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__NOTOC__ | __NOTOC__ | ||
{{Autism}} | {{Autism}} | ||
{{CMG}} | {{CMG}} ; {{AE}} {{SSH}} | ||
==Overview== | ==Overview== | ||
There are multiple therapies for patients with autism to lessen associated deficits and family distress, and to improve quality of their lives. Available approaches include [[applied behavior analysis]] (ABA), developmental models, structured teaching, [[speech and language therapy]], [[social skills]] therapy, and [[occupational therapy]]. Educational interventions have some effectiveness in children: intensive ABA treatment has demonstrated effectiveness in enhancing global functioning in preschool children and is well-established for improving intellectual performance of young children. | |||
==Behavioral Therapy== | ==Behavioral Therapy== | ||
* There are multiple therapies for patients with autism to lessen associated deficits and family distress, and to improve quality of their lives. | |||
Available approaches include [[applied behavior analysis]] (ABA), developmental models, | * Available approaches include [[applied behavior analysis]] (ABA), developmental models, structured teaching, [[speech and language therapy]], [[social skills]] therapy, and [[occupational therapy]].<ref name="CCD">{{cite journal |journal=Pediatrics |date=2007 |volume=120 |issue=5 |pages=1162–82 |title= Management of children with autism spectrum disorders |author= Myers SM, Johnson CP, Council on Children with Disabilities |doi=10.1542/peds.2007-2362 |pmid=17967921 |url=http://pediatrics.aappublications.org/cgi/content/full/120/5/1162 |laysummary=http://aap.org/advocacy/releases/oct07autism.htm |laysource=AAP |laydate=2007-10-29}}</ref> | ||
* Educational interventions have some effectiveness in children: intensive ABA treatment has demonstrated effectiveness in enhancing global functioning in preschool children<ref>{{cite journal |journal= Res Dev Disabil |date=2008 |title= Outcome of comprehensive psycho-educational interventions for young children with autism |author= Eikeseth S |doi=10.1016/j.ridd.2008.02.003 |pmid=18385012}}</ref> and is well-established for improving intellectual performance of young children.<ref name="Rogers">{{cite journal |journal=J Clin Child Adolesc Psychol |date=2008 |volume=37 |issue=1 |pages=8–38 |title= Evidence-based comprehensive treatments for early autism |author= Rogers SJ, Vismara LA |doi=10.1080/15374410701817808 |pmid=18444052}}</ref> | |||
* The limited research on the effectiveness of adult residential programs shows mixed results.<ref>{{cite journal |journal= J Autism Dev Disord |date=2003 |volume=33 |issue=2 |pages=131–40 |title= Effects of a model treatment approach on adults with autism |author= Van Bourgondien ME, Reichle NC, [[Eric Schopler|Schopler E]] |doi=10.1023/A:1022931224934 |pmid=12757352}}</ref> | |||
===Applied Behavior Analysis=== | |||
* Applied behavior analysis (ABA) is one of the intensive behavioral interventions that focuses on behavior modification. | |||
* Principles of stimulus, response and reward are used to reinforce desirable behaviors and decrease undesirable behaviors.<ref name="Howard">{{cite journal |author= Howard JS, Sparkman CR, Cohen HG, Green G, Stanislaw H |title= A comparison of intensive behavior analytic and eclectic treatments for young children with autism |journal= Res Dev Disabil |volume=26 |issue=4 |pages=359–83 |year=2005 |pmid=15766629 |doi=10.1016/j.ridd.2004.09.005}}</ref><ref name="CCD" /> | |||
* There is wide variation in the [[professional practice of behavior analysis]] and among the assessments and interventions used in school-based ABA programs.<ref name="Steege">{{cite journal |journal= Psychol Schools |year=2007 |volume=44 |issue=1 |pages=91–9 |title= Applied behavior analysis: beyond discrete trial teaching |author= Steege MW, Mace FC, Perry L, Longenecker H |doi=10.1002/pits.20208}}</ref> | |||
===TEACCH/Structured Teaching method === | |||
* TEACCH uses structured teaching method to organize physical environments, predictably sequenced activities, visual schedules, visually structured activities, and structured tasks.<ref name="CCD" /> | |||
* TEACCH-based home program might be implemented at home.<ref>{{cite journal |author=Ozonoff S, Cathcart K |title= Effectiveness of a home program intervention for young children with autism |journal= J Autism Dev Disord |volume=28 |issue=1 |pages=25–32 |year=1998 |doi=10.1023/A:1026006818310 |pmid=9546299}}</ref> | |||
===Relationship Development Intervention=== | |||
* Relationship Development Intervention (RDI) is a treatment program developed by Dr. Steven E. Gutstein. | |||
