I’ve been meaning to do this post for years. A while back I started a list of short summaries of all the autism treatments I’ve heard of, which just kept growing as I kept hearing of more. My purpose was, and is, to provide some listing for parents and professionals to get a general, but comprehensive, idea of what’s out there. What started as a simple endeavor, however, has blossomed into a huge amount of information much too big for one sitting. My more in-depth research for the following approaches honestly depressed me. Most of us know that there are a lot of snake oil salesmen on the autism gravy train, but it is just extremely difficult parsing through the scads of information (including the piles of dubious and/or refuted claims) not just with these combined, but even with each individual approach. To make this as comprehensive as possible, I’ve included any therapy, including those designed more for reading or language, whose proponents claim the therapy to be beneficial for people with autism.
My first part of this three part post will alphabetically cover approximately half of the most commonly used autism treatment programs. My second part will cover the second half, along with my general opinion on these approaches. In part three, I intend to provide a comprehensive list of the specific language interventions, or techniques, found throughout these programs – as well as many additional ones not found in any them, despite their effectiveness with language intervention. At that time I also intend to provide all parts combined in a handy PDF file, for convenient reference. So, here goes…
Applied Behavior Analysis (ABA) – uses methods of behaviorism, such as classical conditioning, rewards and punishments – intensive – popularly used with autism, but is designed for any severe language disability – there are different ABA based interventions, such as Lovaas Method, and Early Start Denver Model – extensively researched, generally positive, but not conclusive, and seems more effective with certain subgroups – has reputations for both being successful and for creating “robotic,” emotionless children
Applied Verbal Behavior (AVB) – a form of ABA that uses principles of behaviorism focusing on teaching the child to realize that language can get him what he wants – uses terms directly from B.F. Skinner, such as mands and tacts
Animal Therapy – mainly includes dog therapy or horse therapy (so far) – It seems that dogs can be helpful in creating some motivation for socialization. However, the type of dog, the incredible cost for a trained dog, and the lack of research should all be considered. – Horse Therapy, AKA Equine Therapy, seems to be gaining in popularity especially in autism – appears to be beneficial, but, as with many of these therapies, should not ignore directly addressing specific communication disorders that involve disabled people communicating with other people
Auditory Integration Therapy (AIT) – popular ones are the Tomatis and Berard methods – aims to reduce hypersensitivities to sound through systematic desensitization process using music – the use of AIT to treat all sorts of cognitive ailments, from communication disorders to ADHD to preparation for childbirth has continued despite organizations such as the American Speech Language Pathology Association (ASHA) issuing position statements against it – may be mildly helpful, but these practitioners have a history of making huge claims that are unsupported
Biomedical Treatments – there are many of these, too many for me to adequately cover in a short synopsis – a good short review of the research can be found in this link – these include vitamins B6 and C, melatonin, amino acids, folic acids, antifungal agents, gastrointestinal medications, hyperbaric oxygen chambers, immune therapies, chelatin, and more – to this point, for these “alternative” therapies, the jury is way out on any of them that may consistently work for large groups of people with autism
CogMed – commercial software specifically designed to treat working memory in ADHD and other cognitive deficits – 25 sessions cost approximately $2,000 – there seem to be some benefits, but more research needed – gains may be short term and not generalizable to deficits outside of working, or short term, memory
DAN! (Defeat Autism Now) – created by Autism Research Institute, which owns the http://www.autism.com domain, so often first place people happen upon for information – DAN! as a program label has been discontinued, but the ARI seems to still be promoting its foundations that autism as a biomedical disorder should be treated primarily as a combination of lowered immune response, external toxins from vaccines and other sources, and problems caused by certain foods – DAN! and ARI have been the subject of much controversy, but has been extremely influential for many years – advocates ABA, and Theory of Mind, but with no specific language therapy
DIR/ Floor Time – by Dr. Stanley Greenspan – DIR stands for Developmental, Individual-Difference, Relationship-Based – it includes following the child’s lead, and using things that already interest the child. It assumes six milestones of typical emotional and communicative development and attempts, through intensive play and interaction, to guide children through each of these stages – has some very good parts, but the program itself can be grueling and expensive
Elimination diets (casein/gluten free diets) – The current thinking is that there is at least some evidence showing that a casein-free diet, when combined with a gluten-free diet, can help improve the behavior of some children with autism. Although the casein-free diet combined with a gluten-free diet is popular, there is little evidence in the current scientific literature to support or refute this intervention. Scientists have concluded that there are currently not enough published studies to draw a meaningful conclusion. Strong caution should be taken when modifying diets of autistic children, who are often finicky eaters anyway, to ensure that they are getting adequate nutrition.
Fast ForWord – Educational software produced by the Scientific Learning Corporation, with emphasis on phonological awareness. Suggested to help auditory comprehension, memory, attention, and other cognitive skills, as well as reading. Expensive and time consuming. Has been extensively researched, with debatable (and often debated) results
Hanen Program – includes other regimented programs, such as “More Than Words,” and “It Takes Two to Talk” – designed for younger kids, and attempts to intensively involve parents – Speech-language pathologists attend workshops to learn to train parents to learn to become interventionists – expensive and intensive -includes strategies for modeling, expansion, extension, following child’s lead, etc.
Interactive Metronome – according to their site – used by SLPs (among many other groups) for TBI, autism, ADD, Sensory Integration Disorder (and many other etiologies) for things such as focus, coordination, tuning out distractions, and many more – research seems sketchy, and perhaps unethical
Jungle Memory – Dr. Tracy Alloway – computer software for working memory in older kids – progressively difficult games, similar to CogMed – again, research limited, but suggests that gains are short term and not as generalizable as adherents indicate
Language Experiences – also LEA, or learning experience approach – has been used for decades with various populations and disorders, such as hearing impaired, English language learners, reading disorders and poverty – attempts to use student’s own vocabulary, backgrounds, and specific language patterns to create reading texts specific to that child – as usual with these approaches, results seem generally positive, but mixed
Lindamood-Bell (LiPS (Lindamood Phonemic Sequencing)) – this company also has other programs, such as Seeing Stars and Visualizing and Verbalizing for Language Comprehension and Thinking – often is extremely expensive – has been popular since 1986, mainly for phonemic awareness, oral motor coordination, and overall multi-sensory, though it has branched out into comprehension, math, and more – though it has many advocates, it also seems to have very incomplete research – according to this article, of 31 studies that had been submitted by LMB to the What Works Clearinghouse (WWC) division of the U.S. Department of Education Institution of Education Sciences, only one was approved for review
Music Therapy – may be also known as neurological music therapy – some supportive research exists – seems great as an adjunct, but not to shift focus from treating specific language deficits (As an analogy: It can be imagined that research would suggest that “music therapy” could be effective in helping depression. It could cheer a client up after all. But it would obviously not be best practices for somebody to primarily use music therapy to treat depression rather than treating the more complex (and more difficult to treat) root psychological and life situations.)
Magnetic Resonance Therapy (MRT) – seems to use primarily Transcranial Magnetic Stimulation (TMS, of course), along with other forms of neuro-feedback – TMS is a cutting edge modality, which may offer some hope for treating depression, migraines, and some other brain based disorders (and it is very useful in areas such as the study of language and the brain) – research on its effectiveness with autism is extremely limited, and still in very early experimental stages – appears to be very expensive and with dubious effectiveness
Narrative Based Language Intervention (NBLI) – hybrid language intervention approach that combines naturalistic activities such as storytelling with skill-based activities to address language and communication goals – research seems positive, but mainly for older kids