Behavioral Therapies for children with Autism

Don't you know your ABA's? A Guide to Treatment for Kids with Autism

Raising a child with autism at the best of times can be challenging but when you are starting on a treatment plan for your autistic child, it can all seem a little overwhelming. Some treatments have more success than others etc.

Autism is a spectrum disorder, meaning that there are multiple types of autism spectrum disorder (ASD). While the spectrum can vary widely from child to child, there are multiple classifications. If you’re interested in understanding autism spectrum disorder, it’s important that you’re aware of each diagnosis and its corresponding symptoms. The severity of ASD is classified in DSM-5 levels from Level 1 ASD (mild) to Level 5 ASD (severe).

The key thing to remember here is, just like other forms of mental health, for example, there are many different courses of treatment that work best for each individual. In other words, no size fits all. So without further ado, let's check out the different kinds of treatment plans and supports that are available:

Applied Behavioral Therapy (ABA)

ABA refers to a whole collection of different types of therapies and teaching techniques. Let's go through and look at each one:

• Discrete Trial Training (DTT)

Despite being part of ABA, DTT isn't considered therapy all on its own. Essentially, Discrete Trial Training (sometimes described as Discrete Trial Teaching breaks more complex patterns of behavior down to their most basic elements and rewards are given for success. Usually, this teaching treatment if most effective on children aged 2 to6 years but it has been found to work on people of any age as well.

DTT can be used for the activities of daily living like dressing or using utensils properly. It can help children with language and writing skills and even skills to learn sign language. The belief with DTT is that with constant repetition and reward, anybody can learn to do anything.

• Early Intensive Behavioural Intervention (EIBI)

Early Intensive Behavioral Intervention is a form of ABA that is intended specifically for pre-schoolers. This form of therapy is similar to DTT in that it breaks more complex patterns of behavior into small elements. When tasks are broken down into their simplest steps and a child completes those steps, a reward is given but difficult behavior is simply ignored.

The goal of this therapy, as we suggested above, is to teach children appropriate behavior in place of difficult behavior so that they are more easily able to function in society. This type of therapy helps children focus more, learn how to imitate other people, play with others and conduct appropriate daily activities, like brushing one's teeth, at the expense of difficult behavior.

This type of treatment is very customizable. For example, the first step with this treatment is to learn about the skills and difficulties an individual child is facing. Then, therapists put together an individualized treatment program complete with the skills the therapist is trying to target. This treatment plan is then put into action, and then it is re-evaluated periodically for effectiveness and adjustments are made. 

• Incidental Teaching

Incidental Teaching is a naturalistic type of teaching where children get out of the confines of a clinic and head out into the world as they naturally would. A child might be having playtime with a friend at a park or doing something else in nature. Positive behavior, language, and communication are reinforced at the natural level as opposed to in a clinical and sterile environment..

The premise here is that as good behavior is rewarded in natural settings, the child will develop a better and healthier skill set to get along in nature and with others. It is intended for children 2 to 9 years old but it can work for all ages.

• Pivotal Response Treatment (PRT)

Pivotal Response Treatment (PRT) is not a therapy in and of itself. Rather it's a set of teaching techniques that help a child perform more complex behavioral tasks like socializing and the ability to communicate effectively with others and play well with others. It is intended for children 2 to 6 years of age but it can be used for all ages as well.

This technique is aimed at promoting more independence and less intervention. PRT has 4 core pillars to it:

1) Motivation:  
This encourages the child to choose from a variety of tasks, giving the child choice and also used rewards to reinforce behavior.
2) Self-Initiation: 
This rewards children for their natural curiosity and asking questions about what they see.
3) Self-Management: 
This encourages children's independence and encourages the child to take responsibility for their learning.
4) Responsiveness to multiple cues: 
This encourages children to respond to multiple forms of the same instruction. For example: "get your jacket," "get your coat," "go get your windbreaker and put it on."

• Positive Behaviour Support (PBS)

Positive Behaviour Support is used for children and people of all ages that are not only experience autism, but other behavioral challenges as well. The aim here is to make difficult behavior unnecessary by removing triggers and rewards that might reinforce that particular difficult behavior.

Parents and caregivers learn the ways their children or patients communicate to get something that they want. Difficult behavior is then replaced with more positive and appropriate behavior that leads to the same outcome. This type of support is given daily to the child/patient by all involved and it is done in the natural world.

Many of these treatments and learning techniques arose out of the early 1900s and others were more recently developed in the 1970s and '80s. No matter what techniques you use, make sure you consult a psychologist or psychiatrist before you start your treatment program.

Remember that even the most difficult child with autism can be treated and go on to live a healthy and productive life.