How to Tell If an Autism Treatment Is Working

Choose a method that works best for the individual

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Once you learn your child has an autism spectrum diagnosis, you want to do whatever you can to help. In many cases, you'll learn about early intervention programs and therapies that you can access for little to no money through your school district, county, or state. If you start digging even a little bit, you'll learn about a huge range of additional therapies available (most for a significant fee) which might or might not be safe, helpful, or appropriate for your child.

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While any or all of the available therapies and treatments may sound promising, the reality is that every child with autism is different. Some will thrive with treatment A, B, or C while others will improve only slightly—and still, others will see no improvement at all. What's more, while some treatments are well-researched, others are marginal or even questionable in terms of effectiveness and safety.

It can be very difficult to choose among treatments, and even harder to know which are the most effective for your particular child. There are, however, methods for making the smartest possible choices.

Facts About Treatments

Autism isn't like most disorders: there is no single known cause, no therapy that is effective for everyone, and no known cure. That puts you, the caregiver, in the driver's seat.

No practitioner can tell you that any specific path is the absolute right direction for your child—which also makes your situation much more complicated because you can't simply look for the "best" treatment and insist that your child should receive it. With this in mind, it's important to remember some key facts about autism treatments.

  1. There is no such thing as a "window of opportunity" for treatment. While early intervention (treatment before school age) is a very good idea, there is no specific time period that you could potentially "miss out on" for treating autism. People with autism gain skills and abilities throughout their lives.
  2. It is often the quality of the therapist rather than the therapy that makes the difference. If a therapist makes a great connection with your child, your child will probably make progress.
  3. Autism is not a progressive disorder. If your child is autistic, he won't become more autistic as a result of the wrong therapy. On the other hand, children with autism have amazing memories, so a bad experience can have lasting implications for cooperation and engagement.
  4. Schools in the United States have an obligation to provide appropriate therapies for your child. They do not, however, have an obligation to provide the therapies you prefer or to ensure that your child works only with people you've approved.
  5. Some well-regarded therapies are parent-friendly. This means that you can learn to provide the therapies yourself in your own home.
  6. There is no pill (or any other medical treatment) that cures autism. Though, some medications can help alleviate symptoms such as anxiety and aggression. Similarly, while dietary changes can help alleviate painful gastrointestinal issues, they will not have an impact on the core symptoms of autism.
  7. There is a great deal of misinformation about autism therapies. Unfortunately, many people take advantage of others in exchange for unproven, painful, and/or potentially dangerous "autism treatments." If it sounds too good to be true it probably is—investigate very thoroughly before saying yes to a treatment that isn't recommended by a trustworthy professional.

Perhaps most importantly, your child with autism can and will grow and progress just like any other child—and in many cases with or without any given therapy. The fact that your child is gaining skills may or may not be attributable to a particular therapy. It's up to you to determine what's working and what isn't.

How Therapies Are Provided

In the United States, once a child is diagnosed with autism spectrum disorder, he or she is eligible for a range of services funded by the state. These range in cost and quality depending on location. Insurance policies will also pay for certain treatments, again depending on the specific policy.

In general, your child will probably be offered at least some (if not all) of the following therapies, either through the school district or through an early intervention program:

  • Speech therapy. All children with autism, even those with spoken language, can use help with verbal and non-verbal communication.
  • Occupational therapy. Some therapists use a form of play therapy to work on social communication and sensory issues, while others work on more academic skills such as pencil grasp and cutting with scissors.
  • Behavioral therapy. Applied Behavioral Therapy (ABA) is by far the most common form of autism-specific therapy provided in a school setting. ABA therapists reward appropriate behaviors, thus building specific skills ranging from sitting still in a classroom to interacting socially with classmates. There are many different forms of behavioral therapy, but ABA is the most common.
  • Other therapies. Depending on circumstances, your child may also be offered any of a range of fairly common therapies such as physical therapy, social skills therapy, play therapy, feeding therapy, cognitive behavioral therapy, and more. While some are provided through the schools, others may (or may not) be paid for by your insurance.

Very young children may receive these therapies at home—school-age children receive therapies at school.

In addition to the many therapies your child may be offered through various agencies and policies, you will also discover additional therapies that you can provide yourself or pay for out of pocket. These include:

  • developmental therapies such as Floortime, RDI, and Son-Rise
  • art therapies including music, art, dance, and drama
  • "biomedical" therapies ranging from hyperbaric chambers to stem cell therapy

Determining the Effect

It is very easy for an autistic child to wind up receiving three or four different types of therapy per week, with additional new therapies tossed in from time to time to see whether they might be helpful. For example, a child receiving speech, occupational, and behavioral therapies at school may also be offered medication by a developmental pediatrician while her parents also experiment with a gluten-free diet.

When your child is receiving so many therapies, and she suddenly seems to be developing new skills at a rapid pace, which therapy is making all the difference? Often it's tempting to assume that the most recently introduced therapy is the most effective. After all, the new skills blossomed just days after the new therapy was started.

The reality, however, is that association is not the same thing as causation. In other words, the fact that one thing happened after another does not mean that the first thing caused the second. Under ordinary circumstances, this seems obvious. For example, you can eat a hamburger and then win a race without believing that the hamburger caused you to win the race. Autism, however, is a mysterious disorder and as a result, it's easy to see connections where there are none.

To determine whether a particular therapy is really effective, follow these tips.

  • Start with a baseline. If your child is about to start taking a pill to reduce anxiety, work with your doctor and other people in your child's life to determine how anxious your child is, when and where the anxiety occurs, and how it is usually alleviated. You can do this by keeping a journal or records over the course of a couple of weeks. Do the same thing if you're about to start speech, occupational, or any other kind of therapy. Ideally, your practitioner should do this as a matter of course, but if she/he doesn't, you'll need to insist or do it yourself.
  • Set goals. Many therapists just work with your child where she is with the goal of "getting better." As there's no agreed-upon definition of "getting better," there's no way to measure outcomes. As a result, you may disagree about whether the therapy is effective. Work with therapists to set realistic short and long term goals so you can use data to see if your child is reaching those goals.
  • Keep careful records. Rather than intuitively saying "He's less anxious," continue to keep tabs on anxiety levels throughout the day. Use a scale that allows you to compare results (1 through 10, for example) so you can actually see that your child was at a level eight every day but is now at a level three.
  • Be aware of the placebo effect. Very often, a brand new therapy can appear to have a huge positive impact almost instantly. It's not unusual for this apparent effect to be, at least in part, the result of wishful thinking on the parents' part. Keep records, and don't jump to conclusions.
  • Be patient. While many therapies can be helpful, it's best to add them one at a time. Give at least a few months to determine whether any given therapy is really making a difference.
  • Know that your child will have ups and downs. You may find that your child gains significant skills for a period of time and then seems to plateau. This is normal for children with and without autism. No child continues to build skills and abilities at the same rate throughout his life. If a particular therapy and/or therapist is working well for your child, stick with it for a while even if results slow down.

A Word From Verywell

There is a saying that "autism is a marathon, not a sprint." It's a good saying to bear in mind as you take your first steps along the road with your child. It's very tempting to try everything as soon as possible and to say "yes" to every opportunity, but the reality is that you can quickly overwhelm both your child and yourself. By planning your route and taking a deliberate path, you can help your child now and for the future.

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