Autism spectrum disorder - Treatment 

Treating autism spectrum disorder 

Autism: coping with an emergency

Autism is a developmental disorder that affects the way people interact with the world and other people. This film enacts an emergency situation, showing how stressful it can be for a person with autism.

Media last reviewed: 06/11/2013

Next review due: 06/11/2015

Funding treatments

Some of the interventions for ASD take a lot of time and labour, and can cost a significant amount of money if not available on the NHS.

Many local education authorities (LEAs) provide partial or sometimes total funding towards specialist education and training, but this varies widely between LEAs.

If you would like more advice on what funding is available and how to request it, the National Autism Society runs a special service called the Education Rights Service.

There is currently no 'cure' for autism spectrum disorder (ASD). However, a range of specialist education and behavioural programmes (often referred to as interventions) can be effective in improving the skills of children with ASD.

There are many different types of intervention for ASD and it can be hard to judge which one will work best for your child as each person with ASD is affected differently.

Some types of intervention can involve hours of intensive work, and this is not always possible for many families because of the practical, emotional and financial commitments necessary.

The National Autism Society website has information on the many different approaches, therapies and interventions available for ASD.

Any intervention should focus on important aspects of your child's development. These are:

  • communication skills – such as the ability to start conversations
  • social interaction skills – such as the ability to understand other people's feelings and respond to them
  • cognitive skills – such as encouraging imaginative play
  • academic skills – the ‘traditional’ skills a child needs to progress with their education, such as reading, writing and maths

Treatment for ASD often involves a team of different specialists working together, such as a paediatrician, a psychologist, a psychiatrist, a speech and language therapist and an occupational therapist.

Some of the main treatments used for ASD are explained below.

Social-communication programmes

Your child may be offered a type of programme called a 'social-communication intervention'. This aims to help them communicate and interact with people and make social situations easier.

Depending on your child's age, these programmes may take place at school, or with a parent, carer or teacher.

Applied behaviour analysis (ABA)

Applied behaviour analysis (ABA) involves breaking down skills (such as communication and cognitive skills) into small tasks and teaching those tasks in a highly structured way, as well as rewarding and reinforcing positive behaviour while discouraging inappropriate behaviour.

ABA sessions are normally carried out at home, although some programmes can be integrated into schools or nurseries.

An ABA programme usually begins with simple tasks that become more complex over time, which can help your child's development by gradually improving their skills.

There are concerns from some health professionals about the intensity of certain ABA-based programmes and some professionals feel it is not always clear how useful the skills gained are outside of some highly structured programmes. However, there is good evidence to suggest early intervention programmes that integrate with education can be beneficial.

Read more about ABA and early intensive behavioural intervention (EIBI) on the Research Autism website.

TEACCH

TEACCH (Treatment and Education of Autistic and Related Communication Handicapped Children) is a type of educational intervention that places great emphasis on structured learning by using visual prompts. This is because research has found that children with ASD often respond better to information that is presented visually.

TEACCH is often delivered at special day centres, but you can also have training so you can continue the intervention activities at home.

Read more about TEACCH on the Research Autism website.

Parent education and training

The parents of a child with ASD play a crucial role in supporting their child and helping them improve their skills.

If your child is diagnosed with ASD, it can be useful to find out as much as you can about life with the condition. The National Autistic Society has an excellent range of resources and advice about living with autism on its website.

Communication advice for parents

Communication is a particular challenge for children with ASD. Helping your child communicate can lead to reduced anxiety and improved behaviour.

You may find the following tips useful when communicating and interacting with your child:

  • use your child’s name so they know you are addressing them
  • keep background noise to a minimum
  • keep language simple
  • speak slowly and clearly with pauses between words
  • accompany what you say with simple gestures
  • allow extra time for your child to process what you have said 

Parent support programmes

For more in-depth advice, there are some programmes specifically designed to help parents of children recently diagnosed with ASD, such as the EarlyBird programme provided by the National Autism Society.

This is a free three-month course for families with a child who has been diagnosed with ASD but has not yet started school.

The programme aims to support and inform parents, as well as offering practical advice about looking after a child with ASD and helping to improve their skills.

