If an infant or toddler exhibits any unusual behaviors for a day or two after
behaving completely normally, it probably means that he or she is coming down
with a minor illness, doesn't feel well, or is tired or under some other kind of
stress. However, if the child has always had any of these characteristics, or
the characteristic(s) continues over a period of time, a visit to the
pediatrician or health care provider is warranted. The average age for the
diagnosis of autism is 4-6 years, although most parents suspected something was
wrong by 18 months and voiced their concerns by age 2 years.
The national Institute of child health and human development ( NICHD ) and
experts recommend that any child be evaluated for autism who has not met the
following developmental milestones:
If even one of these statements is true of a child, resist the temptation to
"just wait and see." Problems of this type may signal some type of disability,
even if it is not autism. Early diagnosis and prompt intervention are very
important in improving the long-term outcomes for developmental disorders of all
types, including autism.
therapy is the foundation for most treatment programs for children with
autism. More than 30 years of research has shown the benefit of applied
behavioral methods in improving communication, learning, adaptive behavior, and
appropriate social behavior while reducing inappropriate behavior in children
with autism. There is strong evidence that these interventions are most
effective when started early, typically in the preschool years. A range of
scientifically proven behavioral treatment has been developed for children with
autism. These are mainly based on the principles of applied behavior analysis.
Applied behavior analysis (ABA) is designed to both correct behavior and teach
skills for dealing with specific situations. It is based on the principle of
reinforcement: that behavior can be changed by rewarding desired behavior and
removing reinforcement for unwanted behavior. The person will naturally repeat
behaviors for which he or she is rewarded. This principle is applied in many
different ways, such as discrete trial training, incidental teaching, errorless
learning, and shaping and fading. Most treatment programs include a number of
These comprehensive treatment approaches differ in their specifics but are
highly structured, intensive programs in which the child spends a large amount
of time (15-40+ hours per week), usually in one-to-one activities with a
therapist, to change behaviors. Behavioral therapists typically collaborate with
parents, school personnel, and community professionals in providing a
comprehensive treatment program that is individualized to meet each child's
Positive behavioral interventions and support are designed to replace problem
behaviors with positive behaviors and improve the person's quality of life. Like
other approaches, this approach requires examination of the individual's unique
strengths and problems and development of strategies to improve his or her
quality of life overall.
The main principle of education is that each person with autism has his or her
own strengths, abilities, and functional level and that his or her education
should be tailored to meet his or her individual requirements. This is not only
desirable for the child, it is required by federal law. The Individuals with
Disabilities Education Act (IDEA; P.L.101-476) guarantees free and appropriate
public education for every child with a disability. This law specifies that a
written and explicit education plan (the Individualized Education Plan, or IEP)
be prepared by the local education authority in consultation with the child's
parents. When all parties agree on the plan, the plan must be put into place and
the child's progress documented. Preparation of the plan includes a
comprehensive assessment of the child's needs.
Many different options are available for educating children with autism. The
basic assumption is that, whenever possible, children with disabilities should
be educated with their nondisabled peers, who serve as models for appropriate
language, social, and behavioral skills. Thus, some children with autism are
educated in mainstream classrooms, others in special education classes within
mainstream public schools, and others in specialized programs separate from
mainstream public schools. Parents wanting to find the best possible program for
their child are advised to work with the local education authority; full
cooperation and communication are essential for meeting this goal.
The following specific programs have been developed for persons with autism:
It is important that skills learned at school are generalized outside the
classroom setting. Thus, programs for children with autism must include the
family and be coordinated across the child's home and community. Complementary
Complementary therapies include art therapy, music
therapy, animal therapy, and sensory integration therapy. These
are not behavioral or educational approaches per se, but they provide another
opportunity for the child to develop social and communication skills. Although
there is little scientific evidence that these therapies increase skills, many
parents and therapists describe noticeable improvements in a child's behavior
and communication abilities, as well as a sense of enjoyment.
Complementary therapies are typically used in addition to behavioral and
The best thing you can do to help your child is to work with the professional
team. Be informed of the issues surrounding your child's treatment and outlook.
Be sure you are clear about the goals of therapy and how they are to be
achieved. Be organized and cooperative in supplying all information required by
the team. Communicate your questions and reservations about the treatment plan
so they can be addressed.
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