Autism Spectrum Disorder just as complex, varied as treatments

Early identification and treatment is the most important element in improving lives for individuals and families affected by autism.

By Darcie Taggart

Autism is a brain-based developmental disorder that is part of a group of complex disorders classified as Autism Spectrum Disorders (ASD). Other ASD’s include Rett’s Disorder, Childhood Disintegrative Disorder, Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) and Asperger’s Disorder. Each of these disorders have a specific set of criteria used to make the diagnosis but all include impairment in social interaction, communication, and behavioral functioning though the degree of these impairments can vary widely across diagnosis and from person to person. Children with autism demonstrate restricted or repetitive patterns of behavior, interests, or activities in addition to these other difficulties.

Autism can be also be associated with intellectual disabilities, attention issues, difficulties with motor coordination, physical health problems, and sensory processing deficits. However, it would be a misconception to state that all individuals with an ASD are affected by these. Some individuals with autism are gifted or excel in one or more academic or creative capacities. Another common misconception is that individuals with autism are incapable of forming social relationships. The variation of difficulty is wide amongst individuals with autism and while all exhibit some social impairments some are quite capable of forming close relationships with friends and family members.

Autism on the Rise
The prevalence of autism is now estimated to be one in every 88 children, and boys are five times more likely to be diagnosed than girls. In the past several years the number of individuals diagnosed with autism has risen leading some to believe that the incidence of autism is on the rise. Yet the increase in diagnosis is more likely due to a widening of the spectrum and definition of autism, better screeners with which to identify autism characteristics, and an increase in the awareness of the symptoms of autism by the general public.

Signs and symptoms of autism usually present before three years of age and early diagnosis and interventions are key in making strides to increase the functioning across all areas for these individuals. Screeners are administered to parents of children suspected to have autism to identify possible characteristics of ASD. If a screener indicates that a child has similar characteristics to others with ASD then a more in depth assessment and evaluation should occur to make the full diagnosis.

Some red flags associated with ASD include but are not limited to: limited to no eye contact, not showing joint attention or shared attention on an interesting object or person (by 12 months), does not share sounds, smiles, or facial expressions back and forth with caregiver (by 9 months), no babbling (by 12 months), no meaningful two-word phrases (by 24 months), stereotypic behaviors such as rocking, spinning, or hand flapping, becomes easily fixated on parts of toys rather than the toy itself, unable to make friends (either because not interested or doesn’t know how). There is no cure for autism but early and intensive treatment can make a big difference.

Effective Treatments Available
While many treatments have been effective for individuals with autism, no one treatment has been found to be effective for all individuals with autism. No two individuals with autism are exactly alike and therefore no two respond to treatment in the same way.

One of the biggest challenges to treating autism is that each program must be tailored to fit the needs of the child and of the family. Individualized services including goal adjustments, strategies, and evaluations are the main elements of an effective treatment program.

Other elements of effective programs include:

• the earliest possible start to intervention,
• systematic and planned teaching,
• specialized curriculum (relating to imitation of others, use of language, appropriate play and social interactions),
• time intensive engagement in teaching interactions and learning activities,
• developmentally appropriate practices (not just based on a child’s chronological age), and
• family involvement.

If possible treatment programs should also include structured, intentionally arranged environments and intervention in settings typical to the child. In addition to a tailored treatment program some individuals with autism benefit from medication or nutritional and dietary interventions.

Just as ASD is a complex group of disorders with a wide spectrum of variation among individuals so is treatment for individuals with autism. Early identification and treatment is the most important element in improving lives for individuals and families affected by autism.

Darcie Taggart is an early childhood mental health specialist at Seven Counties Services, Inc.