The following information has been developed by Wendy Stone, PhD., Director of the Treatment & Research Institute for Autism Spectrum Disorders (TRIAD), at Vanderbilt Children’s Hospital, Nashville. ACT is using these FAQs with the kind permission of Dr. Stone.
- What is Autism?
- What is Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)?
- What are recommended practices for the screening and diagnosis of autism?
- What are recommended practices in early intervention for children with ASD?
- Can you recognize the early signs of autism?
- How can parents evaluate different treatment options?
- What is Applied Behaviour Analysis (ABA)?
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|What is Applied Behaviour Analysis (ABA)?|
|“ABA” is an abbreviation for Applied Behaviour Analysis, which refers to a variety of systematic approaches and strategies for increasing desired behaviours and skills and decreasing undesired behaviours. ABA approaches include discrete trial training, pivotal response training, incidental teaching, functional communication training, and structured teaching. All of these strategies can be useful in working with children with autism — as well as children without autism.
Many people think that ABA refers to a name brand therapy, such as that used by Lovaas, or that it refers to a 40 hour per week program, or that it was developed specifically for children with autism. These are all misconceptions. There are many types of ABA strategies and approaches, and the specific combination of techniques to be used should be determined after evaluating the child and identifying his or her strengths, needs, and learning style.
It is not TRIAD’s policy to advocate one therapy approach over another, because all children are different and treatments need to be individualized. According to best practice guidelines, ABA therapy can be an important part of the 20-25 hours per week of intervention recommended for children with autism. However, it is not the only appropriate therapy for these children. For example, speech-language therapy is another critical component of intervention programs for children with autism. We encourage families to seek out a combination of intervention approaches that represents the best fit for the child and the family.
Additional information about appropriate components of educational programs for children with autism can be found in the book, Educating Children with Autism, published by the National Academies Press in 2001. The text can be viewed online at www.nap.edu
|What are recommended practices for the screening and diagnosis of autism?|
|In an effort to promote best practices, including early identification, the American Academy of Neurology and the Child Neurology Society recently published a set of Practice Parameters for the screening and diagnosis of children with autism (Filipek et al., 2000). These guidelines were drafted by a multidisciplinary panel of autism specialists led by Dr. Pauline Filipek, a child neurologist and autism researcher at the University of California at Irvine. The panel consisted of professionals in the fields of paediatrics, psychiatry, neurology, psychology, speech-language pathology, audiology and occupational therapy. Wendy Stone, TRIAD director, was invited to participate on this panel as a representative of the American Psychological Association.
The Practice Parameters were developed and refined during a 2-year process that began with an NIH-sponsored conference on the State of the Science in Autism in June 1998 and was followed by a focused working meeting in January 1999. In addition to publication of the Practice Parameters, the work of this panel also led to publication of a background paper on screening and diagnosis of autism spectrum disorders (Filipek et al., 1999).
The Practice Parameters establish firm guidelines for best practices in the screening and diagnosis of children with autism. Both empirically-based and consensus-based recommendations are provided. Highlights of the recommendations are:
During each well-child visit from infancy through school-age, children should receive routine developmental surveillance for atypical development.
Failure to attain the following language milestones is associated with a high probability of a developmental disability and requires referral for further evaluation:
Autism-specific screening should be performed on all children failing the routine developmental surveillance and all siblings of children with autism.
The need for the development of additional screening measures was noted, as was the tendency of current measures to miss milder variants of autism.
In contrast, event-related potentials and neuro-imaging are considered to be research tools rather than clinical tools at the current time.
By the time of publication, the Practice Parameters had received endorsements from professional organizations, including the American Academy of Audiology, the American Occupational Therapy Association, the American Psychological Association, the American Speech-Language-Hearing Association and the Society for Developmental Paediatrics, as well as autism organizations, including the Autism National Committee, Cure Autism Now and the National Alliance for Autism Research.
The full text of the Practice Parameters is available on the website of the American Academy of Neurologywww.aan.com/professionals.
|Can you recognize the early signs of autism?|
|Recent research has indicated that children with autism can be diagnosed accurately at the age of 2 years. In addition, studies of early intervention have revealed that children with autism can make significant—and sometimes dramatic— gains in cognitive, social, behavioural, and language functioning when they take part in appropriately specialized programs. These recent findings highlight the importance of recognizing the early signs of autism.
“Red Flags” for Autism in 2-Year-Olds
Another challenge associated with making an early diagnosis is that children with autism typically do not demonstrate a total absence of social and communicative behaviours. Rather, they display these behaviours less consistently—and their parents have to exert a great deal more energy to elicit them compared with other children.
—Wendy Stone, TRIAD director
|How Can Parents Evaluate Different Treatment Options for Children with Autism Spectrum Disorders?|
|The following suggestions have been compiled from a variety of sources, including the articles referenced below. The purpose of these suggestions is to help parents evaluate different treatment options, not to promote any specific form of treatment.
Considerations for Evaluating Specific Treatments:
Be cautious about any treatment that: