programs and activities that receive Federal education funds. More information on Section 504 is available on the Department of Education website.

During middle and high school years, your youngster's educators will begin to discuss practical issues such as work, living away from a parent or caregiver's home, and hobbies. These lessons should include gaining work experience, using public transportation, and learning skills that will be important in community living.


Some medications can help reduce symptoms that cause problems for your youngster in school or at home. Many other medications may be prescribed off-label, meaning they have not been approved by the U.S. Food and Drug Administration (FDA) for a certain use or for certain people. Physicians may prescribe medications off-label if they have been approved to treat other disorders that have similar symptoms to Aspergers, or if they have been effective in treating adults or older kids with Aspergers and HFA. Physicians prescribe medications off-label to try to help the youngest patients, but more research is needed to be sure that these medicines are safe and effective for kids and teens with the disorder.

At this time, the only medications approved by the FDA to treat aspects of ASDs are the antipsychotics risperidone (Risperdal) and aripripazole (Abilify). These medications can help reduce irritability—meaning aggression, self-harming acts, or temper tantrums—in kids ages 5 to 16 who have the disorder.

Some medications that may be prescribed off-label for kids on the spectrum include the following:
  • Stimulant medications, such as methylphenidate (Ritalin), are safe and effective in treating people with attention deficit hyperactivity disorder (ADHD). Methylphenidate has been shown to effectively treat hyperactivity in kids with Aspergers and HFA as well. But not as many kids with the disorder respond to treatment, and those who do have shown more side effects than kids with ADHD and not ASDs.
  • Antipsychotic medications are more commonly used to treat serious mental illnesses such as schizophrenia. These medicines may help reduce aggression and other serious behavioral problems in kids, including kids with Aspergers and HFA. They may also help reduce repetitive behaviors, hyperactivity, and attention problems.
  • Antidepressant medications, such as fluoxetine (Prozac) or sertraline (Zoloft), are usually prescribed to treat depression and anxiety but are sometimes prescribed to reduce repetitive behaviors. Some antidepressants may also help control aggression and anxiety in kids on the autism spectrum. However, researchers still are not sure if these medications are useful; a recent study suggested that the antidepressant citalopram (Celexa) was no more effective than a placebo (sugar pill) at reducing repetitive behaviors in these young people.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism


Do you need the advice of a professional who specializes in parenting children and teens with Autism Spectrum Disorders?  Sign-up for Online Parent Coaching today.



Anonymous said...

MR. Hutten
I had so send you a message. Your information has been a god send. It Has been so wonderful and informative I can not even begin to tell you how alone I have felt for these last 16 years. My Husband's head is totally is the sand and the school dept has fought me on everything. my daughter is very high functioning, however all the social and behavioral anxiety etc....and much more is there. It has destroyed our family. As hard as Ive tried it has taken a huge toll on my other daughter as well. Thank you so very much for this web site .

Anonymous said...

Hello, Mark –

I have downloaded the book and read most of it already! Thank you very much.

My 7-year-old son was diagnosed with Asperger’s this summer and in the process of the evaluation, my husband and I both realized that my 21-year-old stepson also has it (although he internalizes rather than externalizing like the 7-year-old). I also came to realize that my husband, although he does not have an actual diagnosis and might not technically qualify for one, has MANY Aspergian traits. Just realizing that has helped me to “cut him a little slack” but your book is helpful as well.

I subscribe to your newsletter and appreciate the information you provide. Thank you for all your work in this field.

Best regards,

Anonymous said...

my son used to bottle up his feelings all day trying so hard to blend in and not act 'weird' he used to melt down every day when he got home. A change of school, growing up and us all working together to understand the things that stressed him out has got rid of all that. He is 16 and has just completed year 11 exams with a fairly normal level of teenage stress behaviour

Anonymous said...

Here's my question: a lot of my son's "challenging"/aggressive behavior gets saved up for when he gets home from school. I am currently not getting any training from the school on how to cope with this at home to spite my repeated requests. Is this something they should be providing? Any ideas? I know that this is an important part of the equation. I feel like he has a lot of the supports he needs at school, but I don't feel like I have the support to give him what he needs at home.

Anonymous said...

We asked the school to add in a Resource class with a special ed teacher at the end of each day - even if just for 20 minutes so that he had someone to vent his day to. Especially since I cannot solve all the school issues. If he at least had an ear at school who could help him problem solve, then he didn't have to vent it all at home. I have a wonderful 12 year old son.

Anonymous said...

my son used to bottle up his feelings all day trying so hard to blend in and not act 'weird' he used to melt down every day when he got home. A change of school, growing up and us all working together to understand the things that stressed him out has got rid of all that. He is 16 and has just completed year 11 exams with a fairly normal level of teenage stress behaviour

My child has been rejected by his peers, ridiculed and bullied !!!

Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

How to Prevent Meltdowns in Children on the Spectrum

Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

Click here for the full article...

Parenting Defiant Teens on the Spectrum

Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

Click here to read the full article…

Older Teens and Young Adult Children with ASD Still Living At Home

Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

Click here to read the full article…

Parenting Children and Teens with High-Functioning Autism

Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

Click here
to read the full article...

Highly Effective Research-Based Parenting Strategies for Children with Asperger's and HFA

Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

Click here for the full article...