Behavioral and Educational Interventions
here are many behavioral and educational approaches for individuals with ASD. The best known is Applied Behavior Analysis (ABA), which is well-supported by evidence. ABA focuses on systematically encouraging (and reinforcing) positive, functional behaviors, while reducing negative or nonfunctional ones, often by teaching a more appropriate replacement skill.
Many studies have shown that children who receive intensive early intervention services—especially those who receive at least two years of intensive intervention prior to entering elementary school—experience significant gains in functional communication, cognitive skills, and behavior and need fewer support services in school.
Social Skills Interventions
- Social skills groups – individuals with ASD practice social skills with each other and/or other children on a regular basis.
- Social StoriesTM – teachers, therapists, clinicians, and caregivers use stories and drawings to build social understanding.
- Hidden Curriculum – teachers and clinicians directly point out “unspoken” social rules.
- Social scripts – teachers and clinicians give individuals with ASD “scripts” for common social situations.
- Computers and other technology – teachers and clinicians use videos, software, or virtual-reality programs to teach complex social skills, such as recognition of emotions in facial expressions and tone of voice.
- Non-verbal communication – teaching communication through gestures, a picture exchange system (such as PECS), an electronic talking device, or another alternative or augmentative communication tool.
- Pragmatics – helping individuals understand when and how to use language socially.
- Conversation skills – practicing back-and-forth exchanges, such as turn-taking or joint attention.
- Concepts – helping individuals understand abstract concepts.
For example, an occupational therapist may help individuals with ASD by:
- Leading activities that help improve attention and awareness (when the individual is theorized to be “under-reactive”) or reduce overall arousal (in the case of “hyper-arousal”).
- Facilitating play that teaches and helps individuals with ASD to participate in communication with others.
- Teaching strategies to help transition from one place or activity to the next.
- Developing adaptive techniques and strategies to get around apparent disabilities (e.g., keyboarding or using a weighted pencil to facilitate handwriting).
- Antipsychotic drugs
- Alpha-adrenergic agonists
- Mood stabilizers
- Sleep medications
- Gastrointestinal agents
Vitamins and Minerals
Some experts and parents believe that children with ASD do not break down or process the nutrients they consume in expected ways. To address this, providers sometimes recommend a daily multi-vitamin, especially if the children.
The use of mega-dose vitamins and nutritional supplements beyond a multi-vitamin are not fully supported for routine use. Below is a list of some vitamins and supplements that have been recently studied regarding their use with individuals with ASD.
- Vitamin B6 and Magnesium (Mg)
- Vitamin MB12, Folinic Acid, Dimethylglycine (DMG), and Glutathione
- Vitamins C, E, Selenium, and Glutathione
- Amino Acids and Carnosine
- Vitamin A
- Vitamin D and Calcium
- Casein-free diet – Casein is a protein found in milk; this diet eliminates milk and all by-products of milk.
- Gluten-free diet – Gluten is a protein found in many grains; this diet eliminates such grains.
- Feingold diet – Eliminates additives and chemicals.
- Specific carbohydrate diet – Removes specific carbohydrates, including all grains, lactose, and sucrose.
- Yeast-free diet – Eliminates yeast and sugar.
- Camel Milk – Heals the Gut!
Below are a couple of alternative therapies with limited supporting evidence that pose significant risks.
The connection between the immune system and ASD is being studied. It has been reported that children with ASD are more likely to have infectious and allergy-related disorders, and many abnormalities have been reported related to the functioning of the immune system. Some immune system-altering medications used by children with ASD include: intravenous immunoglobulins (IVIG), anti-viral medications, anti-fungal medications, and steroids. IVIG is not FDA-approved for autism; it is costly and may carry risks of headaches, anaphylactic shock, meningitis, or infectious disease. While one study by Sandler reported short-term behavioral improvements in 11 children taking vancomycin, further studies are not available.
Hyperbaric oxygen therapy (HBOT)
The use of HBOT in individuals with ASD has been suggested for its ability to increase blood flow in the brain, reduce inflammation, and reduce oxidative stress. A preliminary multi-site randomized controlled trial by Rossingol revealed significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness after HBOT in individuals with autism. However, a subsequent similar study by Granpeesheha did not find HBOT to be effective in multiple assessments. HBOT carries significant potential risks, including ear pain and oxygen toxicity, and it can be expensive. Further investigation is necessary to determine safety and efficacy.
Some experts and partents theorize that individuals with ASD have less capacity to clear heavy metals or are more susceptible to the effects of heavy metals on immune function and the central nervous system. Chelation therapy involves the use of agents to remove heavy metals from the body. No controlled studies have evaluated the safety or efficacy of chelation in individuals with ASD. ALA, DMSA, and DMPS are the top three chelating agents.
By way of energies and remedies one can address each issue a child may be fighting. CEASE therapy allows for remedies for individual vaccine treatments.