There is currently no cure for autistic spectrum disorder (ASD). However, a range of specialist education and behavioural programmes (often referred to as interventions) can be effective in improving the skills of children with ASD.
There are many different types of intervention for ASD, so it is often hard to judge which one will work best for your child.
Some types of intervention can involve hours of intensive work, and this is not always possible for many families because of the practical, emotional and financial commitments necessary.
The National Autism Society website has information on the many different approaches, therapies and interventions available for ASD.
Any intervention should focus on important aspects of your child’s development. These are:
- communication skills – such as the ability to start conversations
- social interaction skills – such as the ability to understand other people’s feelings and respond to them
- cognitive skills – such as encouraging imaginative play
- academic skills – the “traditional” skills that a child needs to progress with their education, such as reading, writing and maths
Some widely used interventions for ASD are explained below.
Applied behavioural analysis (ABA)
Applied behavioural analysis (ABA) is based on:
- breaking down skills (such as communication and cognitive skills) into small tasks, and then teaching those tasks in a highly structured way
- rewarding and reinforcing positive behaviour while discouraging and redirecting inappropriate behaviour
ABA programmes usually take place in the home. They consist of 40 hours a week of intensive therapy over two to three years.
An ABA programme is usually delivered by a consultant, who oversees the programme, and a team consisting of at least three therapists who alternate working with your child.
The programme team will work with your child on a one-to-one basis, in sessions of two to three hours. The team will try to teach your child by breaking skills down into smaller tasks. These tasks are then taught in a repetitive and structured way, with a particular emphasis on praising your child and reinforcing positive behaviour.
An ABA programme usually begins with simple tasks. Over time, these small tasks will build up into more complex skills that will help with your child’s development.
TEACCH
TEACCH is a type of educational intervention that places great emphasis on structured learning by using visual prompts. Research has found that children with ASD often respond better to information that is presented visually.
TEACCH is often delivered at special day centres, but you can also have training so you can continue the intervention activities in your own home.
Speech and language therapy (SLT)
Speech and language therapy is a type of skills training designed to improve your child’s language skills. This can improve their ability to interact with others socially.
The therapist uses a number of techniques, such as visual aids, stories and toys to improve communications skills.
Funding
Many of the interventions mentioned above take a lot of time and labour, and can cost a significant amount of money.
Many local education authorities (LEAs) provide partial or sometimes total funding towards specialist education and training, but this varies widely between LEAs.
If you would like more advice on what funding is available and how to request it, the National Autism Society runs a special service called the Education Rights Service.
Medication
No medication is available to treat the core symptoms of ASD, but medication may be able to treat some of the related symptoms, such as:
- repetitive thoughts and behaviour
- aggressive behaviour, such as tantrums or self-harming
One type of medication used in the UK is the class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These work by changing the levels of a chemical called serotonin in the brain. Serotonin is known to affect behaviour and mood.
However, SSRIs are used only extremely rarely to treat children and young people, and only by specialist consultants such as a child psychiatrist.
It is more common for specialists to use melatonin or other prescribed medication to help sleep (which is commonly disturbed in ASD). Specialist consultants may also use stimulant medication such as methylphenidate for young people who also have attention deficit hyperactivity disorder (ADHD).
It is not possible to predict how an individual will respond to SSRIs and whether they are a suitable treatment, but the clinical use of SSRIs has increased greatly in the last decade.
Examples of SSRIs include:
Some children with ASD who are taking SSRIs can suddenly have a sharp rise in serotonin levels. This can trigger a group of side effects known as serotonin syndrome.
Symptoms of mild to moderate serotonin syndrome include:
- confusion
- agitation
- muscle twitching
- sweating
- shivering
- diarrhoea
If your child has any of the above symptoms, stop their medication and seek immediate advice from your GP. If this is not possible, call NHS Direct on 0845 4647.
Symptoms of severe serotonin syndrome include:
- a high temperature of 39.4C (103F) or above
- seizures (fits)
- irregular heartbeat
- unconsciousness
If your child has any of these severe symptoms, call 999 and ask for an ambulance.
Complementary and alternative medicines (CAM)
A number of studies have found that most parents have tried at least one type of complementary and alternative medicine (CAM) to improve their child’s symptoms.
Examples of suggested CAMS to treat ASD include:
- special diets, such as gluten-free diets
- vitamin supplements
- anti-fungal medication
- chelation therapy, which uses medication or other agents to remove metal, in particular mercury, from the body
There is little or no evidence that any of these approaches are effective, and some may even be potentially dangerous.
Do not make changes to your child’s diet without first consulting your GP.
It is strongly recommended that you do not try chelation therapy as there is no evidence of its effectiveness. It is based on a theory that mercury is responsible for the symptoms of ASD. But this theory is not shared by mainstream ASD experts, and it is potentially dangerous.
Risks associated with chelation therapy include kidney damage and liver failure. One child is reported to have died as a result of chelation therapy.
If you are considering a CAM, look out for certain claims and signs that suggest that the treatment may be unsound. These include claims that:
- are based on overly simplified scientific theories – for example, that ASD is caused by mercury in the body
- promise effective treatment for a wide range of unrelated symptoms
- offer dramatic results or the possibility of a cure
- rely on unpublished case reports rather than carefully designed studies
- the treatment has no risks or side effects
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