What Is the Best Treatment for ASD?
The best treatment for ASD must combine several disciplines – behavioral, developmental, academic, and medications. The treatment must be customized to each individual child’s requirements and must follow the general principle of trying to achieve the best possible functional ability using the available resources as needed.
Behavioral Modification
Behavioral modification may be very helpful. Children with ASD may assume a wild behavior that if not corrected may lead to severe, life threatening behaviors that may require extreme measures. Early strict behavioral modifications may prevent future use of medications and institutionalization.
Parents must remember! If the family changes their normal behavior and assumes abnormal routines (in order to accommodate to the child’s abnormal behaviors and prevent his temper tantrum), instead of the family teaching the child normal behavior, the entire family becomes behaviorally disrupted and the child with ASD loses his chance to learn normal, socially accepted behavior.
Behavioral modification is effective if strictly applied and should be directed at correcting everything that is abnormal in the child’s behavior, and that is potentially correctable. (See next section on behavioral modification.) Other behavioral and developmental treatment disciplines include ABA, speech therapy, occupational therapy, and special education.
Physical Therapy
Occasionally, physical therapy may be helpful in some kids with ASD who also suffer from hypotonia (low muscle tone) or other physical impairments.
Medications
Medications for ASD are utilized as required, directed at specific treatment goals. One must take into consideration the fact that children with ASD may react unexpectedly and differently than expected to any medications used. Kids who also suffer from hyperactivity (a common combination) may benefit from stimulants (Adderall, Ritalin, Dexedrine) as indicated in our AD/HD section of the site. These may reduce hyperactivity and improve the attention span in children with ASD as well.
Children who have a lot of obsessive-compulsive symptoms (OCD) may benefit from SSRI (selective serotonin reuptake inhibitors). Available in the US in liquid form are Prozac, Paxil, and Celexa. Others include Lurox and Zoloft. These are antidepressants that also have a benefit in treating OCD by increasing serotonin concentration in the brain. These medications were studied and have shown a statistically significant improvement in some autistic symptoms compared to placebo. Some children, however, become more restless when exposed to the SSRI’s. Still, these may be considered some of the safest, most beneficial medications to try.
Major tranquilizers are used in children that have very erratic, disruptive, dangerous behaviors. If prescribed at night, this may help with sleeping difficulties. These medications include Risperidal (liquid form), Zyprexa, Abilify, Melleril, Haldol, and Seroquel. One must use these with caution and look out for some side effects. Weight gain is a very common side effect. Somnolence or drowsiness may also occur. Rare long-term side effects include tardive dyskinesia, a movement disorder involving the oral muscles, tongue, and extremities. This may be irreversible. Changes in liver enzyme counts have also been reported.
Other medications, including some traditional antidepressants, anti-anxiety medications, and combinations of some anticonvulsants have also been used for ASD but less commonly.
Other different treatments
Other different treatments such as auditory integration training, vitamin and mineral treatments, and secretin injections have been anecdotally reported to be helpful, yet were never proven to make a difference and are not recommended by the American Academy of Neurology; therefore their use is controversial, and not recommended. One must remember that some kids with ASD improve “spontaneously” without any apparent treatment. This makes it difficult to decide whether the improvement was related to a treatment or occurred spontaneously, unless studies are done in a controlled fashion and compared to placebo. Unfortunately, none of the controversial treatments wer ever proven effective in a scientific fashion.