Treatment of Autism Spectrum Disorder

The two most frequently used early intervention methods are: the Lovaas method, based on Applied Behavior Analysis (ABA) and the Early Start Denver Model.

Treatment for pre-schoolers and small children

Scientific studies have shown that early intensive behavioural intervention improves learning, communication and social skills in small children with autism. Researchers have developed a series of effective early intervention models that include the following characteristics:

• The child receives structured, therapeutic activities for at least 25 hours per week and preferably in their natural environment.
• The activities are performed individually or in small groups, with a low student to therapist/teacher ratio.
• Highly trained teachers and/or therapists oversee the intervention. Other specially trained professionals may assist in the intervention under the supervision of a professional with experience in treating autism.
• The therapy is guided by specific, well-defined learning objectives. The child’s progress in terms of fulfilling these targets is assessed and recorded regularly.
• The intervention focuses on the central areas affected by autism. These include social skills, language and communication, imitation, playtime skills, daily life and motor skills.
• The programme offers the child the opportunity to interact with their counterparts who are developing normally.
• The programme requires the parents’ active participation in the intervention, both when taking decisions and applying the treatment.
• The programme involves a multidisciplinary team including, as necessary, a doctor, a speech therapist and an occupational therapist.

In the case of children with language difficulties or a delay in developing appropriate language skills, an early intervention is particularly important in order to stimulate their ability to learn the language and communication skills required to communicate with the people around them. To meet this end, the interventions make use of alternative communication systems, such as PECS (Picture Exchange Communication System).

Another primary aim during the preschool stage, and also later in school-age children, is to encourage independent living skills. In this regard, it is worth highlighting the intervention programme derived from the TEACCH model developed by the University of North Carolina and based around the learning characteristics of people with autism (e.g., a greater capacity for processing visual information). This intervention model is based on structured teaching and visual organisation, wherein these principles are incorporated through the organisation of the physical space, personalised timetables, work systems and visual structures, making it one of the most recommendable programmes in school environments.

Other play-based programmes, designed specifically for this developmental stage and which place special emphasis on the child’s natural interests and emotions, have been developed recently. Although we still require more evidence regarding their effectiveness, some studies that lend support to these programmes have already been published (DIR/Floortime).

There are currently multiple social skill intervention programmes designed for children and adolescents with ASD and without any associated intellectual disability. The majority have proven effective in terms of improving these skills; the PEERS programme designed by researchers at the University of California in Los Angeles represents one of the most verified interventions. These social skills training programmes have also been seen to help adults with ASD. 

Furthermore, psychological intervention programmes have also been developed with a specific focus on improving the skills of people with autism so they may understand and predict what other people think or feel (i.e., improve their theory of mind skills) , as well as understanding multiple social rules (e.g., M.G. Winner’s social thinking treatment , Carol Gray’s work with Social Stories™ and Comic Strip Conversations) or the programmes based on the SCERTS® model.

Emotion regulation is another skill that many children and adolescents also need to work on in order to improve their adaption and quality of life; some programs include work modules that focus specifically on this area (SCERTS®).

Regarding language, even though children and adolescents with high-functioning autism present appropriate linguistic skills, they often experience significant difficulties when it comes to appropriate language use (pragmatic language) and so this represents another specific area of intervention that requires attention.

These programmes can be delivered in both healthcare centres and more natural environments; the latter is preferable to help ensure the lessons learnt are assimilated and persist.

In any case, evidence indicates that children and adolescents with autism benefit the most from structured psychological interventions that incorporate visual information. Most social skills and social thinking intervention programmes follow these principles, although further research is still required, especially into social thinking interventions. Notwithstanding, the psychologist or therapist imparting these interventions must have experience and training in the treatment of autism.