Asperger syndrome behavioral therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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.[1] Although progress has been made, data supporting the efficacy of particular interventions are limited.[2]
Behavioral and Other Therapies
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:
- The training of social skills for more effective interpersonal interactions;[3]
- Cognitive behavioral therapy to improve stress management relating to anxiety or explosive emotions,[4] and to cut back on obsessive interests and repetitive routines;
- Medication, for coexisting conditions such as depression and anxiety;
- Occupational or physical therapy to assist with poor 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;[5]
- 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, stereotypies, or spontaneous language; unintended side effects are largely ignored.[6] Despite the popularity of social skills training, its effectiveness is not firmly established.[7] 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.[8] 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.
References
- ↑ Khouzam HR, El-Gabalawi F, Pirwani N, Priest F (2004). "Asperger's disorder: a review of its diagnosis and treatment". Compr Psychiatry. 45 (3): 184–91. doi:10.1016/j.comppsych.2004.02.004. PMID 15124148.
- ↑ Attwood T (2003). "Frameworks for behavioral interventions". Child Child Adolesc Psychiatr Clin N Am. 12 (1): 65–86. doi:10.1016/S1056-4993(02)00054-8. PMID 12512399.
- ↑ Krasny L, Williams BJ, Provencal S, Ozonoff S (2003). "Social skills interventions for the autism spectrum: essential ingredients and a model curriculum". Child Adolesc Psychiatr Clin N Am. 12 (1): 107–22. doi:10.1016/S1056-4993(02)00051-2. PMID 12512401.
- ↑ Myles BS (2003). "Behavioral forms of stress management for individuals with Asperger syndrome". Child Adolesc Psychiatr Clin N Am. 12 (1): 123–41. doi:10.1016/S1056-4993(02)00048-2. PMID 12512402.
- ↑ Paul R (2003). "Promoting social communication in high functioning individuals with autistic spectrum disorders". Child Adolesc Psychiatr Clin N Am. 12 (1): 87–106. doi:10.1016/S1056-4993(02)00047-0. PMID 12512400.
- ↑ Matson JL (2007). "Determining treatment outcome in early intervention programs for autism spectrum disorders: a critical analysis of measurement issues in learning based interventions". Res Dev Disabil. 28 (2): 207–18. doi:10.1016/j.ridd.2005.07.006. PMID 16682171.
- ↑ Rao PA, Beidel DC, Murray MJ (2008). "Social skills interventions for children with Asperger's syndrome or high-functioning autism: a review and recommendations". J Autism Dev Disord. 38 (2): 353–61. doi:10.1007/s10803-007-0402-4. PMID 17641962.
- ↑ Sofronoff K, Leslie A, Brown W (2004). "Parent management training and Asperger syndrome: a randomized controlled trial to evaluate a parent based intervention". Autism. 8 (3): 301–17. doi:10.1177/1362361304045215. PMID 15358872.