What are interventions for autism spectrum disorder?
Intervention means doing something, taking action or using a treatment to try to improve a particular condition or problem.
When it comes to autism spectrum disorder (ASD), there are many kinds of interventions. Different interventions might involve children, parents or both. They might be one-off events or involve many sessions spread over years.
What types of interventions are there?
There’s a huge range of interventions for ASD. They range from those based on behaviour and development to those based on medicine or alternative therapy. Some interventions combine several different types – for example, a mix of behavioural and developmental approaches.
Interventions are based on different theories about the causes of ASD. These theories guide the approach taken, so hearing the theory behind an intervention helps you understand what it’s trying to do. For example, a theory about chemical imbalance in the body leading to ASD might lead to a therapy involving taking prescribed drugs or making changes in diet to address the imbalance.
Below is a summary of the main types of intervention, with a look at what the research says. This is just one way to categorise interventions, and you’ll find that some interventions are based on, or include the use of, others.
Behaviour-based approaches to autism spectrum disorder (ASD) focus on teaching children new behaviours and skills by using specialised, structured techniques. These techniques are the best teaching tools for developing skills and encouraging appropriate behaviour.
Behaviour-based approaches are probably the most studied and best supported by evidence and research. Therefore, they’re the most commonly used type of intervention for children with ASD. Interventions using an Applied Behaviour Analysis (ABA) approach are particularly common and well supported.
There’s still some discussion about different behaviour-based interventions and how the research on them should be interpreted. For example, it isn’t always clear whether the research is claiming that the intervention has led to ‘recovery’ or to a reduction in symptoms.
Examples of behaviour-based interventions include:
- Discrete Trial Training (DTT)
- Douglass Developmental Disabilities Center (DDDC) Program
- Incidental teaching
- Lovaas Program
- Pivotal Response Treatment (PRT)
- Positive Behaviour Support (PBS)
- Princeton Child Development Institute Program.
Developmental approaches to autism spectrum disorder (ASD) aim to help children form positive, meaningful relationships with other people. They focus on teaching children social and communication skills in everyday, structured settings. They also aim to help children develop skills for daily living.
Although there isn’t enough good-quality research on developmental interventions, studies on small parts of some of these interventions have shown potentially positive results.
Developmental interventions are sometimes called ‘normalised’ interventions.
Examples of developmental interventions include:
- Developmental social-pragmatic (DSP) model
- Relationship Development Intervention® (RDI®)
- Responsive teaching.
Some approaches combine elements of behavioural and developmental methods, and also use new information about autism spectrum disorder (ASD) and typical development.
Often a combined approach is the most effective, because it brings together characteristics of several good interventions. For example, any behavioural intervention will be much more effective if it’s also family-based.
Examples of combined interventions include:
Family-based interventions for autism spectrum disorder (ASD) emphasise the idea that family involvement in therapy is central to meeting children’s developmental needs. In particular, parents not only drive the decision-making about interventions, but they also take a key role in delivering them.
These interventions are designed to provide guidance, training, information and support to family members.
Research on how well family-based interventions work is limited but growing. The success of these interventions depends on having strong and collaborative parent-professional relationships. Their effectiveness also relies on addressing the needs of the whole family, so that everyone in the family benefits, not just the child with ASD.
An example of a family-based intervention is the More Than Words® program.
Therapy-based approaches to autism spectrum disorder (ASD) provide a specific therapy that targets specific difficulties. Examples include using:
- speech therapy to develop a child’s communication and social skills
- occupational therapy to develop skills for daily life, including physical skills.
Therapy-based approaches are often used together with, or as part of, other intervention programs.
Examples of therapy-based interventions include:
Every now and then, you’ll hear about a new ‘miracle cure’ for autism spectrum disorder (ASD). So far there is no medicine proven as a cure for ASD. Rather, most medication is used to improve, but not necessarily remove, problems that are sometimes seen in children with ASD. The problems include:
- behaviour associated with ADHD, like inattention or hyperactivity
- symptoms of anxiety
- obsessive compulsive behaviour
- self-harming behaviour
- sleep disorders.
Prescribed medications might reduce these behaviours enough so that behavioural or developmental interventions are more effective.
Examples of medical interventions include:
Things to consider about medications
It’s always best to talk through medication options and use with your doctor, because there are clear rules about how medical interventions should be managed.
Some medications have had positive effects on particular symptoms, like aggressive or hyperactive behaviour. But measuring the effects properly isn’t easy, and symptoms need to be monitored very carefully.
Also, more research is needed on the long-term side effects of medication. Check with your doctor that the medication suggested has been tested with children.
Alternative interventions for autism spectrum disorder (ASD) include a broad range of treatments not often used in the mainstream medical system, because they’re not supported by scientific evidence.
There’s a lot of discussion and controversy about alternative treatments for ASD. This is because there is little or no evidence to support their effectiveness. Considerable evidence shows no effect at all for some – for example, secretin. And there are potential risks associated with some of these treatments – for example, withholding the MMR vaccine.
Another common concern about these types of therapies – even those that do no direct harm – is that they use time, energy and sometimes money that families could otherwise spend on well-established and well-supported therapies.
Examples of alternative interventions include:
These include a range of interventions that sit outside the categories listed above. So far there isn’t much quality research testing the outcomes for these programs.
Anexample of this type of intervention is music therapy.