Autism 101: Supports and Interventions Overview {Part 3}

Welcome back to my Autism 101 series. Today is Part 3 of the series where we will focus on supports and treatments for individuals with autism, or ASD. If you want to know more about what autism is, or the warning signs and causes of autism, check Part 1 and Part 2 respectively.

Today we will be talking about different support strategies for those with an ASD diagnosis. Keep in mind, that we've previously discussed how each person with ASD is different, thus these supports and ideas are not a one-size-fits-all approach. You will need to take these approaches and individualize them to your students or adults you're working with.

Notice how I didn't say "cure". It's important to differentiate between supports and cures in this case, as there is no cure for autism, and many autism advocates push to have those with autism be viewed as an individual with strengths and weakness, just like anyone else, rather than someone who needs to be fixed. We all have our deficits (such as my organizational challenges), and wouldn't identify ourselves as someone who needs to be treated. Instead, we look for ways to help manage our deficits and supports our selves in being as independent as possible. This should be the drive when working with people with autism as well. Even still, with a word like "treatment" it's important to note that we are treating the symptoms and challenges that can come with autism, not the actual disorder itself.

Remember - there is no single, definitive treatment for ASD. Most treatment package is geared toward minimizing the impact the disorder has on one's life and to help support the individual in living a happy and successful life with as much independence as possible. Typically, these packages include a combination of behavioral supports, educational assistance, and therapeutic interventions, as well as medication options.

Interventions

Some interventions involve intensive, comprehensive supports from the individual's treatment team, including family and  a team of professionals. These supports can take place in the home, a clinic, school setting, or a combination of all three. The most successful interventions encompass all aspects of an individual's life, as autism is a pervasive disorder that affects a person's life across many domains.

There is an emphasis on the need for evidence-based interventions, or interventions that have been proven to be effective based on repeated research taking into account the risks and benefits of such interventions. Funding agencies are often reluctant to fund interventions that have not been proven empirically sound by evidence-based research.

An evidence-based practice widely used with those with ASD is applied behavior analysis, or ABA. Insurance companies are funding and covering ABA as an intervention for those with an ASD diagnosis in many states across the United States. ABA has been identified as medically necessary for the treatment of autism through research and individual state insurance mandates. ABA therapy seeks to improve undesirable behaviors while also increasing desired or adaptive behaviors. For more on ABA, check out this awesome post by The Autism Helper and this one at Autism Classroom Resources.

Under the Individuals with Disabilities Education Act (IDEA), all children with disabilities (ASD included) are guaranteed a free and appropriate public education. This means that federal laws mandate that a child be educated in the least restrictive environment that is appropriate for them, with "least restrictive" meaning providing as much education as possible in the general education population.

As with any special education services, if a child with ASD qualifies, a team of professionals (medical and psychological), parents/caregivers, and teachers work together to create an Individualized Educational Plan (IEP). An IEP includes specific academic, communication, motor, learning, functional, and socialization goals for a child based on his or her educational needs. Under IDEA, it is required that a school system provide these needed services and support the child's educational needs. Prior to school-aged services, a child will also receive Early Intervention Services (EIS) if they are eligible under the IDEA mandate. Instead of an IEP, the child will have an IFSP, or Individual Family Service Plan. As a child transitions to adulthood, if they still qualify for adult disability services, they will have a similar team of professionals and caregivers, and will include the individual themselves, who will draft an Individualized Support Plan, or ISP. This plan may include vocational, residential, behavioral, communication, functional, independence and socialization goals for the individual.

Who Provides the Services?

A variety of educational and health processionals may be recruited to help an individual with ASD and their family. This can include, but is not limited to: special educators, psychologists, registered behavior technicians (RBT), Board Certified Behavior Analyst (BCBA), speech and language pathologist (SLP), occupational therapists (OT), and physical therapist (PT). This multi-disciplinary team meets regularly to review the individual's progress, and at least once a year as a minimum, as required by federal law.

Medication Options

Currently, there is no medication that can cure ASD. The FDA has approved one medication for the  treatment of autism: Risperidone. This medication was approved for treating irritability in children with autism (ages 5-16).

Other medications have been shown to help some individuals with ASD, including those with self-injury and those with anxiety. As always, it is necessary to consult the individual's doctor to discuss medication options, if it is decided that medication is the way to go. 

ABA at Play: antecedent manipulations, motivating operations, function-based interventions, prompting, evidence-based practices, task analyses, generalization, shaping, visuals, self-monitoring, operational definitions, socially significant behavior

Check back next Monday when we dive into the specifics of identifying support strategies in Part 4 of the Autism 101 series!