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.
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Behavioral 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 ABA therapies.
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 specific needs.
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 therapies
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 educational approaches.
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.
