How Autism Is Treated

Every child with autism spectrum disorder (ASD) has different needs, so the treatment plan needs to be individualized. Since autism is not an illness and therefore can't be "cured," the goal is to help a child gain and hone communication, interpersonal, and behavioral skills to better navigate daily life and, whenever possible, function independently.

This may involve a variety of different therapies, including speech therapy and social skills therapy, as well as prescription drugs to help manage issues with focus and commonly co-occurring mental illnesses. Lifestyle modifications and practices can help reinforce the goals of therapy at home.

This article looks at the various treatments that may be used if a child is diagnosed with autism. It also explores the role that complementary and alternative therapies may play in the treatment plan.

Specialized Therapies

The cornerstone of autism treatment is a variety of therapies that address specific symptoms, such as repetitive behaviors, obsessive interests, abnormal responses to sensory stimuli, and difficulties with social interactions and communication.

Developmental Approach

Developmental therapies aim to improve specific skills, such as language or physical skills. The treatment plan often involves more than one of the following therapies:

• Occupational therapy: The aim is to help a child with autism manage everyday life. Occupational therapy helps improve practical skills like independent dressing, eating, grooming, or using the bathroom. Or, it may be focused on mastering fine motor skills like writing, coloring, and cutting with scissors.
  
• Physical therapy: This includes activities and exercises that build motor skills and improve strength, posture, and balance. Doing so can help a child, for instance, play with other kids more easily.
  
• Play therapy: This uses play to develop relationships and build social and communication skills by building upon a child's own interests.
• Recreational therapy: This is used to improve motor skills and emotional well-being with indoor activities (like puzzles and cooking) or outdoor activities (like horseback riding and hiking).
• Relationship development intervention (RDI): This involves activities that increase motivation, interest, and the ability to participate in social interactions.
• Sensory integration therapy: This helps children avoid excessive reactions to sounds, sight, and other stimuli (referred to as sensory overload). It can also help children with autism who are hyporesponsive, which means they lack the expected response to stimuli.
• Social skills therapy: This teaches children how to interact appropriately by sharing, collaborating, taking turns, asking and answering questions, and using other essential social skills. This is usually done in a group setting.
• Speech and language therapy: If your child is non-verbal, this may focus on achieving basic communication skills. If they are verbal, it may focus more on speech pragmatics (or the ability to use language in a social setting).
  

Behavioral Approach

Behavioral therapies aim to change behaviors by understanding and modifying replacements for the child's specific behaviors.

One of the oldest and most researched behavioral therapies is applied behavior analysis (ABA). It is a system that rewards a child for desired behaviors, and, rather than offering consequences for undesired behaviors, offers no reaction and no reward.

There are two styles of teaching used for ABA:

• Discrete trial training (DTT): This breaks down specific activities, such as brushing one's teeth, into their simplest parts. Each part is practiced and then integrated into a string of activities.
• Pivotal response training (PRT): This is done in a natural setting and teaches "pivotal skills" from which other skills can be learned. Examples include teaching a child how to initiate a conversation or ask for something that they want rather than skipping ahead inappropriately.
  

Educational Approach

One of the most commonly used educational approaches to ASD is Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH). It is an individualized "whole-life" program built on the idea that people with autism thrive on consistency and visual learning.

TEACCH is used to promote communication and social skills, independence and coping skills, and skills for everyday life in the company of peers. Children are individually assessed to see where they are developmentally, after which the teacher adjusts the classroom structure to accommodate those needs.

Each child is provided with a tailored visual schedule of their daily activities (such as a wall chart). Verbal instructions are reinforced with visual instructions or physical demonstrations. As a child becomes more skilled, the environment becomes less structured to help them gain independence.

Prescriptions

Medications can help manage behavioral issues such as hyperactivity, the inability to focus, or self-harming behavior like head banging or hand biting. Medications can also help manage co-occurring conditions like anxiety, depression, or insomnia.

These medications can be used in children or adults with ASD and may be covered by insurance.

Medications for Behavioral Issues

Certain types of antipsychotic drugs may be prescribed if a child with autism exhibits behaviors that are out of control or potentially harmful. These include aggression, irritability, or self-harming behaviors.

There are two second-generation antipsychotics (known as atypical antipsychotics) approved by the Food and Drug Administration (FDA) for use in children with autism:

• Abilify (aripiprazole): Approved for children ages 6 and older
• Risperdal (risperidone): Approved for children ages 5 and older
  

First-generation (typical) antipsychotics like Haldol (haloperidol), Prolixin (fluphenazine), and Thorazine (chlorpromazine) are sometimes used off-label for severe behavioral symptoms. Even so, they are used with caution due to a greater risk of long-term side effects like tardive dyskinesia (involuntary body or facial movements).

Medications for Depression, OCD, and Anxiety

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that can help treat depression and/or obsessive-compulsive disorder (OCD) in children with ASD.

