Selecting the most appropriate intervention for an individual with ASD is complicated. The following factors should influence intervention selection:
(a) evidence of intervention effectiveness;
(b) professional judgment and data-based clinical decision making;
(c) values and preferences of families (including the individual on the autism spectrum);
(d) capacity to accurately implement an intervention.
The National Standards Project of the National Autism Center has identified interventions that have sufficient evidence to show they are effective for individuals with ASD. We recommend considering these interventions unless they are deemed inappropriate based on one of the other factors influencing treatment selection.
The 14 Established Interventions for children, adolescents, and young adults (under 22 years of age) identified in the National Standards Report, Phase 2 (2015) are:
Cognitive Behavioral Intervention Package
Comprehensive Behavioral Treatment for Young Children
Language Training (Production)
Natural Teaching Strategies
Peer Training Package
Pivotal Response Training
Social Skills Package
Most of the interventions identified above come from the behavioral literature (including applied behavior analysis, behavioral psychology, and positive behavior supports). Increasingly, a broad range of fields (e.g., developmental psychology, special education, speech-language pathology) are making contributions to the autism literature, so this trend may change over time.
FOR ADULTS: The only intervention to be identified as Established for individuals ages 22 years and older is Behavioral Interventions. The Behavioral Intervention category consists of applied behavior analytic interventions to increase adaptive behaviors and decrease challenging behaviors.
How is ASD diagnosed?
There are no medical tests for diagnosing autism, but when parents become concerned about developmental delays in children, they should consult a physician. He or she can rule out various potential medical causes, such as hearing problems. Before a child can be diagnosed, that child should be evaluated by an autism specialist. Such a person may be a psychologist, psychiatrist, pediatric neurologist, or developmental pediatrician who specializes in diagnosing and treating children with ASD. Best practice guidelines identify the following six components of a comprehensive diagnostic evaluation for autism:
Parent or caregiver interview
Review of relevant medical, psychological, and/or school records
Direct play observation
Measurement of adaptive functioning
Comprehensive medical examination
ASD diagnostic criteria are described by the American Psychiatric Association (APA) in its Diagnostic & Statistical Manual of Mental Disorders (DSM-V). Qualified professionals provide these diagnoses when symptoms of ASD (social interaction and social communication, and repetitive behaviors) are present in ranges that are inappropriate for the child’s age and developmental level.
ASD is diagnosed when all these symptoms are present to some degree. A diagnosis also includes a specification of severity. Specifically, qualified professionals will use information gathered during the diagnostic assessment to indicate the level of support an individual with ASD requires; Level 1 Requiring Support, Level 2 Requiring Substantial Support, Level 3 Requiring Very Substantial Support.
What are the symptoms of ASD?
Social Interaction and Social Communication: Child shows little interest in making friends; initiates social interactions primarily to have immediate needs met (e.g., to get food, preferred toy); and tends not to share accomplishments and experiences. Other symptoms include lack of eye contact, and absent or limited and atypical gestures (e.g., using someone’s hand as a tool for opening the door). Loss of language occurs in some cases. Restricted Interests and Repetitive Behaviors: Intensely repetitive motor movements or use of objects; child is consumed with a single item, idea, or person; experiences difficulty with changes in the environment or transitioning from one situation to another; may have frequent tantrums; and may be aggressive or self-injurious.
How do you find the right program?
Look for programs that:
involve direct consultation by senior clinicians (doctoral-level or board certified professionals)
include staff who can clearly describe the design and implementation of an intervention
integrate research findings with professional judgment and data-based clinical decision making, the values and preferences of families, and capacity to effectively implement interventions
address the comprehensive needs of individuals on the autism spectrum with sufficient intensity so children and adolescents can make meaningful progress
Our therapists offer assessment, program development/design and implementation, to address:
Receptive and expressive language
Play skills, shared and joint attention
Attending skills and hyperactivity
Social and pragmatic skills
Hypo and hypersensitivity issues
Aggression and emotional regulation
Behaviour management and compliancy shaping
Theory of mind (social cognition)
Self-help and life skills
Pre-academic and academic skills
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