Current Problems in Pediatric and Adolescent Health Care
Full Length ArticleEvidenced-Based Interventions for Children With Autism Spectrum Disorder
Introduction
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by pervasive deficits in social interaction and communication, as well as the presence of rigid and/or repetitive behaviors or sensory concerns that impact the individual's functioning and development. Individuals with this disorder may experience symptoms with or without intellectual or language impairment. The term “spectrum” is used to capture the wide array of symptomology seen across age and developmental levels.1 According to the Center for Disease Control and Prevention's 2018 published data, approximately 1 in 59 children in the United States are diagnosed with ASD, with reported prevalence in all racial, ethnic, and socioeconomic groups. ASD is about 4 times more common among males (26.6 per 1000) than among females (6.6 per 1000).2 The documented rise in the prevalence of ASD is a much-debated topic, and may be linked to improvement in diagnostic tools, increasing awareness of the disorder, and/or an increase in incidence over time.
The manifestation and severity of symptoms of ASD vary widely, with treatment typically focusing on the core features of ASD such as: deficits in social communication or social interactions, restricted behaviors, sensory concerns, or on co-occurring challenging behaviors that impact the development of functional skills and independence. Symptom presentation and treatment may be further complicated by medical concerns such as: epilepsy, sleep problems, and gastrointestinal problems, as well as intellectual/cognitive impairment, and, in some children, the presence of challenging maladaptive behaviors such as hyperactivity, anxiety, irritability, self-injury, and aggression.3 Effective treatment for children with ASD involves an interdisciplinary approach. It includes a combination of educational interventions, psychological/behavioral therapies, speech-language therapy, occupational/physical therapy, and medical treatments (e.g., psychopharmacology). The focus of this paper is on the non-pharmacologic treatments and therapies that support optimal outcomes for children and adolescents with ASD.
Section snippets
What is meant by evidence-based practice?
There is a wide range of possible interventions available to treat core symptoms of ASD and co-occurring conditions. The cause of ASD is unknown and believed to be multi-factorial, including a combination of predisposing genetic factors and environmental exposures.4 There is no single cause for ASD, and there is no single best treatment option. Given the heterogeneity of ASD symptoms and severity across the spectrum, ASD is generally not a condition that can be “cured.” The primary goal of
Developmental screening and monitoring
Following guidelines of the American Academy of Pediatrics (AAP), primary care clinicians who provide well child care for children are expected to conduct routine developmental surveillance at all well child visits and structured developmental screening at 9, 18, and 30-months, including the use of ASD-specific screening tools at ages 18 and 24-months.11 Despite the AAP's 2006 recommendations for developmental screening, a 2014 report from the Centers for Disease Control and Prevention (CDC)
Treatment interventions
The goal of this paper is to provide an overview of evidence-based therapeutic interventions that clinicians in the fields of primary care and developmental pediatrics should consider for treatment of children and adolescents with ASD. This includes a review of the evidence-based therapies (non-pharmacologic treatments) across disciplines including the fields of: psychology, speech-language pathology, and occupational therapy. It is important to note that the scope of many treatments overlaps
Conclusion
There is a wide range of interventions available, with varying levels of evidence to treat the core features of ASD, which include communication and social deficits, challenging behaviors, and sensory processing and motor coordination difficulties. Since ASD is a pervasive disorder that affects multiple areas of functioning, it is important for clinicians to be knowledgeable about the most effective and evidenced-informed interventions across disciplines in order to provide clinical care that
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Cited by (28)
Evidence-Based Interventions in Autism
2024, Pediatric Clinics of North AmericaCharacteristics and treatment patterns of autism spectrum disorder in China, 2020
2022, Psychiatry ResearchCitation Excerpt :Although the exact cause of ASD remains unknown and while ASD is a condition that generally cannot be cured, appropriate treatments may help relieve symptoms and improve social interactions and verbal communication (Sharma et al., 2018). One previous study suggested that evidence-based treatments, especially if initiated early, could reduce the core symptoms of ASD and co-existing conditions (Will et al., 2018). In our current study, we found that children who were male, had lower parental education level and were diagnosed with ASD later on had a higher likelihood of non-treatment than their counterparts.
Adapting multisystemic therapy to the treatment of disruptive behavior problems in youths with autism spectrum disorder: Toward improving the practice of health care
2021, Neural Engineering Techniques for Autism Spectrum Disorder: Volume 1: Imaging and Signal AnalysisFeasibility of a school-based mindfulness program for improving inhibitory skills in children with autism spectrum disorder
2020, Research in Developmental DisabilitiesCitation Excerpt :With nearly one third (31 %) of individuals who have ASD utilizing some form of therapy (Lavelle et al., 2014), establishing effective treatment methods that are both efficient and cost-effective are crucial. There are well-established, evidence-based interventions for children who are diagnosed with ASD, with several other promising interventions gaining support (Will et al., 2018). In order to improve functional independence, these treatments frequently focus on reducing the symptom severity of the core features of ASD, including deficits in social communication, as well as restrictive and repetitive behaviors (RRBs; American Psychiatric Association, 2013).
Autism spectrum disorder and complex healthcare needs: The role of healthcare experiences
2020, Research in Autism Spectrum DisordersCitation Excerpt :Autism severity is clinically determined during the evaluation process by widely accepted and reputable instruments such as the Autism Diagnostic Observation Scale, Second Edition (ADOS – 2; Lord, Rutter, DiLavore, & Risi, 2012). Yet the varying definitions of ASD severity that are represented in the available research may be conceptualized by ratings from standardized measures (e.g., ADOS), the frequency of externalizing/challenging behaviors, or the presence of co-occurring conditions (Will et al., 2018). There is a high prevalence of co-occurring conditions associated with ASD, including emotional and behavioral disorders, chronic medical conditions, and related developmental impairments, which further complicates the presentation of autism – related symptoms (Fava & Strauss, 2014; Levy et al., 2010).