EarlyBird is offered in most areas of the UK by licensed teams. To find out if there is a team in your area you can call 01226 779218, email earlybird@nas.org.uk, or check for EarlyBird licensed teams on the National Autistic Society website.

Improving communication skills

As well as the social-communication interventions mentioned above, a number of other treatments may be offered to specifically help overcome communication difficulties your child may have. Some of the main treatments used are described below.

Speech and language therapy

Speech and language therapy (SLT) is a type of skills training designed to improve your child's language skills. This can improve their ability to interact with others socially.

The therapist uses a number of techniques, such as visual aids, stories and toys to improve communication skills. Watch a video about speech and language therapy for more information.

Picture Exchange Communication System (PECS)

Some children with ASD find picture symbols helpful in allowing them to communicate more effectively, which is why an approach called the Picture Exchange Communication System (PECS) is sometimes carried out by trained specialists to help children with the condition.

PECS teaches children to communicate with adults by giving them cards with pictures on them. Over time, the child is taught progressively more difficult skills, such as using pictures to make whole sentences. This approach aims to eventually help children learn to initiate communication with others without prompting.

Read more about PECS on the Research Autism website.

Makaton

Makaton is a communication programme that involves using signs and symbols in support of spoken language to help people with ASD communicate with others.

The signs used in Makaton are based on British Sign Language and each sign has a corresponding symbol. These symbols are simple drawings that can often be used independently of the signs. These signs or symbols can be used with speech to help provide extra clues as to what someone is saying.

Over time, as their speech and language skills develop, many people with ASD will stop using the signs or symbols naturally at their own pace and start to rely more on their speech to communicate.

Makaton can be helpful in improving basic communication in some people with ASD, as well as helping to improve social interaction and the ability to build relationships.

Psychological therapy

If your child has ASD and a mental health problem (such as anxiety), or if their behaviour is causing problems, a psychological treatment may be offered.

Psychological treatments, such as cognitive behavioural therapy (CBT), involve meeting with a therapist to talk about feelings and thoughts and how these affect behaviour and wellbeing.

If a treatment like CBT is offered, the professionals involved in the treatment should also be aware of any changes that need to be made to the treatment because of the ASD. This might include more written or visual information (for example, worksheets and images), and using plain English.

Read more about CBT on the Research Autism website.

Medication

No medication is available to treat the core symptoms of ASD, but medication may be able to treat some of the related symptoms or conditions, such as:

However, these medications can have significant side effects and are usually only prescribed by a doctor specialising in the condition being treated. If medication is offered, your child will usually have a check-up after a few weeks to see if it is helping.

Treatments not recommended

A number of alternative treatments have been suggested as potential treatments for ASD.

However, these should be avoided because there is little or no evidence that any of these approaches are effective, and some may even be potentially dangerous.

Some of the treatments not recommended for ASD include:

  • special diets – such as gluten-free or casein-free diets
  • neurofeedback – where brain activity is monitored (usually with electrodes placed on the head) and the person being treated can see their brain activity on a screen and is taught how to change it
  • auditory integration training – a therapy that involves listening to music that varies in tone, pitch and volume
  • chelation therapy – which uses medication or other agents to remove metal (in particular mercury) from the body
  • hyperbaric oxygen therapy – treatment with oxygen in a pressurised chamber
  • facilitated communication – where a therapist or other person supports and guides a person's hand or arm while using a device such as a computer keyboard or mouse

 


Page last reviewed: 18/12/2013

Next review due: 18/12/2015

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Comments

The 14 comments posted are personal views. Any information they give has not been checked and may not be accurate.

purplemonkeydishwasher said on 04 September 2014

I dont like how they use the word "currently". By saying theres currently no cure gives ignorant, desperate parents hope that there will someday be a "cure". When thats just not going to happen, since theres really nothing to cure to begin with. You cant "cure" the way someone brain is wired.

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ChrisDM said on 11 June 2014

Please update the section on ABA!

