Evaluating Options

How to Select Treatments

When considering any therapy for your child with autism, whether evidence-based, complementary, or alternative, you should first gather as much information about the treatment as possible in order to make an informed decision. Given the lack of scientific research in most cases involving alternative therapies, you may consider these therapies as recreational activities. That is, art and riding horses may be motivational and lead to short term gains, but you are not likely to see measurable cognitive or behavioral changes. If your child enjoys the activity and behavior improves as a result, then you may consider it a worthwhile form of therapy. To decide which form of therapies to include in addition to your evidence-based treatment program, seek information and opinions from fellow mothers and fathers, health care providers and autism groups.

You should also discuss therapies you are considering with your child’s current treatment professionals. They may be able to advise you on its safety, use, and effectiveness. Then, working as a team, you and the therapists should talk about the areas of your child’s development an additional therapy might improve. It’s important that your inquiries go beyond the therapies to include evaluation and careful scrutiny of the facilities before beginning any program.

Beyond a therapist or treatment facility, an independent professional organization associated with the type of therapy is another possible source of reliable information, such as the BACB website (www.bacb.org). The staff may be able to explain the treatment and offer information on the level of training required by a treatment provider, and perhaps a list of certified providers.  Information may include treatment guidelines, or a list of best practices.  If this kind of organization or information does not exist, it’s probably best to consider the therapy as recreational and have fun.

Some intervention approaches may be effective and well-suited for one child, while a different intervention approach is more appropriate for another child. The most effective approach may also vary across time and specific treatment goals for an individual child. More research is needed to better understand which children with autism will be most responsive to different treatments. Therefore, when considering treatment options, it is helpful to work closely with someone who has extensive experience in developing programs for children with autism.

How to Select Therapists

After selecting a therapy, you should begin contacting therapists to gain further information about the therapy, the therapist, the facility, and the providing agency’s philosophy toward and experience in treating children with autism. Ask for a brief consultation in person or by phone with the therapy provider. This gives you the opportunity to ask critical questions that assess the appropriateness of the service to your child’s needs, and more.

To prepare your son or daughter for any therapy ultimately chosen, you should inquire about what will happen during your child’s initial visit. Observe very closely. After each of the first few visits, you should evaluate your child’s comfort level with the therapy and the provider to gauge your child’s progress. If you are not satisfied or comfortable with the treatment, you should discuss modifications, pursue different options, or perhaps discontinue the therapy. If you decide to discontinue the treatment, remember to share that information with your child’s other treatment providers in case they need to make decisions or adjustments to the treatment they provide your child.

Comorbid Conditions

A final consideration to keep in mind is that some children with autism—though certainly not all—may have underlying medical or co-morbid conditions that can affect their ability to respond or respond as well to evidence-based treatments. Medically addressing co-morbid conditions such as seizures/epilepsy, anxiety, gastrointestinal issues, and attention deficits may optimize other treatments may help to improve effectiveness of the behavioral treatment program. While there are presently no FDA approved medications that improve social-communication skills in individuals with autism, there are two that are approved to treat aggression and irritability.  It is best to consult with a qualified developmental pediatrician or psychiatrist who can evaluate your child’s need, prescribe medication, and monitor health and overall progress while on the medication. Just keep in mind that the primary goal of using medication is to remove pain and/or discomfort; make attention more available; diminish irritability; and/or reduce seizures so that children with autism can more fully benefit from behavioral, educational, and therapeutic interventions. Again, an accurate assessment should identify whether there is any need or value in beginning a medical treatment regimen. If begun, ongoing assessment is critical for determining whether such treatments should be continued or adjusted.

Conclusion

For all children with autism, it is important to remember that comprehensive, socially valid and research-supported educational methods lie at the center of any effective package of interventions. Alternative therapies are often supported with anecdotal reports and testimonials, but lack scientific support. Anecdotal evidence should never be confused with researched efficacy. Taking the time to do your homework and selecting the right therapy and provider are key to ensuring children receive sound treatment. The selection process will be most effective if parents fully consider their child’s strengths and needs. You are expected to do your own research and draw conclusions about the appropriateness of a therapy for your child, as you know your child best. It may feel time consuming, but it is time well spent to ensure your child’s progress.

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