Interventions in the Treatment of Autism - Research Paper Example

?Interventions in the Treatment of Autism Introduction Autism is defined as a developmental disorder which adversely affects verbal and nonverbal communication, causing a detrimental influence on social interaction, on educational performance, and in relating to other people. The psychological disorder is generally evident before age three, and includes impaired and irregular communication skills, avoidance of eye contact, poor development of language for social communication, inability for symbolic or imaginative play, engagement in repetitive activities and stereotyped movements, resistances to changes in the environment or daily routine, and unusual responses to sensory experiences. Autism is not one specific condition, but refers to a group of disorders with disparate underlying etiologies (Corbier, 2005). Hence, treatment for autism is multidimensional, including behavioral management, individualized education plan, medical treatment, psychoanalytic therapy, and rehabilitative therapeutic strategies, together with patience, faith and belief. Integrated treatment plans focus on preparing people with autism to live in their home community in the least restrictive environment (Hardman et al, 2007). Thesis Statement: The purpose of this paper is to investigate the current treatments for children with autism, and determine their effectiveness. Behavioral Management as a Treatment Intervention in Autism Behavioral interventions aim to improve specific appropriate behaviors, or to lessen inappropriate behavior (Hardman et al, 2007). This approach is commonly considered to be the most effective in treating autism in children. A research study was conducted by Sallows and Graupner (2005) on twenty-four children with autism, aged between 24 to 42 months at the beginning of the study. They were randomly assigned to early intensive behavioral treatment, and to treatment involving intensive hours but less supervision by equally qualified supervisors. The results were similar for both groups, after four years of multidimensional treatment including cognitive, language, adaptive, social and academic measures. This indicates that supervision by trained staff is not an essential criterion for improved behavioral outcomes, when the same intensive treatment is given to both the study sample and the control group. By combining the two groups, it was found that the results were optimized, and by age seven the children could adapt themselves to mainstream classrooms. However, pretreatment skills played a significant part in determining the success of the interventions, particularly verbal imitation ability, language and social responsiveness. Lovaas (1993) discovered that early identification of the environmental variables that controlled the extent of treatment gains, was essential. Effective treatment for severe behavioral disorders requires early intervention which is conducted throughout the child’s waking hours, while taking all significant behaviors in all the child’s environments into consideration, by all significant persons caring for the child, and for many years. Research on early intensive behavioral treatment for children with autism was conducted by Cohen et al (2006) in the community setting, to replicate earlier studies which had shown favorable results. The three-year prospective outcome study using a quasi-experimental design consisted of the sample group of 21 children which received early intensive behavioral therapy (EIBT) from a community agency, and the other control group of 21 children who of equal age and IQ as compared to the first group, and belonging to special education classes at local public schools. The results showed marked improvement in language, nonverbal skill, and adaptive behavior; hence early intensive behavioral therapy can be successfully undertaken in the community setting. Individualized Education Plan and Educational Interventions “Early intervention and a highly structured education program are currently regarded as the best treatment for children with autism” (Bos et al, 2004, p.217), since they offer the highest possibilities for normal schooling and a typical, age-appropriate life. For children with autism, an individualized education plan (IEP) stating short term and long term goals is one of the key interventions in treatment. The core elements of IEP should be the promotion of functional communication, social skills, individual strengths, and the skills required for maximum independence. Individualized help to develop functional skills and knowledge is vital because the requirement for these differ among children with autism. While some children may need support in developing skills for self-help, self-protection, communication and social interaction, others may require specialized help in studying traditional academic subjects, or topics not in general education curricula such as sexual awareness and sex education which are frequently areas of concern to their parents (Hardman et al, 2007). As compared to children with other disabilities, those with autism require teachers with a positive approach based on creativity and innovativeness. The teachers need to have skills for meeting the unique challenges these children present in the teaching-learning environment. It is also