Asperger syndrome behavioral therapy: Difference between revisions

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{{Asperger syndrome}}
{{Asperger syndrome}}
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==Overview==
== Overview ==
Behavioral therapies in Asperger Syndrome (AS) are used to help the patients with their social communication and to develop social skills.<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>


{{see|Autism therapies}}
== Behavioral Therapy  ==
Asperger syndrome treatment attempts to manage distressing symptoms and to teach age-appropriate social, communication and vocational skills that are not naturally acquired during development, with intervention tailored to the needs of the individual child, based on multidisciplinary assessment.<ref>{{cite journal |journal= Compr Psychiatry |year=2004 |volume=45 |issue=3 |pages=184–91 |title= Asperger's disorder: a review of its diagnosis and treatment |author= Khouzam HR, El-Gabalawi F, Pirwani N, Priest F |doi=10.1016/j.comppsych.2004.02.004 |pmid=15124148}}</ref> Although progress has been made, data supporting the efficacy of particular interventions are limited.<ref>{{cite journal |author= Attwood T |title= Frameworks for behavioral interventions |journal= Child Child Adolesc Psychiatr Clin N Am |volume=12 |issue=1 |pages=65–86 |year=2003 |pmid=12512399 |url=http://www.childpsych.theclinics.com/article/PIIS1056499302000548/fulltext |doi= 10.1016/S1056-4993(02)00054-8}}</ref>


==Behavioral and Other Therapies==
*[[Behaviour therapy|Behavioral therapies]] in Asperger Syndrome (AS) are used to help the patients with their social communication and to develop social skills.<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>
*[[Behaviour therapy|Behavioral therapy]] in Asperger Syndrome (AS) include:<ref name="pmid25655905">{{cite journal| author=Tarazi FI, Sahli ZT, Pleskow J, Mousa SA| title=Asperger's syndrome: diagnosis, comorbidity and therapy. | journal=Expert Rev Neurother | year= 2015 | volume= 15 | issue= 3 | pages= 281-93 | pmid=25655905 | doi=10.1586/14737175.2015.1009898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25655905  }} </ref>
** Sociobehavioral therapy  
*** Peer-evaluated intervention programs (improvement in [[irritability]] and social interaction)<ref name="pmid25655905" />
*** Video or computerized training programs (improvement in social function)<ref name="pmid25655905" /><ref name="pmid18503531">{{cite journal| author=Beaumont R, Sofronoff K| title=A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program. | journal=J Child Psychol Psychiatry | year= 2008 | volume= 49 | issue= 7 | pages= 743-53 | pmid=18503531 | doi=10.1111/j.1469-7610.2008.01920.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18503531  }} </ref><ref name="pmid22570145">{{cite journal| author=Kandalaft MR, Didehbani N, Krawczyk DC, Allen TT, Chapman SB| title=Virtual reality social cognition training for young adults with high-functioning autism. | journal=J Autism Dev Disord | year= 2013 | volume= 43 | issue= 1 | pages= 34-44 | pmid=22570145 | doi=10.1007/s10803-012-1544-6 | pmc=3536992 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22570145  }} </ref>
***Rote verbal learning of social rules<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>
***Parts to whole approach (verbal information is presented as a series)<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>
***Small classes and small group activities<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>
***AS patients should be integrated with their normotypical peers<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>  
***Adaption of the curriculum for the child with AS (eg. allowing more time to complete tasks)<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>
***Adaptive skills should be taught explicitly (eg. by scheduling, practicing and rehearsing)<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>
***Targeted organizational skills (eg. the use of scheduling, scripts, lists (things to do’) or rules)<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>
***Social skills and pragmatic language training<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>    
**[[Cognitive-behavioral therapy|Cognitive behavioral therapy (CBT)]]<ref name="pmid25655905" />
*** Used in treatment of some associated conditions in AS such as [[depression]], [[anxiety]], [[Social phobia|social phobias]] and [[anger]].<ref name="pmid25655905" /><ref name="pmid16199119">{{cite journal| author=Butler AC, Chapman JE, Forman EM, Beck AT| title=The empirical status of cognitive-behavioral therapy: a review of meta-analyses. | journal=Clin Psychol Rev | year= 2006 | volume= 26 | issue= 1 | pages= 17-31 | pmid=16199119 | doi=10.1016/j.cpr.2005.07.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16199119  }} </ref><ref name="pmid17082978">{{cite journal| author=Sofronoff K, Attwood T, Hinton S, Levin I| title=A randomized controlled trial of a cognitive behavioural intervention for anger management in children diagnosed with Asperger syndrome. | journal=J Autism Dev Disord | year= 2007 | volume= 37 | issue= 7 | pages= 1203-14 | pmid=17082978 | doi=10.1007/s10803-006-0262-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17082978  }} </ref>


