Autism Spectrum Disorders: Navigating through Diagnosis and Intervention

When a parent considers the possibility a child may have a spectrum disorder, coming to a diagnosis and treatment plan takes time and patience.  Autism Spectrum Disorders (ASDs) share three core features: impaired social interactions, difficulty communicating with others, and repetitive or inflexible behavior.   The cause of ASD is not clear but one thing that is clear is the earlier the diagnosis, the better the possibility of taking advantage of the child’s developing brain at a time when it is most available to change.  This change happens in response to experience and early intervention.

The earliest signs of ASD are subtle, but many parents express concerns about atypical development as early as 12-18 months.  These signs often include problems making eye contact and inability to follow objects visually, turn in response to hearing their own name, smile, or imitate other people.  Screening for ASD is more than a one-time test: it is a process and one that involves both parents and clinicians.  Clinicians rely on standard assessments combined with parental response.  For example, the Modified Checklist for Autism in Toddler’s (M-CHAT) relies on parent response to questions assessing components to social interaction seen in their toddler.  Once a diagnosis is made, there are a variety of intervention options.

Psychosocial interventions aim to help a child better interact and communicate with other people.  Most psychosocial interventions are delivered both in-home and at school.  These include:

Applied Behavioral Analysis (ABA): This approach relies on positive reinforcement to encourage behavior change.  Pivotal behaviors such as play skills, communication ability, social skills, and language acquisition are taught and strengthened.  Research shows that children in ABA programs show an improvement in IQ scores, language skills, school performance and ability to adapt.

Developmental Models: Models such as the Early Start Denver Model (ESDM) work to combine ABA techniques with other social skills tailored to the deficit or need of each child.

Other Interventions: Other interventions include working to change the child’s environment to fit around his or her specific needs.  Speech and language therapy may also be added to improve social skills by encouraging specific interactions with other children or focusing on language acquisition.  Occupational therapy is also used to teach self-care or other skills such as using utensils when eating.  It is often useful to consider medical management of symptoms such as irritability or sleep disturbances through the use of stimulants, antipsychotics, or selective-serotonin reuuptake inhibitors (SSRI’s).

When considering the host of intervention options available, it is important to remember that every child is different.  It is imperative to look for the best mix of therapeutic options based on the child’s individual needs.  For many parents, this can seem an overwhelming task but once a treatment team is put together, it becomes clear that collaboration and communication work well to create the best intervention for each in

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