Coping with Autism

Autism is a lifelong condition, which is apparently an intrinsic part of the brain's hard wiring and although it seems unlikely that a cure will ever be found, some types of treatment may be very helpful in enhancing the quality of life both for autistic individuals and their families.

Behavioural and Educational Approaches

Speech therapists, occupational therapists and others, working together can provide structured and intensive programmes with an orientation on social and language skills. There's a lot of evidence that the earlier this specific type of intervention is started, the better the results.

Until quite recently, autism was usually diagnosed around age 3, when children either weren't talking, or were going through a regression of language skills. Recent research and greater social awareness have led to a situation where experts suggest that doctors and parents can pick up on the condition as early as 18 months, with clues like problems with eye gaze, inappropriate interaction with other children or poor joint attention with parents.

There are also more formalised suggested screening instruments like the Checklist for Autism in Toddlers – CHAT. It's been suggested that paediatricians should routinely check all 18 month olds with this test, in order to identify which children may need more careful screening for autism when they're older.

Studies show that children who are identified early, and educated with a lot of speech therapy, occupational therapy and some specific behavioural treatments, tend to cope best with their autism in later life.

A diagnosis of autism impacts hugely not only on the child, but also on the lives of everyone else in the family, both in terms of practical coping and emotional responses, and other family members often also benefit from appropriate counselling.

Applied Behavioural Analysis

One type of behavioural treatment, which seems to show good results is called applied behavioural analysis (ABA). Non autistic children typically learn a vast amount of information and skills very rapidly, just from exposure to the environment of other people, without any specific assistance.

Autistic children learn much, much less from their social environment, since they have far less active interaction with other people.

Children who focus all of their attention on the same things and activities do not enhance their chances for learning and developing.

ABA rests on the premise that autistic children are capable of learning, but only in a very structured environment, where conditions are optimised for acquiring, with active assistance, the same skills that others pick up naturally. They are taught how to learn from parents, siblings, peers and others. Intensive teaching is used to overcome the "learning blockage" that apparently underlies autism, so that they can learn how to respond and behave in social situations.

For example, the teacher gives the child a stimulus along with the required response. The stimulus may be something like a request to go and ask Mummy for an apple, or a question like "Are you excited about your birthday?".

The required response can be given directly at first: - "Go up to Mummy, and say "please may I have an apple", or strongly hinted at: -"Say –yes, I'm excited about opening my…", so that the child can pick up the sentence and complete it, by saying "Yes, I'm excited about opening my presents".

The child gets a small reward, like a smartie, or just a big smile and a "well done" if he repeats the correct answer. Anything else is ignored or treated neutrally. As his response becomes reliable, the teacher uses less hints and clues, till the child can respond to that particular stimulus independently and correctly.

The best results come about when this type of teaching is reinforced by everyone in the child's environment, in natural as well as classroom situations.

There is some - not conclusive - evidence that the developmentally disordered brain "learns how to learn" best if the basic skills are taught in early childhood.

It seems that the worst effects of autism can be prevented in many cases and early, intensive behavioural programmes may even eliminate completely the symptoms of autism in some children and greatly improve the lives of many others.

What About Medication?

A number of drugs seem to help with some of the symptoms of autism. In a targeted approach, a particular characteristic of autistic behaviour is selected and treated. For example, autistic individuals with lots of narrow, restricted interests, repetitive and compulsive behaviours may benefit from very low doses of drugs like Prozac. This helps to improve both the core symptoms and overall functioning.

Autistic individuals with a lot of disruptive behaviour like impulsivity, aggression and tantruming may benefit from a different class of drug, the antipsychotics. Anticonvulsant medicines, of the type used in epilepsy seem to help autistic people with language related functioning.

What Does the Future Hold?

It seems unlikely that any simple cure for autism will appear on the horizon, but there is a lot of optimism about the options that are becoming available for autistic individuals and their families. Apparently even enhanced IQ can result from combinations of the behavioural and medical approaches to autism, especially when the condition is identified early.

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