Autism Treatment Options

Autism treatment is an ongoing journey that requires individualized approaches tailored to each person’s unique needs and challenges. While autism spectrum disorder (ASD) is a lifelong condition, evidence-based treatments and interventions can significantly improve symptoms and help those with ASD to develop skills that will enhance their quality of life. Understanding these treatment options helps people with autism, as well as their caregivers or family members, to make informed decisions about their unique care path.

What is Autism Spectrum Disorder?

Autism spectrum disorder (ASD) presents a remarkable tapestry of human experiences and abilities. Individuals with ASD range from those with exceptional conversation skills to people who communicate without words. Similarly, support needs vary widely, as some individuals require comprehensive assistance in daily life while others navigate work and personal responsibilities with minimal support ^[1]. 

In terms of onset, ASD typically emerges before age three, though development differs significantly from person to person. In some cases, signs appear within the first year of life, but for others, symptoms don’t become noticeable until after the second birthday or even later. Additionally, some children develop typically at first, hitting all the expected milestones until around 18-24 months of age, when they might plateau or even lose previously gained skills ^[1].

As these children age, they often face unique social hurdles. For example, building meaningful friendships, navigating complex communications, or understanding unwritten social rules at school or work can be particularly challenging. Additionally, many individuals with ASD initially seek healthcare not for autism itself, but rather for common co-occurring conditions like anxiety, depression, or ADHD, all of which appear more frequently in people on the autism spectrum than in the general population ^[1].

The diagnosis rate for ASD seems to be increasing. For example, Autism insights from the Centers for Disease Control and Prevention show that between 2018 and 2023, autism prevalence increased significantly. That said, some question the validity of this rise in autism rates, pointing out that it could be due in part not only to an increase in ASD but also to increased diagnosis and reporting. Nevertheless, the fact remains that among 8-year-olds, 1 in 36 (2.8%) are reported to have ASD ^[2].

Diagnosis and Signs of Autism

Diagnosing ASD, which typically occurs in childhood, requires a comprehensive approach rather than a single assessment tool. The diagnostic process typically combines two essential information sources: detailed accounts from parents or caregivers about their child’s developmental journey and professional observations of the child’s behavioral patterns. 

This assessment is often initiated by primary care providers, but families are regularly referred to specialists such as neurodevelopmental pediatricians, developmental-behavioral pediatricians, child neurologists, geneticists, or early intervention programs that offer specialized assessment services ^[3]. During these assessments, evaluators look for various deficits and identifiers. 

ASD deficits in social communication can include ^[4]:
 

• Limited enthusiasm for sharing personal interests
• Challenges understanding emotional cues 
• Discomfort with sustained eye contact 
• Difficulty using and understanding non-verbal gestures
• Mechanical or awkward speech patterns
• Interpreting abstract ideas literally
• Difficulties establishing and maintaining peer relationships over time

Those with ASD can also exhibit repetitive behaviors and restrictive interests such as ^[4]:

• Rigid behavioral patterns and significant distress when faced with unexpected changes
• Difficulty tolerating changes in routines 
• Intense concentration on specialized topics with minimal interest in other subjects
• Assumption that others share the same level of enthusiasm for preferred topics
• Heightened sensory reactions, such as discomfort with loud sounds or specific textures
• Repetitive physical movements such as rocking or spinning
• Precise arrangement of objects (e.g., toys or clothes)

“What if we understood autism not as a checklist of deficits, 

but as a different way of being human?”—Dr. Barry M. Prizant

Types of Treatment for Autism

While there is no cure for autism, ASD treatment can significantly improve functioning and well-being. Treatment for ASD is not uniform. The right approach is unique to each person, with the goal of reducing symptoms that interfere with quality of life and daily functioning. 

Treatment types are often organized into the following categories; however, some overlap exists between them ^[5]:

• Developmental: Developmental treatments for ASD target specific skills like language or broader physical abilities, often complementing behavioral therapies. Speech and language therapy are the most common developmental techniques, although occupational therapy and physical therapy also fall under the umbrella of developmental therapy.
  
• Educational: Specialized educational programs help people with autism learn academic, social, and life skills. These may include altered classroom settings, individualized education plans (IEPs), or specific teaching strategies tailored to how people with autism learn.
  
• Behavioral: These interventions focus on teaching new skills and reducing challenging behaviors through positive reinforcement and structured learning environments. Applied Behavior Analysis (ABA) is one of the most widely used behavioral approaches.
  
