گفتار درمانی و توانبخشی پایگاه اطلاع رسانی گفتار توان گستر
Discovering that your child has an autism spectrum disorder (ASD) can be an
overwhelming experience. For some, the diagnosis may come as a complete
surprise; others may have had suspicions and tried for months or years to get an
accurate diagnosis. In either case, a diagnosis brings a multitude of questions
about how to proceed. A generation ago, many people with autism were placed in
institutions. Professionals were less educated about autism than they are today
and specific services and supports were largely non-existent. Today the picture
is much clearer. With appropriate services and supports, training, and
information, children on the autism spectrum will grow, learn and flourish, even
if at a different developmental rate than others
While there is no known cure for autism, there are treatment and education
approaches that may reduce some of the challenges associated with the condition.
Intervention may help to lessen disruptive behaviors, and education can teach
self-help skills that allow for greater independence. But just as there is no
one symptom or behavior that identifies individuals with ASD, there is no single
treatment that will be effective for all people on the spectrum. Individuals can
learn to function within the confines of ASD and use the positive aspects of
their condition to their benefit, but treatment must begin as early as possible
and be tailored to the child's unique strengths, weaknesses and needs
Throughout the history of the Autism Society of America, parents and
professionals have been confounded by conflicting messages regarding what are,
versus what are not, appropriate treatment approaches for children and adults on
the autism spectrum
The purpose of this section is to provide a general overview of a variety of
available approaches, not specific treatment recommendations. Keep in mind that
the word "treatment" is used in a very limited sense. While typically used for
children under 3, the approaches described herein may be included in an
educational program for older children as well
It is important to match a child's potential and specific needs with treatments
or strategies that are likely to be effective in moving him/her closer to
established goals and greatest potential. ASA does not want to give the
impression that parents or professionals will select one item from a list of
available treatments. A search for appropriate treatment must be paired with the
knowledge that all treatment approaches are not equal, what works for one will
not work for all, and other options do not have to be excluded. The basis for
choosing any treatment plan should come from a thorough evaluation of the
strengths and weaknesses observed in the child
Understanding
Your Options
Treatment approaches are constantly evolving
as more is learned about the autism
spectrum. There are many therapeutic
programs, both conventional and
complementary, that focus on replacing
dysfunctional behaviors and developing
specific skills
As a parent, it's natural to want to do
something immediately. The literature states
time and time again the importance of early
treatment for individuals on the autism
spectrum However, it is important not to
rush in with changes. It does no good to
push ahead with a treatment that is not
appropriate for the individual or one that
may be harmful. You also much consider the
larger implications of beginning a new
treatment. A child may have already learned
to cope with his or her current environment
and sudden changes or unexpected different
expectations could be stressful and
confusing. Various treatment approaches
should be investigated and information
gathered concerning various options before
proceeding with any child's treatment
Parents will encounter numerous accounts
from other parents about successes and
failures with many of the treatment
approaches mentioned. Professionals also
differ in their theories of what they feel
is the most successful treatment for autism.
It can be frustrating! Parents do learn to
sift through the information, examine
options with a critical eye and make
rational, educated decisions on what is
appropriate given the individual
circumstance. Parents live with the
individual on the spectrum every day and
best know his/her needs and the unique ways
that autism impacts their lives. Parents
must be empowered to trust their instincts
as various options are explored, considered
and implemented
The descriptions of treatment approaches
provided here are for informational purposes
only. They serve as overviews and should
always be followed with contact with
qualified professionals and should be
discussed with parents or individuals on the
spectrum who have person experiences. The
Autism Society of America does not endorse
any specific treatment or therapy
While doing research, parents and
professionals will hear about many different
treatments approaches, such as auditory
training, discrete trial training, vitamin
therapy, anti-yeast therapy, facilitated
communication, music therapy, occupational
therapy, physical therapy, and sensory
integration. These approaches can generally
be broken down into
three categories
Learning Approaches
Biomedical & Dietary Approaches
Complementary Approaches
Some of these treatment approaches have research studies that support their
efficacy; others may not. Some parents will only want to try treatment methods
that have undergone research and testing and are generally accepted by the
professional community. But keep in mind that scientific studies are often
difficult to do since each individual on the autism spectrum is different
For others, formal testing might not be a pre-requisite for them to try a
treatment with their child. Even for those with "scientific" proof, the Autism
Society of America recommends that all options available are investigated to
determine the approach that is most appropriate
Experts agree though, that early intervention is important in addressing the
symptoms associated with ASD. The earlier treatment is started, the more
opportunity for the individual to reach their highest potential. Many of the
approaches described can be used on children as young as age 2 or 3. They may
also continue to be used in conjunction with special education programs or
traditional elementary school for children who are mainstreamed
Programs for
Children Under 3
If a child is younger than 3 years old, he
or she is eligible for "early intervention"
assistance. This federally-funded program is
available in every state, but may be
provided by different agencies. Contact the
local chapter of the Autism Society of
America in your area for more specific
information, search program listings in
Autism Source™ located on the web at
http://www.autismsource.org/, or obtain a
state resource sheet from the National
Information Center for Children and Youth
with Disabilities
This early education assistance may be
available in two forms: home-based or
school-based. Home-based programs generally
assign members of an early intervention team
to come to the home to train parents or
caregivers to educate the child on the
spectrum. School-based programs may be in a
public school or a private organization.
