Various latest advances in therapies and their importance in treating ASD

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By Niharika Thakkar, Clinical Psychologist, Child Guidance Centre and Department of Behavioral Sciences and Mental Health, Sahyadri Hospitals Pune

Autism is a complex neurobiological disorder of development. A number of the behavioral symptoms of autism are observable by 18 months of age. While there is no proven cure for Autism Spectrum Disorders(ASD), an early diagnosis and interventions delivered at a younger age, such as in the preschool period, give children the best start possible and the best chance of developing their full potential. As a young child’s brain is still forming, the sooner a child begins to get help, the more opportunity for learning. Even so, no matter when a person is diagnosed with autism, it’s never too late to benefit from treatment. People of all ages with ASD at all levels of ability generally respond positively to well designed interventions.

Recent developments in treatment for ASD establish that providing focused and challenging learning activities at the proper developmental level for at least 25 hours per week and 12 months per year and having small classes to allow each child to have one-on-one time with the therapist or teacher and small group learning activities promote better functioning. Besides, having special training for parents and family to sensitize them towards the problems faced by the child are important. Encouraging goal directed activities that include typically developing children also have more positive outcomes.

As children with Autism sometimes find it difficult to adapt to changes in schedule, providing a high degree of structure, routine, and visual cues, such as posted activity schedules and clearly defined boundaries, to reduce distractions, as also, guiding the child in adapting learned skills to new situations and settings and maintaining the learned skills is beneficial.

In schools, using a curriculum that focuses on language and communication, social skills, self-help and daily living skills is stated to be effective at an early age. Research suggests that during middle and high school years, the child adapts more effectively, when teachers begin to discuss practical issues such as work, living away from a parent or caregiver's home, and hobbies. These lessons may include gaining work experience, using public transportation, and learning skills that will be important in community living. Interventions that are tailor-cut with specific academic, communication, motor, learning, functional, and socialization goals for a child based on his/her educational needs are also effective ( Individualized Educational Plan). Using research-based methods to reduce challenging behaviours like aggression, tantrums, pretend play or seeing someone else's point of view and typical school-readiness skills have positive outcomes.

One of the most widely accepted treatment is applied behaviour analyses (ABA) in which specific goals are shaped and new behaviours are reinforced to reduce undesirable ones. Pivotal Response Training that aims at identifying pivotal skills, such as initiation and self-management enables the child to function in inclusive settings. Recent developments also focus on building healthy and meaningful relationships and abilities by following the natural emotions and interests of the child. One particular example is the Early Start Denver Model, which fosters improvements in communication, thinking, language, and other social skills and seeks to reduce atypical behaviours. Students with ASD may benefit from social skills training program too that help improve skills necessary for creating positive social interactions and avoiding negative responses. For example, Children's Friendship Training focuses on improving children's conversation and interaction skills and teaches them how to make friends, be a good sport, and respond appropriately to teasing. Significant evidence supporting the value of music therapy in promoting social, emotional and motivational development in children with autism has also been found.

Keeping in mind the different treatments for Autism, it is of utmost importance to measure and record each child's progress and adjust the intervention programs as needed.