MORE ABOUT TREATING AUTISM
More on Applied Behavior Analysis
ABA targets the learning of skills and the reduction of challenging behaviors. Most ABA programs are highly structured. Targeted skills and behaviors are based on an established curriculum. ABA therapists break down each skill into small steps and teach them using prompts that are gradually eliminated as the steps are mastered. They give the child repeated opportunities to learn and practice each step in a variety of settings. Each time the child achieves the desired result, they get positive reinforcement, such as verbal praise or something else that is motivating. The therapist then builds on these skills so that the child learns how to learn in a natural environment.
ABA programs often include support for the child in a school setting with a one-on-one aide. Therapists measure success by direct observation and data collection and analysis – all critical components of ABA.
Effective ABA for autism is not a “one size fits all” approach and is not a “canned” set of programs or drills. Instead, a skilled therapist customizes the intervention to each child’s skills, needs, interests, preferences and family situation. So an ABA program for one learner looks different than a program for another learner. ABA changes as the needs of the learner change. Families can use ABA principles in their daily lives.
There are a number of specific ABA techniques and approaches used by providers to treat children with autism. The most traditional technique used in early childhood is Discrete Trial Training (DTT), which involves teaching individual skills one at a time using several repeated teaching trials and reinforcements that may or may not be related to the skill that is being taught. Pivotal Response Treatment (PRT) and Early Start Denver Model (ESDM) are two other approaches that use natural reinforcement opportunities – for example, if a child makes a meaningful attempt to request a stuffed animal, the reward is the stuffed animal, not a candy or other unrelated reward. While these ABA approaches are used most frequently in early childhood, the approaches continue to be integrated into ABA-based treatment of school-age children.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) has been shown to be helpful for reducing anxious and depressed feelings and behavior sometimes exhibited in individuals with autism by making changes in thoughts and perceptions of situations. The key ingredient of CBT, which distin-guishes it from regular behavior therapy, is working on a change in cognition or how thinking is processed. Therapists seek to reduce challenging behaviors, such as interruptions, obsessions, melt-downs or angry outbursts, while also teaching individuals how to become familiar with and manage certain feelings that may arise.
Cognitive behavioral therapy can be individualized for each patient, and as a result, is very effective at improving very specific behaviors and challenges in each child or young adult. Stabilizing emotions and improving behavior allows those with autism to prepare for and respond more appropriately in specific situations.
CBT elements are often included in school age social skills training to help children to think more accurately about the social world and to help social skills generalize across situations.
Medication for autism
There is no medication specifically to treat autism. Rather, medications can be used to treat some symptoms of autism. These medicines are most effective when used with behavioral therapies, such as ABA. Ideally, medicines are a complement to other treatment strategies.
Medicines for treating the two core symptoms of autism – social communication/interaction and restricted and repetitive behaviors – have long been a huge area of unmet need. Unfortunately, there are no drugs on The market today that effectively relieve these symptoms.
Today, most medicines prescribed to ease the symptoms of autism are used “off label,” meaning that their FDA approval is for other sometimes-related conditions such as attention deficit hyperactivity disorder (ADHD), sleep disturbances or depression. Speak to your child’s health care provider about medications that might help your child.
Autism Speaks ATN has developed two tool kits that can help you learn more: Autism and Medication: Safe and Careful Use and a Parent's Guide to Medication and Autism. Both can be found at autismspeaks.org/tool-kit.