* RDI focuses primarily on building a general "dynamic intelligence" believed to improve social skills demonstrated in neurotypical children. | |||
* It motivates children by developing [[episodic memory]]. | |||
* RDI emphasizes declarative communication, and aims for an appropriate balance of verbal and nonverbal communication. | |||
===Floortime=== | |||
* Floortime is a treatment program developed by [[Stanley Greenspan]]. | |||
* Floortime focuses on improving attachment between the child with autism and the parent through play. | |||
* The parent is encouraged to follow the child's lead and joins with the child in his or her preferred activity. | |||
===Communication Interventions=== | |||
* Communication interventions are used to improve autistic behaviors, which include: | |||
** Communication improvement: | |||
*** It is used for children who do not speak, or have little speech, or have difficulties in effective use of language. | |||
*** It is conducted by speech and language therapists, and work on joint attention, communicative intent, and alternative or augmented communication methods such as visual methods.<ref name="SIGN" /><ref name="Weber">{{cite journal |journal= Pediatr Clin North Am |date=2007 |volume=54 |issue=6 |pages=983–1006 |title= Complementary and alternative medical therapies for attention-deficit/hyperactivity disorder and autism |author= Weber W, Newmark S |doi=10.1016/j.pcl.2007.09.006 |pmid=18061787}}</ref><ref>{{cite journal |author= Kasari C, Freeman S, Paparella T |title= Joint attention and symbolic play in young children with autism: a randomized controlled intervention study |journal= J Child Psychol Psychiatry |volume=47 |issue=6 |pages=611–20 |year=2006 |pmid=16712638 |doi=10.1111/j.1469-7610.2005.01567.x}} Erratum. ''J Child Psychol Psychiatry'' '''48''' (5): 523. {{doi|10.1111/j.1469-7610.2007.01768.x}}</ref><ref>{{cite journal |author= Gulsrud AC, Kasari C, Freeman S, Paparella T |title= Children with autism's response to novel stimuli while participating in interventions targeting joint attention or symbolic play skills |journal=Autism |volume=11 |issue=6 |pages=535–46 |year=2007 |pmid=17947289 |doi=10.1177/1362361307083255}}</ref> | |||
** Social skills treatment | |||
*** It is used to increase social and communicative skills of autistic individuals, addressing a core deficit of autism. | |||
*** There are many approaches including modeling and reinforcement, adult and peer mediation strategies, peer tutoring, social games and stories, self-management, [[pivotal response therapy]], video modeling, direct instruction, visual cuing, circle of friends, and social-skills groups.<ref>{{cite journal |author= Matson JL, Matson ML, Rivet TT |title= Social-skills treatments for children with autism spectrum disorders: an overview |journal= Behav Modif |volume=31 |issue=5 |pages=682–707 |year=2007 |pmid=17699124 |doi=10.1177/0145445507301650}}</ref> | |||
===Therapy in Education=== | |||
* Teachers need to be aware of a student's disorder, and ideally should have specific training in autism education, so that they are able to help the student get the best out of his or her classroom experiences. | |||
* '''Visual schedules''' | |||
** Since some students learn more effectively with visual aids, many teachers create “visual schedules” for their autistic students. This allows students to concretely see what is going on throughout the day, so they know what to prepare for and what activity they will be doing next. | |||
* '''Working in pairs''' | |||
** Working in pairs may be beneficial to autistic children. | |||
** Peer interaction can help students with autism make friends, which in turn can help them cope with problems or understand the world around them. | |||
* '''A teacher's aide''' | |||
** A teacher's aide can also be useful to the student. | |||
** The aide is able to give more elaborate directions that the teacher may not have time to explain to the autistic child and can help the child to stay at an equivalent level to the rest of the class through the special one-on-one instruction. | |||
* There are many different techniques that teachers can use to assist their students. A teacher needs to become familiar with the child’s disorder to know what will work best with that particular child. Every child is going to be different and teachers have to be able to adjust with every one of them. | |||
===Prosthetics=== | |||