Both of these programs should be staffed by
teachers and other professionals who have
experience working with children with
disabilities specifically autism. Related
services should also be offered, such as
speech, physical or occupational therapy,
depending on the needs of each child. The
program may be only for children with
disabilities or it may also include
typically developing peers
Programs for
School-Aged Children
From the age of
3 through the age of 21, every child
diagnosed on the autism spectrum is
guaranteed a free appropriate public
education supplied by the local education
agency. The Individuals with Disabilities
Education Act (IDEA) is a federal mandate
that guarantees this education. Whatever the
level of impairment, the educational program
for an individual on the autism spectrum
should be based on the unique needs of the
student, and thoroughly documented in the
IEP (Individualized Education Program). If
this is the first attempt by the parents and
the school system to develop the appropriate
curriculum, conducting a comprehensive needs
assessment is a good place to start. Consult
with professionals who are well versed in
the spectrum of autism and related
conditions about the best possible
educational methods that will be effective
in assisting the student to learn and
benefit from his/her school program.
Educational programming for students with
ASD often addresses a wide range of skill
development, including: academics, language,
social skills, self-help skills, behavioral
issues, and leisure skills
Parents can and should be an active and
equal participant in deciding on an
appropriate educational plan for their
child. Parents know the child best and can
provide valuable information to teachers and
other professionals who will be providing
educational services. Collaboration between
parents and professionals is essential; open
communication will certainly lead to better
evaluation of progress and improved outcomes
for the student
To learn about other services specific to an
area, contact resources in the community,
such as the local ASA chapter, a local
University Affiliated Program for
Developmental Disabilities, the local ARC,
Easter Seals, or Parent Training and
Information Center. Be persistent but be
patient it may take days or weeks to find
the information you need. If a local
resource is not able to provide the
information or services sought, ask for a
referral to another agency or local resource
that may be helpful
Evaluating
Approaches
Because no two
children on the autism spectrum have the
exact same symptoms and behavioral patterns,
a treatment approach that works for one
child may not be successful with another.
This makes evaluating different approaches
difficult and that much more essential.
There is little comparative research between
treatment approaches. Primarily this is
because there are too many variables that
have to be controlled. So, it's no wonder
that parents might be confused about what to
do
The Autism Society of America has long
promoted the empowerment of individual
consumers (including people on the spectrum,
parents and professionals) to critically
examine a variety of available options and
be forearmed with a set of parameters under
which they can better determine associated
threats and opportunities and, therefore,
make informed decisions. Further, better
educated consumers, would help control the
embracing of unproven notions that may
distract from effective courses of treatment
for individuals with ASD
In the article "Behavioral and Educational
Treatment for Autistic Spectrum Disorders"
(Autism Advocate, Volume 33, No. 6), Bryna
Siegel, Ph.D., suggests thinking about "each
symptom as an autism specific learning
disability…" that tells "something about a
barrier to understanding." Using this model,
what the student can and cannot do well can
be evaluated. "…take stock of which autistic
learning disabilities are present," and
"then select treatments that address that
particular child's unique autism learning
disability profile
Understanding these learning differences is
the first step in assessing whether a
specific treatment approach may be helpful;
understanding a child's strengths is equally
important. For example, some children are
good visual learners, while another child
may need written, rather than oral, cues
Finding
Treatment Programs in Your Area
Once familiar
with the treatments that are available and
appropriate for individuals with ASD,
parents begin to think about where they can
receive these services. Treatments may be
obtained through either the medical or
educational community, depending on the
nature of the treatment. There are also a
variety of resources useful in finding
qualified professionals or service providers
in your area. There are several state
agencies established to provide this type of
information and support, including
Protection and Advocacy agencies;
Developmental Disabilities Councils;
Vocational Rehabilitation Centers; Parent
Training Centers; and Educational Resources.
Local chapters of the Autism Society of
America are run by parents of individuals on
the autism spectrum and have been
established to provide guidance, advice and
referrals to programs and professionals in a
specific geographic region.