important for parents to collaborate with teachers, to ensure that the child is prepared for the classroom situation. According to Hardman et al (2007), parents should develop a positive attitude in the child, help in scheduling time, guide the child about the layout of the school, teach him about a safe place to go to and a safe person to approach if needed, in order to help the child get adjusted in school. Medical Treatment for Children with Autism Drug therapy is a commonly used treatment method for autism, by medical practitioners. Though there are no FDA approved drugs for the treatment of autism, medications are used to control the various symptoms of the disorder. These include behavioral problems such as aggressive behavior, tantrums; neurological problems such as seizures; psychiatric conditions such as attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), anxiety disturbances, obsessive compulsive disorder (OCD) and general anxiety disorder. Only when the severity levels of the symptoms are high, is medication advisable. Examples of the classes of drugs commonly used are: “antipsychotic agents used for behavioral problems, antidepressants used for OCD and anxiety disorders, selective serotonin reuptake inhibitors, anticonvulsants, ADHD medications, and various other drugs based on symptoms present” (Corbier, 2005, p.121). Since drug therapy has limitations such as side effects, even when they are successfully effective, they should not be used in place of treating the underlying condition. Shea et al (2004) investigated the efficacy and safety of Risperidone as medication for disruptive behavioral symtoms for children with autism and other pervasive developmental disorders (PDD). The research study was an 8-week, randomized, double-blind, placebo-controlled trial, with a study sample of 79 children with pervasive develpmental disorders such as autism, aged between 5 to 12 years. The children were administered a mean dosage of 0.04 mg/kg/day. Evidence from the study indicates that Risperidone was effective in treating behavioral disorder symptoms in children with PDD. However, the drug produced side effects such as somnolence, headache, weight gain, increased pulse rate, and higher systolic blood pressure; but the adverse effects were self limiting or could be managed by modifying the doses. The improvement in the patient’s condition far outweighed the minor drawbacks. The beneficial outcomes of using Risperidone had been found earlier by similar research on children aged 5 to 12 years, conducted by Aman et al (2002) for 6 weeks, using a dosage of 0.02 to 0.06 mg/kg/day. Hence Risperidone offers new hope for the management of behavioral symptoms in children with autism and other PDD conditions. Conclusion This paper has highlighted current treatments for children with autism, and investigated their effectiveness. Three interventions discussed include behavioral management, individualized educational interventions, and medications. The evidence indicates the importance of early intensive behavioral therapy in treating children with autism; the crucial requirement for skilled teachers with specialized training; and the effectiveness of medication using Risperidone. The various types of treatment need to be skilfully integrated to design individualized, effective therapeutic strategies. Hence, evidence-based multidimensional treatment plans should be used for achieving optimal outcomes in children with autism. For ensuring ethical future research where the control group of children are not deprived of treatment interventions, different integrated-treatment approaches should be compared for effectiveness, and those with positive effects should be replicated on a large scale, for achieving confirmed results. References Aman, M.G., De Smedt, G., Derivan, A., Lyons, B. & Findling, R.L. (2002). Double-blind, placebo-controlled study of Risperidone for the treatment of disruptive behaviors in children with subaverage intelligence. American Journal of Psychiatry, 159: pp.1337- 1346. Bos, L., Laxminarayan, S. & Marsh, A. (2004). Medical and care compunetics 1. The United States of America: IOS Press, Inc. Cohen, H., Amerine-Dickens, M. & Smith, T. (April 2006). Early intensive behavioral treatment: Replication of the UCLA model in a community setting. Developmental and Behavioral Pediatrics, 27(2): pp.S145-S154. Corbier, J.R. (2005). Optimal treatment for children with autism and other neuropsychiatric conditions. The United States of America: iUniverse Publishers. Hardman, M.L., Drew, C.J., & Egan, M.W. (2007). Human exceptionality: School, community and family. Edition 9. Boston: Houghton Mifflin. Lovaas, O.I. (1993). The development of a treatment-research project for developmentally disabled and autistic children. Journal of Applied Behavior Analysis, 26(4): pp.617-630. Rogers, S.J. (1998). Empirically supported comprehensive treatments for young children with autism. Journal of Clinical Child Psychology, 27(2): pp.168-175. Sallows, G.O. & Graupner, T.D. (2005). Intensive behavioral treatment for children with autism: Four-year outcome and predictors. American Journal on Mental Retardation, 110(6): pp.417-438. Shea, S., Turgay, A., Carroll, A. Schulz, M., Orlik, H. & Smith, I. (2004). Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Pediatrics, 114(5): pp.1-10. Read More