Happy Sprouts

The needs of individuals with autism are unique, complex, and can impact their lives and the lives of people around them 24/7. It is often harder for them to learn the same way as we do and time is of essence. The later in life they start learning, harder it becomes to build up all the skills they need. It is crucial to provide treatment that is most likely to be effective. There is still a lot of lack of information when it comes to understanding someone on the spectrum. All that we know so far that some strategies have been empirically proven to be effective for learners with ASD while others have been proven ineffective, even harmful. Every individual requires a different type of support. Based on what type of support our learners are provided, their abilities of learning and succeeding could increase or remain the same.

Whether you are a parent, a professional or a career, it is important to be informed about what research says about the many treatment options you may come across. Having to check all the conflicting information found on the internet or from other recommendations can be a very stressful, tiresome and overwhelming process for everyone, but especially for parents.  Happy Sprouts is here to help you understand what research suggests about diverse methodologies and how important is to have evidence of the treatment you decide when starting the journey.

A Framework for Understanding What Is Evidence-Based Treatment:

A lot of treatment information is presented as factual when it may not be. Looking through the filter of science helps us differentiate opinions/testimonials from substantiated data as well as faulty or poorly designed research from well-designed studies, not to mention saving time and taking justified financial decisions. The simple stoplight analogy helps to translate the body of empirical autism-specific research.

Green Light

Treatments shown through research to be most effective for individuals with autism

Applied Behaviour Analysis (ABA)

ABA Main Areas of work:

  • Teaching, maintaining and generalising skills
  • Treating behaviours of concern

The science and practice of ABA includes a variety of evidence-based practices:

  • Activity Schedules
  • Backward and Forward Chaining
  • Comprehensive Behavioural Treatment for Young Children3
  • Differential Observing Response
  • Direct Instruction
  • Discrete Trial Instruction
  • Errorless Learning/Teaching
  • Imitation Training
  • Incidental Teaching
  • Joint Attention Intervention
  • Modeling
  • Picture Exchange Communication System
  • Pivotal Response Treatment
  • Precision Teaching/Fluency-Based Instruction
  • Prompting
  • Reinforcement Schedules and Systems
  • Repeated Practice
  • Scripting/Script Fading Procedures
  • Self-management
  • Shaping
  • Social Skills Package
  • Standard Echoic Training
  • Story-based Intervention
  • Verbal Behavior/Applied Verbal Behavior
  • Video Modeling

Positive Behaviour Support (PBS)

PBS is an ABA-based service delivery package that incorporates the following components to understand and treat challenging behaviour as well as many of the components listed above to teach functionally-equivalent replacement skills.

  • Function-based Intervention
  • Functional Behavior Assessment
  • Functional Communication Training
  • Antecedent-based interventions
  • Differential Reinforcement
  • Response Interruption and Redirection

Yellow light:

Treatments that have not been studied enough (or at all) to put them in another category

PRELIMINARY EVIDENCE SUGGESTS EFFECTIVENESS:

  • Melatonin (neurohormone to treat sleep, not ASD)

MORE RESEARCH NEEDED:

  • Acupuncture
  • Animal therapies (therapy dogs, therapeutic riding)
  • Antifungal agents
  • Art therapy
  • Developmental therapies (DIR/Floortime, RDI, SCERTS, ESDM, RPMT)
  • Herbs and homeopathic
  • Immune therapy
  • Massage therapy
  • Medical marijuana
  • Mindfulness-based practices
  • Music therapy
  • Neurofeedback/Neurotherapy
  • Omega-3 fatty acids
  • Oral motor therapy/training (PROMPT, Kaufman)
  • Oxytocin
  • Project TEACCH
  • Social stories (if done in isolation)
  • Son-Rise Program
  • Vision therapy
  • Vitamin supplements

PRELIMINARY EVIDENCE SUGGESTS INEFFECTIVENESS:

  • Craniosacral therapy
  • Dietary changes
  • Sensory integration
  • Vitamin B6 with magnesium

Red light:

Treatments shown through research to be harmful or ineffective for individuals with autism

  • Auditory Integration Therapy/Training and any type of listening program
  • Chelation
  • Detoxifying clay baths
  • Facilitated Communication
  • Hyperbaric oxygen
  • Psychoanalysis
  • Rapid Prompting Method
  • Secretin

Considerations on the Yellow and Red Light Treatments:

Many of the red and yellow light interventions fall into one of two categories:

  1. They were created to address an unproven theory about a cause of autism
  2. They may be beneficial for individuals with other special needs but don’t address the unique challenges faced by those with autism

 It is important to differentiate between treatment/therapy and recreation. Some of the activities which are not established as evidence-based practices for autism may be enjoyable to individuals and valuable as reinforcers (opportunities they would like to work for) or leisure activities (hobbies to enjoy). However, they do not qualify as therapeutic treatment unless they directly improve the quality of life of a person on the spectrum,  teach skills, or reduce behaviours of concern.

Some individuals may respond well to an intervention that is not documented as effective for the majority of people with autism but that does not prove that will work for others. As with any intervention, we recommend collecting and analysing data regularly to assess progress with the treatment team. Being alert to possible side effects is also important.

Measuring Effectiveness

At the end of the day, you the parent, career, professional will decide and represent the individual on the autistic spectrum. ANY strategy that is attempted,  should be backed up by regularly  data collection to analyse and determine if the intervention is bringing about improvement on a specific goal, is significant for the individual and has social validity. Implementation can vary, so even established interventions need to be monitored and adjusted to maximize effectiveness. Progress may be slow, so it’s important to keep records that will guide the team’s decisions and keep everyone informed.

The Road Less Traveled (Celiberti et al., 2004) is a helpful resource for evaluating any intervention and its implementation for your child/learner.