* [[Affective computing]] devices, typically with image or voice recognition capabilities, have been proposed to help autistic individuals improve their social communication skills.<ref>{{cite journal |journal= Ann N Y Acad Sci |date=2006 |volume=1093 |pages=228–48 |title= Affective computing and autism |author= el Kaliouby R, Picard R, Baron-Cohen S |doi=10.1196/annals.1382.016 |pmid=17312261}}</ref> | |||
===Neurofeedback=== | |||
* [[Neurofeedback]] has been hypothesized to improve focusing and decrease anxiety in individuals with ASD.<ref>{{cite journal |journal= Int J Rehabil Res |year=2005 |volume=28 |issue=2 |pages=159–63 |title= Effects of electroencephalogram biofeedback with Asperger's syndrome |author= Scolnick B |pmid=15900187}}</ref> | |||
===Patterning=== | |||
* Patterning is a set of exercises that attempts to improve the organization of a child's neurologic impairments. | |||
* It has been used for decades to treat children with many unrelated neurologic disorders, including autism. | |||
* The therapy is based on oversimplified theories and is not supported by carefully designed research studies.<ref>{{cite journal |journal=Pediatrics |date=1999 |volume=104 |issue=5 |pages=1149–51 |title= The treatment of neurologically impaired children using patterning |author= American Academy of Pediatrics. Committee on Children with Disabilities |pmid=10545565 |url=http://pediatrics.aappublications.org/cgi/content/full/104/5/1149}}</ref> | |||
===Parent Mediated Interventions=== | |||
* Parent mediated interventions offer support and practical advice to parents of autistic children.<ref name="SIGN">{{cite paper |author= Scottish Intercollegiate Guidelines Network (SIGN) |date=2007 |title= Assessment, diagnosis and clinical interventions for children and young people with autism spectrum disorders |version= SIGN publication no. 98 |url=http://www.sign.ac.uk/pdf/sign98.pdf |accessdate=2007-09-01 |format=PDF}}</ref> | |||
* Randomized and controlled studies suggest that parent training leads to reduced maternal depression, improved maternal knowledge of autism and communication style, and improved child communicative behavior.<ref>{{cite journal |journal= J Eval Clin Pract |date=2007 |volume=13 |issue=1 |pages=120–9 |title= Parent implemented early intervention for young children with autism spectrum disorder: a systematic review |author= McConachie H, Diggle T |doi=10.1111/j.1365-2753.2006.00674.x |pmid=17286734}}</ref> | |||
===Educational Interventions=== | |||
* Educational interventions attempt to help children not only to learn academic subjects and gain traditional readiness skills, but also to communicate functionally and spontaneously, socialize with skills such as joint attention, gain cognitive skills such as symbolic play, reduce disruptive behavior, and generalize by applying learned skills to new situations. | |||
* Several model programs have been developed, which in practice often overlap and share many features, including:<ref name="CCD" /> | |||
**Early intervention that does not wait for a definitive diagnosis | |||
**Intense intervention, at least 25 hours/week, 12 months/year | |||
**Low student/teacher ratio | |||
**Family involvement, including training of parents | |||
**Interaction with [[neurotypical]] peers | |||
**Predictable routine structure and clear physical boundaries to lessen distraction | |||
**Ongoing measurement of a systematically planned intervention | |||
==References== | ==References== | ||
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[[Category:Mature chapter]] | [[Category:Mature chapter]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Psychiatry]] | [[Category:Psychiatry]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
Latest revision as of 14:09, 2 April 2018
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Autism behavioral therapy On the Web |
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Risk calculators and risk factors for Autism behavioral therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
There are multiple therapies for patients with autism to lessen associated deficits and family distress, and to improve quality of their lives. Available approaches include applied behavior analysis (ABA), developmental models, structured teaching, speech and language therapy, social skills therapy, and occupational therapy. Educational interventions have some effectiveness in children: intensive ABA treatment has demonstrated effectiveness in enhancing global functioning in preschool children and is well-established for improving intellectual performance of young children.
Behavioral Therapy
- There are multiple therapies for patients with autism to lessen associated deficits and family distress, and to improve quality of their lives.
