Autism spectrum disorder is a lifelong disease and it has been discovered that this disease can’t be cured completely. The three core symptoms of autism- the difficulties in verbal and non verbal communication, interaction with social world and repetitive behaviors have not been able to get treated via any medication procedures. There are some treatments available for these autistic children which can help them function in a better way.
Since the medicines do not produce same effect on every individual, hence one should always consult the healthcare professionals for monitoring the child’s improvements and to see if there is any side effect of the medication which is provided to the children.
- Early Start Denver Model therapy
The early start Denver model (ESDM) is an inclusive behavioral approach for the children of ages 12 to 48 months. The model circumscribes a developmental schedule that includes what skills should be taught at a particular given time and also the teaching procedures used to deliver the content. It can be done either by combined parents and/or therapy teams or by individual therapy sessions in a child’s home or a clinical setting. The significant features of this model are as following:
- Sound involvement of parents
- Naturalistic applied behavioral analytic strategies
- Positive affect and interpersonal reciprocity
- Verbal and non verbal communication taught in an affect-based relationship
- Careful to normal progress cycle
- Participation in joint activities
- Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is psycho-social therapy for the children suffering from autism who have at least average IQ. There are various types of CBT approaches but all of them have some common constituents such as every approach is goal directed and usually takes 12-16 sessions. The success of any CBT program can be measured accurately as it is goal oriented and time limited therapy. The main aim of CBT is to change a person’s belief system.
In autism, the CBT can be delivered in a variety of ways:
INDIVIDUAL- The affected individual is inspired to change both his beliefs and negative thoughts through various techniques with the help of a therapist. The individual is asked to assume his belief, not as a fact but as a hypothesis or any possible outcome. Then he is asked to test the validity of his hypothesis by finding the real evidences (which he would not be able to find in the reality). He can use self talk to guide himself across any situation thereby intentionally replacing the negative thoughts with more positive ones. Many more steps, for instance, deep breathing, relaxation, stimulating internal conversation can help him coping with the situation. Once the individual learn all these things, then the therapist exposes him to more difficult situations. This process is called as graded exposure.
GROUP- This CBT has an additional advantage that since the affected individuals will see the others who are dealing with the same problem hence they will help each other to cope up. Social support and friendship gained through this process can be healing in themselves.
FAMILY- The advantage of family CBT is that it involves parents who are educated about their child’s challenges and they are taught to embolden the use of CBT techniques in the real life situations with their child. It gives them a feeling of confidence in their ability to be conducive to positive changes in their child’s life. One limitation to this type of CBT is that the parents are reluctant to expose their child to any failures as their child has already exposed to many emotional and behavioral challenges. But this can also help the child to be independent and avoid anxiety.
- FLOOR TIME AND PIVOTAL RESPONSE TRAINING
This approach was developed by Dr. Stanley Greenspan for the uplift of the children with ASD. He was majorly concerned for the social challenges and the relational deficits for autistic children. He called his model as DIR model (developmental, individual-difference, and relationship based). Its most known part is floor time. Hence it is also called as DIR/Floor time model.
This approach is completely focused on child and an adult sits on the floor by focusing the child’s interests for various toys. For instance, the child is interested in driving a car toy by spinning it again and again, so the parent who is accompanying the child can do the same. This can catch the child’s interests and help him in connecting emotionally to his parents. This can also enhance the emotional, cognitive, sensory, motor and language functioning of the affected child.
- PIVOTAL RESPONSE TRAINING
Pivotal response training is one of the therapies which includes on both the child-led approach and behavioral components. The scientists Robert and Lynn Koegel believed that child’s ability can be improved by focusing the pivotal areas and other functioning areas. They believed that social motivation is the most significant in a child’s development. The two main pivotal targets for intervention are:
- Self management- child’s ability to regulate his own mood and behavior.
- Self initiation- A child’s willingness to create social and learning interactions.
In 2011, the research was funded where PRT was used with babies for the earliest intervention techniques by the Autism Science Foundation.
- VERBAL BEHAVIORAL THERAPY
It follows the principles of applied behavior analysis for communication and also the theories of a well known behaviorist, B.F. Skinner. This therapy focuses on increasing an individual’s motivation to learn language by connecting words with their purposes. It avoids emphasizing on words which are mere labels (example: toy, bike etc.). Rather, the student gains knowledge to use language for making requests and exchange ideas with the other social beings.
In the book written by Skinner named as verbal behavior, there are 4 operants which are described as various types of verbal behaviors:
- Mand– an appeal. For example- “cake”, to ask for a cake.
- Tact– a statement used to participate in sharing of experiences and pointing towards objects. For example- “a car”, pointing towards the car.
- Intra verbal– a word or a phrase used for answering the questions. For example- where do you stay? Donald’s street.
- Echoic– repetition of word. For example- “ice cream?” “Ice cream!”
Learning all these 4 parts help the child in communicating in at least a better way and hence, able to convey his/her message to the others.