• Pharmacological: While medications don’t treat autism itself, they may help manage co-occurring conditions such as anxiety, depression, attention difficulties, or challenging behaviors such as an inability to focus and high energy levels.

• Societal: These interventions focus on building social skills and relationships through structured activities and guided interactions with peers and family members.

• Psychological: Psychological therapies address emotional regulation, anxiety management, and social skills development through individual or group counseling sessions.

Therapeutic Approaches to Autism Treatment

Several evidence-based therapeutic approaches have been developed to support individuals with ASD. Each of the following therapies targets specific aspects of development and can be customized to meet individual needs.

• Applied Behavior Analysis (ABA): This systematic approach uses positive reinforcement to improve communication, learning, social skills, and behavior. ABA therapy helps individuals develop practical skills for daily living while reducing challenging behaviors ^[6].
  
• Early Start Denver Model (ESDM): As a comprehensive behavioral intervention for children aged 12-48 months, ESDM combines relationship-focused developmental approaches with ABA principles. ESDM emphasizes positive affect and natural teaching strategies during daily routines and play ^[7].
  
• Pivotal Response Treatment (PRT): PRT targets motivation, response to multiple cues, and self-management, emphasizing child-led activities and natural reinforcement ^[8].
  
• Relationship Development Intervention (RDI): As a family-based treatment that focuses on building social connections and improving dynamic intelligence, RDI helps individuals develop flexible thinking and meaningful relationships ^[9].
  
• Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH): This structured teaching approach emphasizes visual learning and organization. TEACCH helps individuals understand their environment and develop independence through structured routines ^[10].
  
• Verbal Behavior Therapy: Focused on teaching communication skills through motivation and reinforcement, this approach helps individuals understand the purpose of language and how to use it effectively ^[11].

Holistic Strategies for Treating Autism

Many families explore holistic and complementary approaches to support traditional autism treatments. These holistic strategies address various aspects of autism, including sensory sensitivities, behavioral challenges, and overall well-being. 

The Centers for Disease Control and Prevention (CDC) indicates that the following therapies offer some benefits when used in conjunction with evidence-based treatments ^[12]:

• Creative therapies: Many families explore complementary approaches like art and music therapy alongside traditional interventions to address sensory sensitivities, enhance communication skills, and reduce sensitivity to touch or sound.
  
• Sensory-based therapies: While based on the unproven theory that those with ASD have a sensory processing disorder, sensory-based therapies involve the use of brushes, squeeze toys, trampolines, and other materials to stimulate the senses.
  
• Massage: While research hasn’t demonstrated that massage improves ASD symptoms, many families employ massage as a relaxation tool for those with ASD.
  
• Pet or horse therapy: Similar to massage therapy, the effectiveness of pet and horse therapy for ASD symptoms isn’t backed by valid research. However, families often use this form of therapy to provide companionship and recreation.

Impact of Autism on Mental Health

Research indicates that 70% to 90% of people with ASD experience at least one co-occurring mental health condition, e.g., anxiety, depression, attention-deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), Tourette’s disorder, etc. ^[13]. Additionally, people with ASD often face unique mental health challenges that can significantly impact their daily lives. For example, social and communication differences can lead to increased stress and feelings of isolation. Plus, many individuals with autism experience difficulties in forming and maintaining relationships, which may contribute to emotional challenges. Sensory sensitivities and the effort required to navigate social situations can be mentally and emotionally taxing, leading to further isolation and withdrawal.

Finding a Therapist Who Specializes in Autism

Finding the right therapist is crucial for supporting someone with ASD. The most qualified professionals typically hold specialized certifications, including Board Certified Behavior Analysts (BCBAs), licensed psychologists with autism expertise, speech-language pathologists, and occupational therapists with autism specialization. 

Families can begin their search by consulting primary healthcare providers for referrals, connecting with local autism organizations and support groups, or working with insurance providers to identify in-network specialists. The autism community itself can be an invaluable resource, as experienced families often share recommendations based on personal experiences. 

While each person’s journey with autism is unique, appropriate professional support can help people with autism develop their unique strengths, manage challenges, and ultimately lead happy, fulfilling lives. With dedication, understanding, and the right therapeutic partnership, those living with ASD can unlock their full potential and thrive in ways that might have once seemed impossible.