Child Development

Treatment for autism is primarily based on methods of changing maladaptive behavior and developing

learning and communication skills. This line drawing was created by an autistic child, who has

identified both himself (‘‘Mike’’) and his brother (‘‘Kevin’’) as passengers in the same car. (Gladys Agell

and Vermont College of Norwich University)

learning skills. Behavior modification approaches,
educationally based approaches, speech therapy, par-
ent skill training, and adaptive skill training are gen-
erally part of an individualized multimodal treatment
plan. The prescribing of drugs is used as an adjunct
to treat specific symptoms, but there is no medication
that treats autism as a whole. In the latter part of the
1990s, comparative reviews of model programs have
shown that multiple methods are effective and that
there is no one behavioral approach that is of singular
value. Intensity of treatment, age of initiation of treat-
ment, parent training, high teacher to student ratios,
and use of structured intervention procedures all con-
tribute to positive outcomes. Proven treatments in-
clude the use of behavior analysis procedures using
discrete trial training methods tailored for areas of
common autistic cognitive and motivational deficit,
and the Treatment and Education for Autistic and
Communication Handicapped Children (TEACCH)
curriculum for structure with its emphasis on visually
based guidance. Other treatment approaches target
specific symptom areas such as the Picture Exchange
Communication System (PECS), which targets com-
munication. Most treatment programs are eclectic
and integrate features of a number of approaches.

The field of autism treatment, both behavioral

and medical, has been subject to many treatment

fads, all claiming high levels of success that are either

invalidated or simply not supported by subsequent

controlled studies. On the behavioral side, such puta-

tive cures include facilitated communication, holding

therapy, auditory integration therapy, and sensory-

integration therapy. Putative cures on the medical

side include treatment with megavitamins, B vita-

mins, dimethylglycene, secretin, and elimination

diets for gluten and casein. Most families, at least ini-

tially, undertake multiple treatments including trials

of some unproven treatments, which over time, tend

to be tailored by perceived or measurable positive re-

sponses.

See also: FACILITATED COMMUNICATION; SOCIAL

DEVELOPMENT

Bibliography

American Psychiatric Association. The Diagnostic and Statistical Man-

ual of Mental Disorders: DSM-IV. Washington, DC: American

Psychiatric Association, 1994.

Bryson, S. E. ‘‘Epidemiology of Autism: Overview and Issues Un-

derstanding.’’ In Donald J. Cohen and Fred R. Volkmar eds.,

Handbook of Autism and Pervasive Developmental Disorders, 2nd

edition. New York: Wiley, 1997.

42 AUTISM