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ChrisDM said on 11 June 2014

I am not happy about the negative remarks made about ABA interventions for autism. These remarks cannot be justified by any professional with the least knowledge or experience of modern ABA programmes with their emphasis on generalisation of skills and integration in to normal community settings and schools as soon as possible. There is absolutely no evidence of harm due to intensity or the nature of this approach and so these remarks have no justification whatsoever and should be removed. I am making a formal complaint about this. NHS Choices should stick to evidence-based information and not ill-informed and out of date opinion like this from un-named 'professionals'. Come on, we need a web site we can trust to be fair and accurate!

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Ivorthorne said on 10 June 2014

This is an utterly bizzare article.

It should be noted that this article uses Research Autism's opinion's. For some reason, they only criticise ABA in spite of the fact that they offer none of the well-known criticisms of the other approaches.

They also fail to mention that PECs is a form of ABA, as are some forms of CBT mentioned.

The statement that ABA programmes are normally carried out at home is misleading in this context. ABA programmes can occur anywhere. There are a number of ABA schools and clinics throughout the UK. It's a pity the NHS doesn't fund any them.

For a more scientific review of autism interventions, I would recommend googling the Association for Science in Autism Treatment.

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sunshine79gp said on 09 June 2014

Since my child's diagnosis we have experienced the following - TEACCH, SALT, OT, Music therapy and ABA. ABA has been the only intervention that addresses my child's needs and the progress has been astonishing. The rest of the interventions were an absolute waste of time. A waste of very valuable developmental time. Also a waste of public expenditure as the LEAs spend their budgets on interventions which have to research evidence to support them. Where is the logic here?

According to the NHS description of ABA here "However, there are concerns from some health professionals about the intensity of such programmes and some professionals feel it is not clear how useful the skills gained are outside of these highly structured programmes." I strongly suggest those professionals to put aside their blind prejudice, read good quality research papers and if they don't know how to do it maybe attend a clinical research training course. Moreover, they can also go and observe some ABA programmes and talk to the parents. Parents know their children best, their progress and are the most motivated people to develop their children. Not NHS, LEA or school professionals.

My background is nursing and I used to work for NHS. One of the very basic principles I was personally, legally and ethically obliged to follow was that my practice remains research evidence based. Why is it different for other professionals, especially the NHS staff working in the autism field? Again, it doesn't make sense! Unless, of course, money and challenging the "blanket policy" take part in the equation. Professionals MUST protect the welfare, interest and needs of the children they are involved with!

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jas1s said on 07 June 2014

TEACCH- Please provide a research link saying all ASD kids are visual learners?

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jas1s said on 07 June 2014

TEACCH
TEACCH This is because research has found that children with ASD often respond better to information that is presented visually.

Where is the research link, You cannot write a statement without a proper research to support. I have lots of research paper saying, children with Autism learn better with Sign language than it says all ASD kids are Visual learners. That is just an assumptions, as with my Son's case, he has failed to learn the PECS and other visual learning methods- after 4 years of continuous teaching, when we introduced Makaton -with ABA, he has learnt to sign and then to say words.

-I know in my son's School, lots of Non Verbal kids- they are using TEACCH method, only few using PECS and other visual aid. Does it states, all Non verbal kids are visual learners. Visual teaching makes adults easier to teach, as you can use the same thing for all.

Autism is a spectrum and not any two autistic kids are the same. You cannot say- all ASD kids are Visual learners- without proper research?

Please provide evidence, how may improved with TEACCH method?

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poloseanachain said on 11 April 2014

"some professionals feel it is not clear how useful the skills gained are outside of these highly structured programmes" As others have mentioned, this statement can be criticised but there is a concerning truth.The core dimensions of ABA are: Applied, Behaviour, Analytic, Conceptually systematic, Technological, Effective and Generality. The last being the most important for this comment, and I suppose the biggest concern. If practitioners are seeing lack of generality, then that person is not doing good ABA. I think better practitioners are needed for ABA, not that the approach doesn't work. If the number of people going for clinical or forensic coming out of psychology went into ABA, and appropriate funding existed for all age groups and research development went towards ABA, problems like these would be a lot less likely, and rogue "ABA practitioners" or Technologists would not exist.