- Available approaches include applied behavior analysis (ABA), developmental models, structured teaching, speech and language therapy, social skills therapy, and occupational therapy.[1]
- Educational interventions have some effectiveness in children: intensive ABA treatment has demonstrated effectiveness in enhancing global functioning in preschool children[2] and is well-established for improving intellectual performance of young children.[3]
- The limited research on the effectiveness of adult residential programs shows mixed results.[4]
Applied Behavior Analysis
- Applied behavior analysis (ABA) is one of the intensive behavioral interventions that focuses on behavior modification.
- Principles of stimulus, response and reward are used to reinforce desirable behaviors and decrease undesirable behaviors.[5][1]
- There is wide variation in the professional practice of behavior analysis and among the assessments and interventions used in school-based ABA programs.[6]
TEACCH/Structured Teaching method
- TEACCH uses structured teaching method to organize physical environments, predictably sequenced activities, visual schedules, visually structured activities, and structured tasks.[1]
- TEACCH-based home program might be implemented at home.[7]
Relationship Development Intervention
- Relationship Development Intervention (RDI) is a treatment program developed by Dr. Steven E. Gutstein.
- RDI focuses primarily on building a general "dynamic intelligence" believed to improve social skills demonstrated in neurotypical children.
- It motivates children by developing episodic memory.
- RDI emphasizes declarative communication, and aims for an appropriate balance of verbal and nonverbal communication.
Floortime
- Floortime is a treatment program developed by Stanley Greenspan.
- Floortime focuses on improving attachment between the child with autism and the parent through play.
- The parent is encouraged to follow the child's lead and joins with the child in his or her preferred activity.
Communication Interventions
- Communication interventions are used to improve autistic behaviors, which include:
- Communication improvement:
- It is used for children who do not speak, or have little speech, or have difficulties in effective use of language.
- It is conducted by speech and language therapists, and work on joint attention, communicative intent, and alternative or augmented communication methods such as visual methods.[8][9][10][11]
- Social skills treatment
- It is used to increase social and communicative skills of autistic individuals, addressing a core deficit of autism.
- There are many approaches including modeling and reinforcement, adult and peer mediation strategies, peer tutoring, social games and stories, self-management, pivotal response therapy, video modeling, direct instruction, visual cuing, circle of friends, and social-skills groups.[12]
- Communication improvement:
Therapy in Education
- Teachers need to be aware of a student's disorder, and ideally should have specific training in autism education, so that they are able to help the student get the best out of his or her classroom experiences.
- Visual schedules
- Since some students learn more effectively with visual aids, many teachers create “visual schedules” for their autistic students. This allows students to concretely see what is going on throughout the day, so they know what to prepare for and what activity they will be doing next.
- Working in pairs
- Working in pairs may be beneficial to autistic children.
- Peer interaction can help students with autism make friends, which in turn can help them cope with problems or understand the world around them.
- A teacher's aide
- A teacher's aide can also be useful to the student.
- The aide is able to give more elaborate directions that the teacher may not have time to explain to the autistic child and can help the child to stay at an equivalent level to the rest of the class through the special one-on-one instruction.
- There are many different techniques that teachers can use to assist their students. A teacher needs to become familiar with the child’s disorder to know what will work best with that particular child. Every child is going to be different and teachers have to be able to adjust with every one of them.
Prosthetics
- Affective computing devices, typically with image or voice recognition capabilities, have been proposed to help autistic individuals improve their social communication skills.[13]
Neurofeedback
- Neurofeedback has been hypothesized to improve focusing and decrease anxiety in individuals with ASD.[14]
Patterning
- Patterning is a set of exercises that attempts to improve the organization of a child's neurologic impairments.
- It has been used for decades to treat children with many unrelated neurologic disorders, including autism.
- The therapy is based on oversimplified theories and is not supported by carefully designed research studies.[15]
Parent Mediated Interventions
- Parent mediated interventions offer support and practical advice to parents of autistic children.[8]
- Randomized and controlled studies suggest that parent training leads to reduced maternal depression, improved maternal knowledge of autism and communication style, and improved child communicative behavior.[16]
Educational Interventions
- Educational interventions attempt to help children not only to learn academic subjects and gain traditional readiness skills, but also to communicate functionally and spontaneously, socialize with skills such as joint attention, gain cognitive skills such as symbolic play, reduce disruptive behavior, and generalize by applying learned skills to new situations.