The ideal treatment for AS coordinates therapies that address core symptoms of the disorder, including poor communication skills and obsessive or repetitive routines. While most professionals agree that the earlier the intervention, the better, there is no single best treatment package. AS treatment resembles that of other high-functioning ASDs, except that it takes into account the linguistic capabilities, verbal strengths, and nonverbal vulnerabilities of individuals with AS. A typical program generally includes:
==References==
* The training of [[social skills]] for more effective interpersonal interactions;<ref>{{cite journal |author= Krasny L, Williams BJ, Provencal S, Ozonoff S |title= Social skills interventions for the autism spectrum: essential ingredients and a model curriculum |journal= Child Adolesc Psychiatr Clin N Am |volume=12 |issue=1 |pages=107–22 |year=2003 |pmid=12512401 |url=http://www.childpsych.theclinics.com/article/PIIS1056499302000512/fulltext |doi=10.1016/S1056-4993(02)00051-2}}</ref>
{{Reflist|2}}
* [[Cognitive behavioral therapy]] to improve stress management relating to anxiety or explosive emotions,<ref name=Myles>{{cite journal |author= Myles BS |title= Behavioral forms of stress management for individuals with Asperger syndrome |journal= Child Adolesc Psychiatr Clin N Am |volume=12 |issue=1 |pages=123–41 |year=2003 |pmid=12512402 |url=http://www.childpsych.theclinics.com/article/PIIS1056499302000482/fulltext |doi=10.1016/S1056-4993(02)00048-2}}</ref> and to cut back on obsessive interests and repetitive routines;
* [[Medication]], for coexisting conditions such as depression and anxiety;
* [[Occupational therapy|Occupational]] or [[physical therapy]] to assist with poor [[Sensory Integration Dysfunction|sensory integration]] and [[motor coordination]];
* Social communication intervention, which is specialized [[speech therapy]] to help with the [[pragmatics]] of the give and take of normal conversation;<ref>{{cite journal |author= Paul R |title= Promoting social communication in high functioning individuals with autistic spectrum disorders |journal= Child Adolesc Psychiatr Clin N Am |volume=12 |issue=1 |pages=87–106 |year=2003 |pmid=12512400 |url=http://www.childpsych.theclinics.com/article/PIIS1056499302000470/fulltext |doi=10.1016/S1056-4993(02)00047-0}}</ref>
* The training and support of parents, particularly in behavioral techniques to use in the home.