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Sickof said on 04 April 2014

I find that this page reads in a very biased way: you give lots of negatives about ABA but none about any of the other treatments (except those you explicitly do not recommend). Surely you should be more even-handed, given that by any measure there is more good evidence backing for ABA than for Teacch or Salt as therapies for autism? And I speak as an autism mum and stepmum who has tried all three. Why is treatment bias creeping into an NHS page? It was redrafted only 4 months ago, and read far more even-handedly in its previous format. Please reconsider as this looks suspiciously like post-hoc rationalisation so that no-one can ask for ABA.

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VBradley said on 28 February 2014

This page lists ABA therapy as an intensive therapy which has health professionals concerned and has not got clear benefits outside of the structured programmes. This information puts a negative bias on a valid form of help for parents seeking help, when it is not listed in the category of unhelpful/harmful options below. This is likely because the 'concerns of many healthcare professionals' are contradicted by the data which behavioural therapists take every session during programmes. In addition the ABA workshops and liaising with parents, key workers, speech and language therapists, teachers and so on who attest to the transfer and maintenance of skills learned within ABA settings to outside environments.

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Joseph27 said on 05 October 2013

Surprised that there is no mention of:
1. Son Rise Therapy (US)
2. Intensive integration therapy (UK)
3. Floortime
4. Nurtured Heart Approach.

All the therapies mention in this article are well established tried and tested.

But no mention of the most up to date and more effective therapies which have also been around for at least 15 years. UK is far behind the US in the best possible approaches.

I have effectively used the Son Rise Approach and Intensive Interactive Therapy with the effect of bringing child ' out of their isolated word and living happily , attending mainstream schools .

Joseph . Child Psychologist (UK)

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ppatto said on 06 October 2011

alfieraysautismawareness
please email me your details we are really find it hard coping. my son has asd and is nearly 4, he is so loving and very tactile. i am sure he is very clever and understands lots of things childeren of his age would not have a clue, he just can't express verbally. your coments inspired me to become more proactive and we would appreciate any information that you have that has helped

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alfieraysautismawareness said on 17 March 2011

OK you have this slightly wrong.. Spectrum is vast and also complex every individual is unique thats why selection of appropriate therapy is crucial. Proper diagnosis by a qualified therapist is critical and this is pretty much devoid in this country. We have taken drastic steps to repair damage done by NHS in our area. Our son could not communicate and our SLT said she was competant and trained to instruct us in the use of PECS.. big mistake we took her at her word but sussed out real quick she was wrong when our son self harmed and attacked us and others. We have rectified and are living a better life now thanks to PECs as he now has a communication system. We have also had to go to USA to growing minds who will do a proper assessment and custom make him a therapy suited to his condition. The NHS just said he was Autistic and there was limited help.. no recommendation of therapy. We have had to go through press TV & radio to even get them to take notice but to be honest we are the ones who are going to help.
I would recommend to people to complain and not accept excuses like budget cuts or there is no treatment available. A year ago our son was in his own world no sign of communication thanks to PECs he is communicating through picture symbols in a structured fashion and I know he is on the brink of speech. USa will not only push him over that edge but also allow him to accept us and live in our world which is way more messed up than his. I would say to people also never give up hope and never ever let your child be written off ASD people are usually intelligent people capable of way more than us.. The yjust need a push and lots of encouragement. The yanks have a thing the pieces of the puzzle must come together and they are right, there is not just one therapy required its a multi complex disorder but a good therapist is all that required. There are very few in the world but we have found one

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DympnaF said on 04 February 2011

ASD is a "spectrum" diagnosis, and is therefore not an either/or diagnosis - like pregnancy, you are, or are not, no inbetweens.
ASD is not an illness, and those who have been diagnosed are " people who have ASD" and are so diverse that this short summary of " treatments" has only one benefit, in warning of the dangers of some alternative "therapies".
The implication of this page is that ABA is the bees' knees. I've known families lose their house to pay for it, destroy the lives of siblings, and sink into depression when the miracle cure fails to materialise.
I would not agree that SSRIs are the most widely used medications. More likely to be treating co-existing ADHD, or risperidone - not licenced in the UK, although it is in the USA.

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