AN INTRODUCTION TO EARLY INTERVENTION

There is a broad range of therapies for Autistic Spectrum Disorders
such as Autism and Asperger's syndrome, but the effectiveness of each
varies dramatically from child to child. Progress on medical and
behavior modification remedies has been hindered significantly by
disagreements over the nature and causes of Autistic Spectrum
Disorders, and by a relative lack of effective therapies thus far
recognized by medical authorities. The situation is further
complicated by parents who have found a particular treatment
effective, and may advocate this as a cure-all for Autism, Aspergers
syndrome, and other Autistic Spectrum Disorders.

While there is no cure for Autism Spectrum Disorders, research
indicates that intensive educational and behavioural interventions can
have a major effect when started as early as possible (ie. two years
of age and on).

why early intervention is crucial for autisTIC SPECTRUM DISORDERS

If a child experiences a developmental delay, this can compound over
time. The principle of early intervention is to provide appropriate
therapies to minimize these delays and maximize their chances of
reaching normal milestones in development.

The focus of early intervention coordinates therapies to:

· Build better communication and social interaction skills

· Manage obsessive, repetitive and challenging behaviors

· develop activities of daily living skills (hygiene, dressing,
eating, toileting etc.)

· Improve physical coordination

· Teaching joint attention skills, play, and imitation skills
· Manage sensory issues.

why evidence-based treatment is important

There are many types of interventions available for Autistic Spectrum
Disorders, ranging from those with solid research backing their
effectiveness, others relying on anecdotal evidence, to those
deliberately exploiting vulnerable parents. Evidence-based treatment
is based on rigorous research to ensure the effectiveness of a
treatment or intervention is free from the various biases that beset
medical research. The strongest evidence for therapeutic interventions
is provided by randomized, double-blind, placebo-controlled trials
involving a homogeneous patient population and medical condition.
Although still fallible if not conducted properly, it is the highest
standard of proof that currently exists.

Currently the most effective evidence-based treatments are behavioral
interventions such as Applied Behavior Analysis, the Lovaas Program
and Intensive Behavioural Interventions. It should be noted though
that these interventions may still not suit all families due to the
expense, intensity and expertise required.

It should be noted that a lack of rigorous research does not mean an
intervention is ineffective. For example, small studies have shown
that developmental interventions such as Relationship Development
Intervention, Floortime and the Developmental Social-Pragmatic model
provide benefits but more research is required. Other interventions
have had little or no independent research done, but may rely on word-
of-mouth by parents, or at worst, deliberately misleading advertising
that exploits vulnerable parents by aiming to 'cure' Autism. Careful
research is needed to investigate many of the more recent
interventions.

Typical interventions for Autistic spectrum disorders

A typical Autism or Asperger's syndrome intervention program may
include:
· Social skills training for more successful interaction with others
· Cognitive behavioral therapy for managing emotions, obsessions and
repetitive routines
· Medication, for co-existing conditions such as depression and
anxiety
· Occupational/physical therapy for sensory integration and motor
coordination problems
· Specialized speech therapy, to learn the "give and take" in normal
conversation
· Parent training and support, to teach parents behavioral techniques
to use at home.

Some parents explore biomedical interventions with anecdotal evidence
suggesting some find improvements in various symptoms.

Many studies have been done on early behavioral interventions. Most of
these are single case with one to five participants. The single case
studies are usually about controlling non-core autistic problem-
behaviors like self-injury, aggression, noncompliance, stereotypes, or
spontaneous language. Packaged interventions are designed to treat the
entire syndrome e and have been found to be somewhat effective.

Unintended side effects of medication as an intervention have largely
been ignored in the literature about intervention programs for
children or adults with Autism, and there are claims that some
interventions are not ethical and do more harm than good. As with all
types of early intervention, it pays to research first then monitor
the results to see if medication is helping or not.

Selecting therapies for autism or Asperger's syndrome intervention

The therapy should be designed for children with Autistic Spectrum
Disorders. If it focuses specifically on Aspergers syndrome or Autism,
so much the better. The therapists should also take time to observe
and assess your child, then discuss the theory behind the therapy, how
it is works, and its suitability in your child's case.

An experienced therapist will acknowledge and respect your role as a
parent. You know your child best and your involvement should be
emphasized. The therapy should also provide parents with strategies to
implement in the home environment. Ideally a therapy should give you
practical approaches to use in general life situations.

Therapies for Autistic Spectrum Disorders are continually developing,
and can present a bewildering array of approaches, costs, benefits and
waiting lists to parents who may still be reeling from the impact of
their child being diagnosed. Although parents may feel a sense of
urgency to find therapies quickly, in the long term it is advisable to
put time, research and discussion into your choice. For more
information, go to the Early intervention page.

When interventions are too expensive

Do some research through books, the Internet and Autism associations
on the therapy, to see when it was developed, how widely it is used
and its evaluation from Autism specialists. Unfortunately, therapies
are often very expensive, bur remember the most expensive ones may not
be the best one for your child anyway. Your local Autism association
should be able to inform you on subsidies, government treatments and
other options available. While therapy by specialists can make a huge
difference, it is the ongoing therapy provided by parents in the home
which will make the most impact.

reproduced with permission from http://www.autism-help.org