Treatment

Autistic children can be very frustrating to both parents and siblings, disrupting

their lives greatly. Often, individuals with autism also cause grief and

guilt feelings in parents. According to Mary Van Bourgondien, Gary Mesibov,

and Geraldine Dawson, this can be ameliorated by psychodynamic, biological,

or behavioral techniques. These authors point out that all psychodynamic

therapy views autism as an emotional problem, recommending

extensive psychotherapy for the individual with autism and the rest of the

family. In contrast, biological methodology applies psychoactive drugs and

vitamins. Finally, behavioral therapy uses the axioms of experimental psychology,

along with special education techniques that teach and reinforce

appropriate behavior.

Psychodynamic approaches are based on the formation of interpersonal

relationships between the child and others. One example of these is holding

therapy, which involves the mother holding the child for long periods of

time so that a supposedly damaged bond between the two can be mended.

Floor time, joining the child in his or her activities, is a more active method

of establishing a bond with a child. However, both of these methods lack empirical

verification of their effectiveness.

Biological methods, on the other hand, involve affecting how the brain

receives and processes information. Sensory integration is favored by occupational

therapists from the perspective that the nervous system is attempting

to regain homeostasis, causing the individual to behave oddly. The approach,

an attempt to meet the sensory needs through a “sensory diet” of

activities throughout the day, is not supported by scientific research and is

not even implemented in an agreed-upon fashion by all of its practitioners.

Auditory integration training (AIT) works in the same way as sensory integration

with regard to the sensation of sound but is not generally accepted

by professionals as being effective. Drug therapies include antiseizure medications,

tranquilizers, stimulants, antidepressants, and antianxiety medica

tions that have varying results. One of the most controversial drug therapies

is the injection of the hormone secretin, which reportedly causes remarkable

improvements in the symptoms of some children but no change in others.

Dietary interventions include megadoses of vitamins and minerals that

could have very harmful side effects and are not reliably beneficial. Some

parents also follow a gluten-free and casein-free regimen with their children,

effectively eliminating all milk and wheat products from their diets.

Only anecdotal evidence exists of the effectiveness of this and other special

diets.

The last category of therapies, behavioral or skill-based techniques, is the

most empirically supported. The Treatment and Education of Autistic and

Related Communication Handicapped Children (TEACCH) program emphasizes

modification of the environment to improve the adaptive functioning

of the individual given his or her unique characteristics and teaching

others to accommodate autistic children at their particular level of functioning.

In contrast, applied behavior analysis programs, such as those advocated

by Norwegian psychologist Ivar Lovaas, involve manipulating the environment

only for the initial purpose of shaping an individual’s skills toward

more normal functioning, with the eventual goal of mainstreaming the

child with his or her typically developing peers in the regular education setting,

an outcome that is estimated to be more likely for children whose treatment

begins by two or three years of age.