- Several model programs have been developed, which in practice often overlap and share many features, including:[1]
- Early intervention that does not wait for a definitive diagnosis
- Intense intervention, at least 25 hours/week, 12 months/year
- Low student/teacher ratio
- Family involvement, including training of parents
- Interaction with neurotypical peers
- Predictable routine structure and clear physical boundaries to lessen distraction
- Ongoing measurement of a systematically planned intervention
References
- ↑ 1.0 1.1 1.2 1.3 Myers SM, Johnson CP, Council on Children with Disabilities (2007). "Management of children with autism spectrum disorders". Pediatrics. 120 (5): 1162–82. doi:10.1542/peds.2007-2362. PMID 17967921. Lay summary – AAP (2007-10-29).
- ↑ Eikeseth S (2008). "Outcome of comprehensive psycho-educational interventions for young children with autism". Res Dev Disabil. doi:10.1016/j.ridd.2008.02.003. PMID 18385012.
- ↑ Rogers SJ, Vismara LA (2008). "Evidence-based comprehensive treatments for early autism". J Clin Child Adolesc Psychol. 37 (1): 8–38. doi:10.1080/15374410701817808. PMID 18444052.
- ↑ Van Bourgondien ME, Reichle NC, Schopler E (2003). "Effects of a model treatment approach on adults with autism". J Autism Dev Disord. 33 (2): 131–40. doi:10.1023/A:1022931224934. PMID 12757352.
- ↑ Howard JS, Sparkman CR, Cohen HG, Green G, Stanislaw H (2005). "A comparison of intensive behavior analytic and eclectic treatments for young children with autism". Res Dev Disabil. 26 (4): 359–83. doi:10.1016/j.ridd.2004.09.005. PMID 15766629.
- ↑ Steege MW, Mace FC, Perry L, Longenecker H (2007). "Applied behavior analysis: beyond discrete trial teaching". Psychol Schools. 44 (1): 91–9. doi:10.1002/pits.20208.
- ↑ Ozonoff S, Cathcart K (1998). "Effectiveness of a home program intervention for young children with autism". J Autism Dev Disord. 28 (1): 25–32. doi:10.1023/A:1026006818310. PMID 9546299.
- ↑ 8.0 8.1 Template:Cite paper
- ↑ Weber W, Newmark S (2007). "Complementary and alternative medical therapies for attention-deficit/hyperactivity disorder and autism". Pediatr Clin North Am. 54 (6): 983–1006. doi:10.1016/j.pcl.2007.09.006. PMID 18061787.
- ↑ Kasari C, Freeman S, Paparella T (2006). "Joint attention and symbolic play in young children with autism: a randomized controlled intervention study". J Child Psychol Psychiatry. 47 (6): 611–20. doi:10.1111/j.1469-7610.2005.01567.x. PMID 16712638. Erratum. J Child Psychol Psychiatry 48 (5): 523. doi:10.1111/j.1469-7610.2007.01768.x
- ↑ Gulsrud AC, Kasari C, Freeman S, Paparella T (2007). "Children with autism's response to novel stimuli while participating in interventions targeting joint attention or symbolic play skills". Autism. 11 (6): 535–46. doi:10.1177/1362361307083255. PMID 17947289.
- ↑ Matson JL, Matson ML, Rivet TT (2007). "Social-skills treatments for children with autism spectrum disorders: an overview". Behav Modif. 31 (5): 682–707. doi:10.1177/0145445507301650. PMID 17699124.
- ↑ el Kaliouby R, Picard R, Baron-Cohen S (2006). "Affective computing and autism". Ann N Y Acad Sci. 1093: 228–48. doi:10.1196/annals.1382.016. PMID 17312261.
- ↑ Scolnick B (2005). "Effects of electroencephalogram biofeedback with Asperger's syndrome". Int J Rehabil Res. 28 (2): 159–63. PMID 15900187.
- ↑ American Academy of Pediatrics. Committee on Children with Disabilities (1999). "The treatment of neurologically impaired children using patterning". Pediatrics. 104 (5): 1149–51. PMID 10545565.
- ↑ McConachie H, Diggle T (2007). "Parent implemented early intervention for young children with autism spectrum disorder: a systematic review". J Eval Clin Pract. 13 (1): 120–9. doi:10.1111/j.1365-2753.2006.00674.x. PMID 17286734.