Caregivers should use the many accredited bodies that tell us which therapies are most effective for autism. There is not one sole treatment for autism, but rather a menu of options for caregivers and individuals to choose from to address the unique needs of the person with autism. We know that the highest number, over 90%, of children with autism receive speech therapy given the core communication and social deficits of autism. Over 50% receive behavioral intervention or ABA therapy. Over 75% receive occupational therapy services. In best situations children will receive a combination of school-based therapy services and outpatient medical or community mental health therapies to augment what they receive in the school system which is driven by their classroom and curriculum needs. We see the use of many other conventional therapies used effectively with children with autism to address specific issues related to toe-walking, low muscle tone, food aversions, fine motor or attentional delays, among others. People with autism also demonstrate a variety of concomitant developmental and medical issues that are addressed through psychological, rehabilitative, and medical therapies.
Autism Therapy Disciplines
Autism looks differently in each individual. The shared or core features of autism make speech-language, social, and behavioral treatments among the most popular treatments for autism. A wide variety of mental health and rehabilitation therapists provide therapy for people with autism. Each discipline or therapist comes from a different focus of study, background knowledge or expertise, and ideas or approaches to therapy. However these therapies may look similar in the goals that they address and the techniques used to address those goals. Caregivers and individuals with autism have the autonomy to decide which therapies best fit their loved ones circumstance, and should monitor the outcomes of the treatments in which they choose to spend their valuable time.
The Michigan insurance legislation identified core disciplines that should be paid for the treatment of autism including board certified behavior analysts (BCBA), speech-language pathologists (SLP), occupational therapy (OT), physical therapy (PT), and nutrition therapy. All of these therapies have professional organizations and guidelines that monitor their clinical practice, and all except for BCBAs are licensed by the State of Michigan. A bill to license BCBAs in Michigan is currently in progress. The behavior technicians or ‘tutors’ as they are often referred are non-licensed and often non-degreed staff that work under the supervision and responsibility of the BCBA to regulate them.
Evidence Based Therapies
‘Evidence-based’ therapies are those that have been proven to be effective in the scientific literature or professional journals. This means that any other individual who used the treatment in the way that it was designed would find the same benefit in persons with autism. We use the National Autism Center’s published work in the National Standards Project as a guide to identifying which therapies are best proven to be effective. The terms used are:
Established Interventions- those that are well proven to be effective
Emerging Interventions- those that have one or more study that suggest it is effective, however are in need of additional studies
Unestablished- those with little or no evidence in the scientific literature to assure effectiveness and no way to rule out that they are harmful
The current list of established treatments for individuals under 22 years of age include:
- Behavioral Intervention
- Cognitive Behavior Therapy
- Language Production Training
- Natural Teaching Strategies
- Parent Training
- Peer Training
- Pivotal Response Therapy
- Social Skills
- Story-based Interventions
- Emerging therapies for children up to 22 years old include:
- Augmentative and Alternative Communication
- Developmental Relationship-based Therapy
- Functional Communication Training
- Imitation and Imitation Training
- Language Training- Production and Understanding
- Multi-Component Therapy
- Music therapy
- Picture Exchange Communication Therapy
- Reductive Therapy
- Social Communication
- Structured Teaching
- Technology Based Intervention
- Theory of Mind Training
Complementary and Alternative Treatments
These fall under the category of Unestablished Treatments for autism and are not typically paid for by insurance companies and can consume a lot of time and money on the part of families. Some individuals or families have reported improvement with these therapies, however their presence in the unestablished category suggests that there is no guarantee of effectiveness. It is suggested that parents should seek early and intensive treatment in proven treatments for autism.
Some examples of unestablished therapies include:
- Animal-assisted therapy
- Auditory Integration Training
- Concept Mapping
- Movement-based Intervention
- Sense Theatre Intervention
- Sensory Therapies
- Shock Therapy
- Social Behavioral Learning
- Social Thinking
Treatment for Adults with Autism
For individuals over 22 years old Behavioral Intervention strategies have proven to be effective.
Research on emerging therapies for individuals over 22 years of age with autism have shown promise in Vocational Training.
Unestablished therapies for the adult population include music therapy, modeling, cognitive-behavioral, and sensory integration therapies. Some of these interventions made be highly enjoyable for adults on the autism spectrum and ways that adults may choose to spend their time regardless of the guarantee of improvement on skills.