SSRIs approved by the FDA for use in children with ASD include:

• Anafranil (clomipramine): Approved for children 10 and older for the treatment of OCD
• Lexapro (escitalopram): Approved for children 12 and older for depression
• Luvox (fluvoxamine): Approved for children 8 and older for OCD
• Prozac (fluoxetine): Approved for children 8 and older for depression and 7 and older for OCD
• Zoloft (sertraline): Approved for children 6 and older for OCD
  

A similar class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs) can be used to treat anxiety. Although not as commonly used in children, an SNRI such as Effexor (venlafaxine) may also be used off-label for depressive and anxiety symptoms in children.

Medications for Hyperactivity

Symptoms such as inattention and hyperactivity are common in children with ASD. The drugs Ritalin (methylphenidate) and Adderall (amphetamine salts) are commonly used in children with attention deficit-hyperactivity disorder (ADHD) to manage inattention and hyperactive behaviors like excessive movement and impulsiveness.

The FDA has approved the use of Ritalin in children ages 4 and over and Adderall for 3 and older. There are extended-release versions of Ritalin such as Concerta (methylphenidate HCL) and extended release preparations of Adderall that can also be used.

Caution should be used when prescribing Ritalin or Concerta as these stimulant drugs can potentially cause irritability and make aggressive behaviors worse.

Medications for Insomnia

Medications may also be prescribed to treat insomnia in children with ASD. This is important as poor sleep can affect a child's behavior and memory/learning skills, increasing the risk of aggression, irritability, hyperactivity, and depression.

Options for treatment include:

• Melatonin: An over-the-counter supplement commonly used to treat insomnia
• Remeron (mirtazapine): An antidepressant unrelated to SSRIs and SNRIs that can help treat sleep problems and irritability

Home Remedies and Lifestyle

The treatment of autism encompasses every part of a child's life. It requires adjustments at home to accommodate the child's needs and limitations. At the same time, by reducing symptoms of ASD, the stress on the family can also be reduced.

At-Home Therapies

At-home therapies are encouraged for families living with ASD. Some are simply extensions of what is used in classroom or clinical settings, such as play therapy or speech therapy.

Others are specifically centered around home and family life, such as:

• Floortime: This is when a parent or caregiver gets down on the floor to play and interact with the child at their level. It aims to build a relationship that is respectful, playful, and joyful, encouraging back-and-forth interactions, both verbal and non-verbal.
• Parent-child interaction therapy (PCIT): This is used to overcome disruptive and destructive behaviors that can undermine a family's quality of life. It is a structured practice that combines play and behavioral therapies to reinforce desired behaviors and avoid reactions to undesired ones.

Avoiding Sensory Overload

Also important is the need to avoid triggers at home that cause sensory overload. These include sights, sounds, textures, and smells that can inadvertently cause distress, anxiety, and outbursts in children with autism.

It often helps to create a "sensory room" where a child can escape to self-soothe and gain control over their emotions. A sensory room can differ for every child based on what they find soothing and may include:

• A weighted blanket
• Tactile pillows
• Sensory toys (like a weighted stuffed animal or a fidget)
• Mood lighting or a sensory lamp (like a lava lamp)
• Pale or neutral colors without excessive patterns
• Soothing atmospheric sounds or music

Complementary and Alternative Medicine (CAM)

There are few complementary or alternative therapies that have proven beneficial to people with autism. Several are not only ineffective but may be potentially harmful, including hyperbaric oxygen therapy, heavy metal chelation therapy, and antifungal therapy that some claim can "cure" ASD.

Similarly, diets thought by some to be useful for people with autism, including a gluten-free, casein-free (GFCF) diet or omega-3 fatty acids, have not been proven to have any measurable effect on ASD symptoms.

According to National Center for Complementary and Integrative Health (NCCIH), there are a handful of complementary therapies that may not be useful but are unlikely to do any harm, including:

• Acupuncture
• Massage therapy
• Mindfulness-based practices, such as breathing exercises

Summary

The treatment of autism spectrum disorder (ASD) in children helps to improve communication and social interactions, lessen repetitive or obsessive behaviors, and overcome other challenges like anxiety, depression, hyperactivity, insomnia, and sensory overload.

The treatment of ASD often involves multiple approaches, such as behavioral therapies, developmental therapies, medications, and at-home practices.

Autism cannot be cured, but early intervention can help a child learn the skills needed to better navigate daily life.

A Word From Verywell

There is no single road map for treating autism. Finding the right solution takes perseverance and often requires a process of trial and error.

To help you through the journey, find a team of therapists and healthcare professionals with whom you can collaborate as a partner. Never forget that your insights and experiences are vital to making informed judgments. If needed, seek a second or even third opinion until you are fully comfortable with the treatment plan.

It is also important to build a support system of family, friends, and support groups to help you cope as a parent or caregiver. Doing so not only lessens the load emotionally but can help you normalize autism in your life.