Diagnosis & Treatment for Autism Spectrum Disorder

By Wendy Trotter, MS, CCC-SLP/L Autism Diagnostic Clinic Coordinator, Easter Seals

Autism Spectrum Disorder (ASD) is a brain-based, developmental disorder that affects an individual’s ability to relate and socialize with others and to effectively communicate verbally and/or nonverbally. It also is associated with ritualistic and repetitive behaviors and/or restricted areas of interest. It is referred to as a spectrum disorder because the degree to which each individual is affected can vary considerably; however, the core deficits in social-emotional relating and reciprocal communication are evident regardless of the individual’s developmental level.
Routine primary health care for all children should involve parents’ descriptions and observations of important developmental milestones, such as a baby’s ability to look and listen, respond with joy and pleasure, and engage in back-and-forth interactions that include facial expressions, gestures, and vocalizations. Routine health care should involve formal screening assessments at periodic intervals to identify infants, toddlers, and preschool children at risk for autistic spectrum or other developmental delays and disorders. Screening tools should be especially sensitive to problems with interaction, meaningful gestures (e.g., pointing), functional language, and the emergence of pretend play and interactions with peers. At-risk children should immediately receive a full assessment and, if needed, an intervention program. Presently, we don’t have a medical test that can diagnose autism. Instead, specially trained physicians, psychologists and therapists administer autism-specific behavioral evaluations. An ideal diagnostic evaluation involves a multi-disciplinary team which could include a medical doctor, psychologist, speech and language pathologist and occupational therapist. Children have the best chance of making progress when challenges are identified and worked with early.
When developing an intervention program for child with ASD, one of the first questions we must ask is what are the goals of the intervention? When parents first hear about their child’s diagnosis, their initial thoughts often are about helping their child recover from the disorder. However, the majority of research has suggested that, for most people, ASD is a lifelong disorder that may become milder as children grow older, but does not typically “go away”. Therefore, unlike many medical conditions where the goal is to cure the disease or achieve complete remission of symptoms, goals in ASD intervention are to teach the individual skills and strategies to minimize the effects of the disorder and improve daily function.
When parents confront the issue of how to help their child diagnosed with an ASD, it can be hard to know where to begin. Some intervention approaches emphasize changing behaviors; others emphasize building relationships; others emphasize working on academic skills; and others emphasize specific skills like communication or sensory processing. But each child’s needs are unique. Parents should be wary of a one-size-fits-all approach, or of only doing one thing when your child may have challenges in numerous areas. Instead, it is helpful to seek a comprehensive program which includes different intervention strategies that address the fundamentals as well as the surface symptoms.
Based on the major characteristics associated with autism, there are several areas that are important to consider when creating an intervention plan: social-emotional relating, reciprocal communication, behavior, and sensory integration. Behaviorally-based treatments, such as applied behavior analysis (ABA), address how to change the environment to help the child learn and maintain new skills. While ABA includes discrete trial training, a methodology of teaching specific skills, the fuller approach in ABA is to structure the environment so the child responds in a more appropriate and successful manner, generalizing new skills into typical settings. This involves the use of routine, visual supports, and positive reinforcement to establish new behavior. With relationship-based approaches such as DIR/Floortime or P.L.A.Y. Project®, the focus is on building warm relationships with the child and helping him learn to enjoy interacting and relating. The goal is to help the child master the fundamentals of relating, communicating and thinking, based on their unique developmental profile which helps to establish a strong foundation for social, emotional, and intellectual capabilities. Other approaches focus on improving various processing areas, such as auditory processing, motor planning, and sensory modulation.
Overall the most important thing to remember when planning an intervention program for your child is to know your child first. Know how he is unique. Know how he attends, relates, communicates, and thinks. Know how he processes information – auditory and visual. Know how he plans actions. Know your family’s strengths and weaknesses. Then develop your program accordingly. It is a tall order, but a complex problem requires a complex approach.

For additional information on autism services, contact Easter Seals in Bloomington at 309-663-8275, or in Peoria at 309-686-1177.

Easter Seals Peoria-Bloomington

lschoon@ci.easterseals.com
http://www.ci.easterseals.com/