Effective Treatment for Autism in Children - Term Paper Example

Current Treatments for Children with Autism Introduction Autism is defined as a developmental disorder which adversely affects verbal and nonverbal communication, causing a significantly 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 the following characteristics: 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. Treatment for autism is multidimensional, with an individualized education plan with short and long term goals, as an important factors. The main focus of integrated treatment interventions is on preparing individuals with autism to live in their home community in the least restrictive setting (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. Discussion Effective treatment for autism in children is individualized, combining educational interventions, psychotherapy, rehabilitative therapeutic strategies, medication, and behavioral management, together with patience, faith and belief. According to Corbier (2005, p.107), “it is of vital importance to first remember that autism is not just one specific condition, but a group of disorders with disparate underlying etiologies”. Faith in God and Belief in the Treatment Jesus believed that the reign of God belonged to children since they are vulnerable and powerless; hence He extended God’s kingdom to them (Bunge, 2001). Parental faith plays a significant part in children with autism being able to respond to treatment, and in their health progress. This is equally true for belief in the efficacy of treatment, which is according to Frith (2003, p.31) “a powerful promoter of improvement” in children suffering from the condition, and which is often evident from the placebo effect. While examining treatments for children with autism, it is essential to take into account some sections from the Bible (Carroll & Prickett, 1998), which present the Word of God. Jesus gives hope to the sick by stating in Exodus 23:25 that one who faithfully serves the Lord, our God, shall be blessed, and Jesus would take sickness away from his midst which refers to his family and those around him. Similarly, in Deuteronomy 7:15, the Bible states that to reward a devotee’s sincerity, the Lord will take away from him all sickness, and will never afflict him with evil diseases. Further, Deuteronomy 28:59 states that the Lord changes the plagues and also transforms to good health the afflictions of “thy seed” meaning one’s children’s chronic illnesses “of long continuance”. In some of the Proverbs, and also in the Psalms on the Security of God’ protection, and Confidence in God, the scriptures advocate faith and service to God, for His blessing of healing from sickness (Carroll & Prickett, 1998). 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. Psychology and Psychoanalysis Based Therapy Psychoanalysis based therapy is undertaken to correct the emotional damage that is believed to have occurred from faulty family relationships (Hardman et al, 2007). According to Frith (2003), mind blindness is a useful hypothesis for the diagnosis and treatment of autism. It helps in understanding the impairments in communication and social interaction caused by the inability to read minds, in a child with autism. Research in psychosocial interventions has revealed that specialized strategies promoting a structured, consistent environment which encourages social interaction improves autism-specific behaviors. However, the effectiveness of these interventions along with carer awareness and the teaching of communication strategies are not supported by adequate sample size and randomized, blind studies. A pilot, randomized, controlled study on 28 children with autism conducted by Aldred et al (2004) targeted parental communication, educating parents and training them in adapted communication specifically individualized to their child’s competencies. In the study sample this intervention was in addition to routine care, while in the control sample only routine care was provided to the children. The evidence from the study reveals significant additional treatment benefits following a targeted but relatively non-intensive dyadic social communication treatment, as compared to routine care alone. Medical Treatment 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. Behavioral Management 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 (Sallows & Graupner, 2005, p.417). 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 comparing two groups consisted of the first 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. Language, nonverbal skill, and adaptive behavior were studied. The EIBT group scored significantly higher scores in IQ and adaptive behavior; while the two groups did not differ in either language comprehension or nonverbal skill. From the study sample, six children adapted to the mainstream classroom without assistance, and eleven others with support. Contrastingly, only 1 child from the control group was placed in the regular education classroom. The limitation of the study was its lack of random assignment to the groups; however, the evidence is clear that early intensive behavioral therapy can be successfully undertaken in the community setting. Conclusion This paper has highlighted current treatments for children with autism, and investigated their effectiveness. Treatment involves individualized educational interventions, psychotherapy, medications, behavioral management, as well as the crucial factor of belief in the treatment as well as faith in God. It was evident from the literature, that skilled teachers with specialized training in teaching children with autism are a crucial requirement. Moreover, parental belief in the treatment, spiritual faith and optimism are important factors, together with their active participation in the treatment strategy. The importance of early intensive behavioral therapy in treating children with autism has been stressed. Further, improved parental communication, provision of opportunities for social interaction in a structured, consistent environment, and the effectiveness of medication using Risperidone have been discussed. The various treatment options need to be skilfully integrated to design individualized, effective therapeutic strategies. For this purpose, multidimensional treatment plans based on research evidence from double blind controlled trials using large study samples have to be used, for achieving optimal outcomes in children with autism. However, research pertaining to effectiveness of treatment interventions using control groups has an ethical side, since it essentially deprives the affected children in the control group of the particular intervention under study, over long durations of time. This is supported by Rogers (1998), who believes that future research should compare different treatment approaches for effectiveness, investigate the outcome of using models of behavior therapy, and replicate on a large scale those treatments demonstrated as having positive effects from trial studies of pre- and post-intervention. ------------------------------ References Aldred, C., Green, J. & Adams, C. (2004). A new social communication intervention for children with autism: pilot randomized controlled treatment study suggesting effectiveness. Journal of Child Psychology and Psychiatry, 45(8): pp.1420-1430. 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