Of the many studies on behavior-based early intervention programs, most are case studies of up to five participants, and typically examine a few problem behaviors such as [[self-injury]], [[aggression]], noncompliance, [[Stereotypy|stereotypies<!--NOT "stereotypes"-->]], or spontaneous language; unintended [[Adverse effect (medicine)|side effects]] are largely ignored.<ref name=interrev>{{cite journal |author= Matson JL |title= Determining treatment outcome in early intervention programs for autism spectrum disorders: a critical analysis of measurement issues in learning based interventions |journal= Res Dev Disabil |volume=28 |issue=2 |pages=207–18 |year=2007 |pmid=16682171 |doi=10.1016/j.ridd.2005.07.006}}</ref> Despite the popularity of social skills training, its effectiveness is not firmly established.<ref>{{cite journal |journal= J Autism Dev Disord |date=2008 |title= Social skills interventions for children with Asperger's syndrome or high-functioning autism: a review and recommendations |author= Rao PA, Beidel DC, Murray MJ |doi=10.1007/s10803-007-0402-4 |pmid=17641962 |volume=38 |issue=2 |pages=353–61}}</ref> A randomized controlled study of a model for training parents in problem behaviors in their children with AS showed that parents attending a one-day workshop or six individual lessons reported fewer behavioral problems, while parents receiving the individual lessons reported less intense behavioral problems in their AS children.<ref>{{cite journal |author= Sofronoff K, Leslie A, Brown W |title= Parent management training and Asperger syndrome: a randomized controlled trial to evaluate a parent based intervention |journal=Autism |volume=8 |issue=3 |pages=301–17 |year=2004 |pmid=15358872 |doi=10.1177/1362361304045215}}</ref>  Vocational training is important to teach job interview etiquette and workplace behavior to older children and adults with AS, and organization software and personal data assistants to improve the work and life management of people with AS are useful.
[[Category:Genetic disorders]]
[[Category:Psychiatry]]
[[Category:Pediatrics]]
[[Category:Neurology]]
[[Category:Syndromes]]


==References==
{{Reflist|2}}


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Latest revision as of 14:28, 22 June 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]

Overview

Behavioral therapies in Asperger Syndrome (AS) are used to help the patients with their social communication and to develop social skills.[1]

Behavioral Therapy  

  • Behavioral therapies in Asperger Syndrome (AS) are used to help the patients with their social communication and to develop social skills.[1]
  • Behavioral therapy in Asperger Syndrome (AS) include:[2]
    • Sociobehavioral therapy  
      • Peer-evaluated intervention programs (improvement in irritability and social interaction)[2]
      • Video or computerized training programs (improvement in social function)[2][3][4]
      • Rote verbal learning of social rules[1]
      • Parts to whole approach (verbal information is presented as a series)[1]
      • Small classes and small group activities[1]
      • AS patients should be integrated with their normotypical peers[1]  
      • Adaption of the curriculum for the child with AS (eg. allowing more time to complete tasks)[1]
      • Adaptive skills should be taught explicitly (eg. by scheduling, practicing and rehearsing)[1]
      • Targeted organizational skills (eg. the use of scheduling, scripts, lists (things to do’) or rules)[1]
      • Social skills and pragmatic language training[1]    
    • Cognitive behavioral therapy (CBT)[2]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 Woodbury-Smith MR, Volkmar FR (2009). "Asperger syndrome". Eur Child Adolesc Psychiatry. 18 (1): 2–11. doi:10.1007/s00787-008-0701-0. PMID 18563474.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Tarazi FI, Sahli ZT, Pleskow J, Mousa SA (2015). "Asperger's syndrome: diagnosis, comorbidity and therapy". Expert Rev Neurother. 15 (3): 281–93. doi:10.1586/14737175.2015.1009898. PMID 25655905.
  3. ↑ Beaumont R, Sofronoff K (2008). "A multi-component social skills intervention for children with Asperger syndrome: the Junior Detective Training Program". J Child Psychol Psychiatry. 49 (7): 743–53. doi:10.1111/j.1469-7610.2008.01920.x. PMID 18503531.
  4. ↑ Kandalaft MR, Didehbani N, Krawczyk DC, Allen TT, Chapman SB (2013). "Virtual reality social cognition training for young adults with high-functioning autism". J Autism Dev Disord. 43 (1): 34–44. doi:10.1007/s10803-012-1544-6. PMC 3536992. PMID 22570145.
  5. ↑ Butler AC, Chapman JE, Forman EM, Beck AT (2006). "The empirical status of cognitive-behavioral therapy: a review of meta-analyses". Clin Psychol Rev. 26 (1): 17–31. doi:10.1016/j.cpr.2005.07.003. PMID 16199119.
  6. ↑ Sofronoff K, Attwood T, Hinton S, Levin I (2007). "A randomized controlled trial of a cognitive behavioural intervention for anger management in children diagnosed with Asperger syndrome". J Autism Dev Disord. 37 (7): 1203–14. doi:10.1007/s10803-006-0262-3. PMID 17082978.


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