Claire Dawson
Autism Spectrum Disorder (ASD) is a developmental disability that affects how a child's brain works, causing them to socialize and behave in unique ways. Children with ASD may have difficulty making friends and experience anxiety due to feeling misunderstood or not being able to make sense of their surroundings. Early diagnosis and intervention are crucial for effective treatment, and there are various approaches to consider when treating an autistic child in a hospital setting. These include behavioral approaches such as Applied Behavior Analysis (ABA), which encourages desired behaviors and discourages undesired behaviors, as well as educational treatments like the Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH) approach, which focuses on consistency and visual learning in the classroom. Other treatments include occupational therapy, speech therapy, and pharmacological interventions, all tailored to the unique needs of the autistic child.
| Characteristics | Values |
|---|---|
| Treatment | Applied behavior analysis (ABA), occupational therapy, speech therapy, physical therapy, pharmacological therapy, cognitive behavioural therapy (CBT), educational treatments, and sleep plans |
| Timing | The earlier the treatment begins, the better; ideally before age 3 |
| Environment | Calm, quiet, and not brightly coloured |
| Parental involvement | Key to the success of the intervention |
| Individualized Education Plan (IEP) | Meets the child's specific learning needs |
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What You'll Learn
- Early diagnosis and intervention: The earlier the support, ideally before age 3, the more beneficial for the child
- Applied Behavioural Analysis (ABA): A widely accepted approach that encourages desired behaviours and discourages undesired ones
- Speech therapy: Helps autistic children communicate their needs and wants effectively
- Managing anxiety: Autistic children often experience anxiety due to difficulty understanding their surroundings
- Sleep issues: Many autistic children struggle with sleep, and a GP can advise on sleep plans or refer to a specialist
Early diagnosis and intervention: The earlier the support, ideally before age 3, the more beneficial for the child
Early diagnosis and intervention for autism are crucial for a child's long-term development and well-being. Research shows that early intervention can have significant positive effects on a child's symptoms and future skills. The brain is still rapidly developing during the early years, making it more ""plastic" or changeable, and thus more receptive to treatments and interventions.
Autism Spectrum Disorder (ASD) can sometimes be diagnosed in children before they turn two, and early interventions typically start as early as two or three years old. Early intervention programs aim to provide therapeutic services to support the child in gaining essential skills typically learned in the first two years of life. These skills include speech and communication, social skills, gross and fine motor skills, self-care, and independence.
One notable early intervention approach is the Early Start Denver Model (ESDM), which is a broad developmental approach based on Applied Behavior Analysis (ABA) principles. ESDM uses play, social exchanges, and shared attention in natural settings to improve language, social, and learning skills. Children in this program receive therapy and parent training to help caregivers implement strategies at home.
Another effective intervention is the Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH) approach, which is based on the idea that consistency and visual learning are beneficial for children with autism. The TEACCH approach provides teachers with strategies to adjust classroom structures and improve academic and other outcomes for students with autism.
The benefits of early intervention are far-reaching. Studies have shown that early intervention can improve a child's IQ, communication, socialization, and behavior. It helps children develop coping strategies to manage their symptoms, such as handling sensory overload or communicating their needs effectively. Early intervention increases the likelihood of positive outcomes during childhood, adolescence, and adulthood, including higher rates of employment and reduced need for support services later in life.
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Applied Behavioural Analysis (ABA): A widely accepted approach that encourages desired behaviours and discourages undesired ones
Applied Behavior Analysis (ABA) is a widely accepted, research-based behavioural therapy for treating autism. ABA therapy is flexible and can be adapted to meet the unique needs of each individual. It can be provided in various locations, including at home, school, or in the community. The therapy is designed and overseen by a qualified and trained Board Certified Behaviour Analyst (BCBA) who will first assess the child's needs and ability level. The BCBA will then work with therapists, or registered behaviour technicians (RBTs), to implement the ABA program.
ABA therapy focuses on encouraging desired behaviours and discouraging undesired ones to improve a variety of skills. Positive reinforcement is a common strategy used in ABA, where a behaviour is followed by something valued, such as a reward, to encourage the repetition of that behaviour. Undesired behaviours are often ignored. Discrete Trial Training (DTT) is a teaching style used in ABA, where step-by-step instructions are used to teach a desired behaviour or response. Lessons are simplified, and desired answers and behaviours are rewarded. Another teaching style is Pivotal Response Training (PRT), which takes place in a natural setting and aims to improve a few "pivotal skills" to help the child learn many other skills.
ABA therapy is considered an evidence-based best practice treatment by the US Surgeon General and the American Psychological Association, and its effectiveness has been proven by many studies. It is covered by all Medicaid plans for children under the age of 21 if deemed medically necessary by a doctor. ABA therapy can help autistic children improve their social interactions and learn new skills, ultimately helping them become more independent and successful in the short and long term.
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Speech therapy: Helps autistic children communicate their needs and wants effectively
Speech therapy is an effective way to help autistic children communicate their needs and wants. It is a broad developmental approach that can be tailored to the specific needs of the child. For example, the Early Start Denver Model (ESDM) is used with children aged 12-48 months and involves parents and therapists using play, social exchanges, and shared attention to improve language, social, and learning skills.
One of the main goals of speech therapy for autistic children is to improve their communication skills. This may include teaching them how to use words and language to express their needs, wants, and feelings effectively. For instance, applied behavior analysis (ABA) breaks down communication skills into manageable steps for improvement, encouraging desired behaviors and discouraging undesired ones. Discrete trial training (DTT), a type of ABA, uses step-by-step instructions to teach a desired behavior or response, rewarding desired answers and behaviors while ignoring undesired ones. Alternatively, pivotal response treatment (PRT) increases motivation and responsiveness to improve communication.
