What is Autism Spectrum Disorder?
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in two areas; social-communication and restricted, repetitive behaviors or interests. Symptoms of ASD appear early in development, usually within the first three years of life and symptoms can vary depending upon the individual.
ASD is a lifelong disorder and is more common in boys than girls. The main characteristics of ASD within the two domains include:
- Social Communication: difficulty with social-emotional reciprocity, the use of nonverbal communication skills (eye contact, facial expressions, use of gestures) and developing and maintaining social relationships with others.
- Restricted and Repetitive Behaviors:repetitive motor movements (hand flapping), restricted or repetitive interests, ritualized patterns of behavior, behavioral rigidities or insistence on sameness and reactivity to sensory input
Symptoms of ASD cause challenges in how an individual behaves and communicates or interacts socially with others. All individuals with ASD need support to be successful, but the amount and intensity widely varies. Some individuals with ASD are able to function independently and perform normal activities of daily living, while others need substantial support and intervention throughout their lifespan.
What are treatments for Autism Spectrum Disorder?
Treatment for ASD can vary depending on the age and level of functioning of the individual. Common targets for treatment include improving current abilities, teaching new skills (e.g., improved language, back-and-forth play skills and better socialization with others), as well as reducing challenging behaviors (e.g., tantrums, aggression). There are many treatment options for ASD; however, not all treatments have been shown to be effective or even safe. It is important for families to be aware of all the different types of treatment so they can make the best decisions that lead to best outcomes.
What is an evidence-based treatment?
A treatment is considered “evidence-based” if it has been repeatedly shown through well-designed scientific studies to show improvements that are sustained over time. One of the most well established evidence-based treatments for ASD is Applied Behavior Analysis (ABA; also referred to as early intensive behavioral intervention [EIBI]). ABA uses principles learning theory to improve an individual’s developmental, cognitive and behavioral functioning. ABA has been shown to be effective in increasing learning abilities and adaptive functioning in children with ASD. ABA therapies have a long and established “track record” of producing meaningful change over time.
What is the status on alternative treatments?
Alternative treatments are characterized by using non-mainstreamed practice in the place of conventional and proven treatments. Alternative treatments for ASD generally target the physiology or biology of the child, versus teaching new skills directly. Research suggests that families of children with ASD frequently use alternative treatments, with one study discovering that 74 percent of families have used novel, unconventional or off-label treatments. These findings are concerning, because there is not conclusive evidence that alternative treatments help individuals with ASD.
Unfortunately, in some cases, alternative treatments have been shown to be ineffective or even harmful (e.g., chelation therapy, facilitated communication). We need more scientific evidence to determine if and what specific alternative treatments are effective. The following is a list of popular alternative treatments that evidence has shown to be either inconclusive or ineffective in the treatment of ASD:
- Dietary Supplements (magnesium and B6, dimethylglycine, amino acids, omega 3 fatty acids)
- Gluten-Free and Casein-Free (GFCF) Diet
- Auditory Integration Therapy
- Chiropractic Therapies and Massage
- Floortime and Relational Therapies
- Hyperbaric Oxygen Therapy (HBOT)
Unfortunately, individuals and families of children with ASD are often targeted as consumers for fast solutions or quick a cure for ASD. There is not a singular explanation for the cause of ASD, which has led to many theories and alternative treatments to “take hold” in hopes to improve the lives of individuals with ASD. However, many alternative treatments lack scientific evidence to support their use.
Also, many of these alternative treatments are very costly to the family to pursue. We encourage families of individuals with ASD learn how to identify evidence-based treatments and to pursue those treatments wholeheartedly.
For more information about the Center for Autism Spectrum Disorders at Nationwide Children's Hospital, click here.