Autism Spectrum Disorder - Treatments and Therapies
Autism Spectrum Disorder (ASD) is a lifelong neurological condition typically appearing in the first three years of life, marked by pervasive impairment in the areas of social skills and communication. ASD is often associated with hyper or hypo- reactivity to sensory inputs, the unusual interest of stereotypical rituals or behaviors, and may or may not be accompanied by intellectual impairment. Autism Spectrum Disorder encompasses autistic disorder, Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorder. Individuals with ASD often present other co-occurring conditions, including epilepsy, depression, anxiety, and attention deficit hyperactivity disorder (ADHD).
Signs and symptoms of ASD
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM- 5), a guide developed by the American Psychiatric Association to diagnose mental disorders, individuals with ASD have:
- Difficulty in communication and interaction with other people
- Restricted interests and repetitive behaviors
- Symptoms that hurt the person's ability to function properly in school, work, and other areas of life
Common types of behaviors seen in people diagnosed with ASD
Not all people with ASD will show all behaviors, but most will show several. Individuals with ASD may also experience sleep problems and irritability. Despite these challenges, they may have many strengths, including:
- Ability to learn things in detail and remember information for long periods
- Healthy visual and auditory learning ability
- Excellence in maths, science, music, or art
Causes and Risk Factors
While scientists don't know the exact causes of ASD, research suggests that genes can act together with influences from the environment to affect development in ways that lead to ASD. Although scientists are still trying to understand why some people develop ASD and others don't, some risk factors include:
- Having a sibling with ASD
- Childbearing in older age
- Genetic conditions—people with conditions such as Down syndrome, fragile X syndrome, and Rett syndrome are more likely than others to have ASD
- Low birth weight
Treatments and Therapies
Treatment for ASD should begin as soon as it was diagnosed. Early treatment for ASD is necessary as proper care can reduce individuals' difficulties while helping them learn new skills and make the most of their strengths. The wide range of issues faced by people with ASD is the unavailability of a single best treatment. Working closely with a doctor or health care professional is an integral part of finding the right treatment program.
A physician can suggest or recommend appropriate medicines to treat some symptoms that are common with ASD. With medication, a person with ASD may have fewer problems with:
- Repetitive behavior
- Attention problems
- Anxiety and depression
Behavioral, psychological, and educational therapy
People with ASD may be referred to doctors who specialize in providing behavioral, psychological, educational, or skill-building interventions. These programs are typically highly structured and intensive and may involve parents, siblings, and other family members. Programs may help people with ASD to:
- Learn life-skills necessary to live independently
- Reduce challenging behaviors
- Increase or build upon strengths
- Learn social, communication, and language skills
People with ASD have many sensory issues. They have/report problems with their perceptual processing, integration, and interpretations of the passages and meanings of different units/experiences of time. An occupational therapist works on sensory integration activities and daily living skills, such as toilet training, dressing, brushing, and other grooming skills. OT is effective in enhancing fine-motor skills required for holding objects while writing or cutting with scissors, and gross-motor skills for walking or riding a bicycle. OT is also useful in modifying/increasing perceptual skills, visual skills, and social skills.
Speech & Language Therapy Occupational Therapy (OT)
The goal of speech & language intervention is to facilitate overall language development and functional, everyday communication. The selection of treatment options and approaches are based on the individual's current level of language functioning and may reflect views on language acquisition patterns in children with ASD and the role of echolalia. Speech therapy intervention addresses functional disorders such as articulation and phonology and motor speech disorders such as apraxia of speech and dysarthria. Language therapy intervention approaches incorporate a variety of instructional strategies to improve word decoding, word identification, reading fluency, reading vocabulary, and reading comprehension across a variety of materials and in several contexts. Older children with ASD may also have difficulty with higher-level literacy skills that require the theory of mind. Depending on the student's skill level, instructional strategies might include engaging in shared book reading, teaching literacy in natural contexts, labeling objects or pictures to promote sight word reading, reading and writing about personal experiences, promoting phonological awareness, and teaching the student how to monitor comprehension while reading.
Autism treatment in AMMA
In AMMA, treatment for Autism Spectrum Disorder is done by a multidisciplinary team comprising Clinical Psychologist, Occupational therapist, Speech and language pathologist and Special educators, inclusive with parents and caretakers. This approach helps the child acquire functional skills in daily living, manage the core features associated with the disorder, and eliminate the behaviors that are unhelpful or disruptive. The child will be adequately assessed by each professional in the multidisciplinary team. The responsibility to formulate an intervention plan is for the team. The developed plan will then be brought together to tailor the treatment of the child. The parents or caretakers are involved in the entire process of therapy. The plan will address multiple areas such as communication, social skills, motor skills, sensory skills, behaviors, daily living, and learning. The child's progress will be monitored and documented every week.
AMMA multi-specialty clinic provides services through three categories. In category 1, children who are suffering from severe symptoms of autism have to be admitted to the inpatient section (IP). During the period of treatment, the parent/caretaker has to stay with the child. The team of AMMA will monitor all the activities of the child. The procedure may last for three months to one year (as per the need), and the parents can extend the treatment further as per the recommendation of the team.
Category 2 is for the children who show a moderate level of symptoms of autism. They have to be admitted in the therapeutic daycare. The treatment will be from 10 am to 3.30 pm. The parent can drop the child and can leave, or they can be a part of the procedure. In the absence of a parent, a trained therapeutic daycare assistant will be assigned to care for them. The service of the daycare assistant will be provided for any child who shows a moderate level of symptoms and whose parents are working. The duration of the treatment plan lasts for 14 days to 3 months. Parents can extend the treatment further as per the recommendation of the team.
Category 3 is for children who show mild symptoms of autism. Treatment can be provided either in the therapeutic daycare settings or as an outpatient (OP). Each treatment session will be independent and one-to-one by the professionals in the multidisciplinary team. The duration of the treatment will extend up to 45 minutes. These will be direct therapy sessions. Parents can extend the treatment further, or they can shift from another module of therapy as per the recommendation of the team of professionals
Early Intervention Programme (EIP), Applied Behavioural Analysis (ABA), Sensory Integration Therapy (SI or SIT), Sunrise Program, Music therapy, Picture Exchange Communication System (PECS), Natural Language Teaching Programme (NLTP), Treatment and Education of Autistic and Related Communication for Handicapped Children (TEACCH), DIR/Floortime model (Developmental, individual-difference, relationship-based) and video modeling methods are the key therapeutic tools that are used for the improvement of individuals with ASD.