Another important aspect of speech therapy for autistic children is the development of social skills, such as taking turns, making eye contact, and understanding social cues. Social skills training teaches effective interaction and communication in social settings. Additionally, speech therapy can help nonverbal autistic children, who make up about 25-30% of the autistic population, by focusing on alternative forms of communication such as gestures, pointing, and augmentative and alternative communication devices.
The Picture Exchange Communication System (PECS) is another technique used in speech therapy, which has been found to improve communication skills by over 50%. PECS uses picture cards to aid nonverbal communication, helping autistic children use more words and interact more effectively.
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Managing anxiety: Autistic children often experience anxiety due to difficulty understanding their surroundings
Autistic children often experience anxiety due to difficulty understanding their surroundings. This can be managed in several ways, both in the short and long term.
Firstly, it is important to identify the triggers of anxiety. These can vary from person to person but may include unexpected changes to routine, unfamiliar environments, social exchanges, sensory challenges, or underlying fears and phobias. Parents and caregivers can play a crucial role in this identification process by observing and noting any incidents of anger outbursts, withdrawal, increased self-stimulatory behaviour, or other anxiety indicators, and reflecting on the events leading up to such behaviours. Understanding these triggers is essential for developing effective strategies to relieve, reduce, or avoid anxiety.
In the short term, one approach to managing anxiety in autistic children is to provide a calm and predictable environment. This may involve minimising unexpected changes, providing clear and consistent routines, and offering step-by-step instructions for any necessary changes. Visual supports, such as visual schedules or social stories, can also be beneficial in helping autistic children understand their surroundings and promoting a sense of predictability. Additionally, encouraging open communication and providing opportunities for the child to express their emotions verbally or in written form can help identify any increasing anxiety levels.
In the long term, behavioural approaches, such as Applied Behaviour Analysis (ABA), have proven effective in treating anxiety in autistic children. ABA encourages desired behaviours and discourages undesired behaviours to improve a range of skills. This can include teaching coping strategies for anxiety through discrete trial training (DTT), which breaks down lessons into simple parts, rewarding desired behaviours, and ignoring undesired ones. Alternatively, pivotal response training (PRT) focuses on improving a few key "pivotal skills," such as communication and social skills, which can help the child manage their anxiety more effectively and improve other areas of functioning.
Additionally, parental training has been suggested as a method of supporting autistic children in managing their anxiety. This involves educating parents on sensory strategies and practical techniques to help their children recognise and manage their anxiety effectively. By empowering parents with knowledge and strategies, they can better support their children in various settings and promote open communication within the family.
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Sleep issues: Many autistic children struggle with sleep, and a GP can advise on sleep plans or refer to a specialist
Sleep issues are common among autistic children, and there are several strategies that can help. Firstly, it is important to identify any health conditions, such as food sensitivities or breathing problems, or illnesses like colds or ear infections, that may be contributing to sleep difficulties. Addressing these underlying issues can improve sleep.
Additionally, establishing a consistent bedtime routine is crucial. This can include reducing screen time before bed, as the bright lights from electronic devices can disrupt the production of the sleep hormone melatonin. Creating a calm and relaxing environment, free from anxiety-provoking topics of conversation, can also aid in promoting sleep. For autistic children with social cueing problems, a visual timetable or flow chart can help them understand the bedtime routine and make the connection between bedtime and their need for sleep.
If your child is struggling with anxiety, consider discussing therapy options with your GP. Cognitive behavioural therapy (CBT), for instance, may help your child manage their anxiety and improve their sleep. It is also beneficial to encourage your child to engage in physical activity during the day, as this can help regulate their sleep patterns.
In some cases, sleep issues may persist despite your best efforts. If this occurs, your GP can advise on creating a sleep plan or refer you to a specialist, such as a paediatrician, child psychiatrist, or psychologist, with experience in treating sleep issues in autistic children. These specialists may recommend melatonin supplements to aid your child's sleep. It is important to remember that you are not alone in this journey, and seeking support from healthcare professionals can provide much-needed assistance in managing your child's sleep challenges.
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Frequently asked questions
The best way to treat an autistic child in hospital is to seek early intervention (EI) and evidence-based treatment options. Early diagnosis coupled with prompt intervention will result in the best possible prognosis for the child. Treatments can include applied behavioural analysis (ABA), occupational therapy, speech therapy, physical therapy, and pharmacological therapy.
ABA encourages desired behaviours and discourages undesired behaviours to improve a variety of skills. Two ABA teaching styles are discrete trial training (DTT) and pivotal response training (PRT). DTT uses step-by-step instructions to teach a desired behaviour or response, while PRT takes place in a natural setting and focuses on improving a few "pivotal skills" to help the person learn many other skills.
Many autistic children struggle with anxiety, which can be caused by difficulty in understanding their surroundings, and feeling misunderstood or unaccepted. They may also face challenges with eating and sleeping, and often find it hard to make friends.
To address anxiety, it is important to identify the triggers and prepare the child for any changes in routine. Cognitive behavioural therapy (CBT) may also be helpful. For eating and sleeping issues, it is recommended to speak to a GP or autism team for advice and to create a sleep plan if needed. Social challenges can be addressed through educational support and creating an Individualized Education Plan (IEP) to meet the child's learning needs.
