May 27, 2011

Complexities of Autism Extend to Its Treatment

FRIDAY, May 27 (HealthDay News) -- Parents of children with autism often find themselves struggling to make sense of their child's behavior.

What's worse, there's no single best way to treat the frightening and frustrating neurodevelopmental disorder. Children might have a mix of social impairments, communication problems and repetitive behavior patterns. Each child will require a certain blend of therapies, treatments and interventions, all specifically tailored to the child's particular behavioral problems.

"Every person with autism is different," said Lee Grossman, president and chief executive of the Autism Society. "There's a saying, 'If you've met one person with autism, then you've met one person with autism.'"

That means parents usually have to figure it out for themselves, with help from their medical team.

Experts agree on two basic principles when it comes to treating people with autism, according to the U.S. National Institute of Mental Health:

• Early intervention is key to helping a child with autism find a healthy, happy and satisfying life.
• People with autism respond best to programs and therapies that are highly structured and specialized to their needs.

"The earlier the child is diagnosed, and the better the quality and quantity of the programs they are in, the better their prognosis long-term," said James Ball, president and chief executive of JB Autism Consulting, in New Jersey, and chairman of the Autism Society's board of directors.

Many of the leading therapy options for autism are not medical and instead involve education and behavioral intervention.

Ball said that a type of behavioral therapy called applied behavioral analysis, which focuses on teaching useful skills that build upon each other, has helped many children with autism.

"It teaches things repetitively so a child can learn and then generalize those skills," he said.

For example, teaching children to brush their teeth would involve breaking down the activity into different skills -- squeezing out the toothpaste, brushing the teeth, rinsing the mouth -- that are repetitively taught and ultimately woven together. "You teach all the separate components up to the whole," Ball said.

Other children with the disorder might need speech therapy, occupational therapy or other forms of behavioral therapy, Grossman said. It all rests on finding a child's strongest and weakest areas and using their strengths to help them overcome their weaknesses.

Kids with autism will often have more success in these therapies if visual aids and cues are used, he said.

They often "have trouble with verbal instruction," Grossman said. "If you can provide a learning environment where they see the instrument and incorporate it into their activities, you'll have a better situation."

Children with autism also may benefit from medical interventions tailored to their symptoms. Medication can be used to treat such autism-related symptoms as seizures, depression, anxiety or obsessive-compulsive disorder. Kids with severe behavioral problems sometimes benefit from antipsychotic drugs.

Some parents have found that a dietary intervention can help their child, according to the mental health institute. One particular diet that has proven successful for some children involves removing all gluten and casein from their food. Casein is the main source of protein in milk, and gluten is a protein found in wheat and other grains.

Parents also should make sure their child is healthy and not suffering from illnesses that could exacerbate their behavioral problems. "We would encourage all families to get a comprehensive medical exam" for their child, Grossman said.

Health problems such as rashes, gastrointestinal disorders, allergies, asthma and the like can create discomfort and throw children off their beneficial therapies. "These are typically overlooked with a child with autism because they are often nonverbal and noncompliant," Grossman said. "The doctor may miss some other treatable conditions."

Families with an autistic child also should understand that every member will need help and should consider undergoing regular family counseling, Ball said.

"It is a whole-family disorder," he said. "Everyone is affected. Families need to come up with a plan so they can meet everyone's needs."

Finding resources can be challenging, Ball and Grossman said. Grossman knows that firsthand as he has child with autism, who now is 23.

"I was very angry and very frustrated because I couldn't find any help," he recalled. "I didn't know what to do." But he said that the group he now runs, the Autism Society, was key in helping him find doctors and therapists to help his son.

Grossman also speaks from personal knowledge when he says that the best way to help children with autism is to pay attention to how they act and what draws their interest and to then use that knowledge to teach them life skills.

"The goal here is to have a person who has a satisfying quality of life and is a contributing member of their community," Grossman added. "With the proper supports, we believe everyone can achieve that."

More information

Autism Speaks has more on autism.

A companion article looks at living with autism, from one family's perspective.

SOURCES: Lee Grossman, president and chief executive, Autism Society; James Ball, Ed.D., president and chief executive, JB Autism Consulting, Cranbury, N.J.