There are a ton of autism therapies out there. In my experience, parents and professionals often stumble upon one early on in their research, get sold on that one, and then are not exposed to many or any others.
Looking at the various autism therapies as a whole can accomplish some things: one major similarity between all of these therapies becomes evident (besides their high cost). They all are intensive. In fact they often rely on this intensity, which tells us that intensity is crucial. Also, one can’t help but to feel that the time involved in relying on any one program, must preclude one from learning about what other programs have to offer. The evidence suggests that at this point no one approach is more effective than the others, and that the most effective intervention is likely one in which strategies and techniques overlap.
It is my conviction that some of these programs would be best utilized as adjunct or complementary therapies. For others, the scientific evidence is severely lacking. Not only do these methods tend to take a lot of time at a lot of cost, they sometimes tend to essentially over-simplify more complex disorders. There is no short cut to simply treating the deficit. Ultimately, there is nothing better than having a comprehensive evaluation designed to identify deficits, and then working on the deficits themselves one by one. Various programs can be effective in supplementing this, but skepticism is warranted when someone advocates one method at the exclusion of all others, or the ignorance of treating complex sets of disorders.
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
Cognitive-Behavioral Therapy (CBT) – psychotherapy approach that addresses how people think and feel, trying to eliminated negative thoughts and feelings – used for various pyschological disorders, but research suggests CBT may be very effective, especially in helping treat specific behavioral aspects of high functioning autism
DAN! (Defeat Autism Now) – created by Autism Research Institute, which owns thehttp://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
Orton – Gillingham Approach – uses “multi-sensory” methodology – “triple enforced” learning means that students may use visualizations/mental imagery, written, and spoken modalities – highly structured, systematic and hierarchical – has been around since the 1930s – primarily for dyslexia, though claims to help various language disorders, including autism – when used as intended, it is intensive and expensive – research generally positive, though some contradictory
Pivotal Response Training (PRT) – pivotal is another word for crucial, and includes general areas, such as motivation, social initiation, and understanding rather than specific behaviors – derived from ABA, but is more child initiated, play based, and does not focus on specific behaviors – part of Early Start Denver Model approach – research seems generally positive but limited
The PLAY Project – (Play and Language for Autistic Youngsters) – uses DIR/Floortime model – focus is on teaching parents to become interventionists using strategies of DIR/Floortime, such as following child’s lead – intensive and expensive, but perhaps a little less so than most other approaches – research limited, but generally positive
PECS (Picture Exchange Communication System) – approach most effective for establishing communication motivation and initiation – children are taught to use basic pictures to request objects and basic needs – the official approach, taught by the Pyramid Educational Consultants, is, wait for it…intensive and costly, although probably not as much as many other methods – research generally positive, though mainly for short term use and in single settings – difficult to implement, as at least early on requires multiple caregivers
Rapid Prompting Method (RPM) – the main provider of this is called HALO, which labels their method Soma-RPM, developed by a mother (named Soma) with an autistic son – uses stimuli such as rapid speech and paper tearing to supposedly match the preferred modality of the autistic individual – appears to at least sometimes use facilitated communication to “encourage” communication via pointing – has received media attention from PBS, HBO, and CBS – not backed by any good research, and the long debunked methods of facilitated communication have had multiple tragic results
Relationship Development Intervention (RDI) – developed by Dr, Steven Gutstein – intensive training program, primarily for in home use, intended to gradually strengthen social connections – has multiple catch phrases, such as dynamic intelligence, emotional referencing, flexible thinking, relational information processing, etc. – the RDIconnect company trains certified consultants, who then train parents their specific strategies – potentially expensive, and independent research almost nonexistent
Relational Frame Theory (RFT) – extremely confusing theory of language , using operant conditioning principles and loads of jargon – I haven’t heard of anybody actually using this to treat language disorders, but there is tons of information on the internet from its adherents as if RFT is the greatest thing since sliced bread, and that it can treat everything from stress to autism
Reciprocal Imitation Therapy (RIT) – Dr. Brooke Ingersoll – uses principles of ABA and pivotal response training to specifically address imitation and play abilities – involves parallel play and ties imitation into social reasons for imitating – starts by adult imitating, and providing opportunity for child then to imitate – spends more time selecting things with intrinsic interest than traditional ABA like therapy – seems possibly helpful for specific groups – research very limited at this point
TEACCH – Treatment and Education of Autistic and Communication related handicapped Children – school based program developed state-wide in North Carolina, and sometimes used elsewhere – prototype TEACCH model places several children in small self-contained classes, usually with one teacher and one aide – intended to provide autistic individual with structure and organization, with such things as physical boundaries, routines, visually based cues, etc. – sometimes used along with other strategies – some research suggests it may be beneficial, but as usual, almost all research has not been independently verified – also, research results seem to be largely dependent upon skills and experience of staff
Stem Cell Therapy – intended to address possible immunologic based inflammatory conditions that are thought to contribute to autism – treatments involve IV injections of a child’s own banked cord blood – research has yet to link autism and neuroinflammation, let alone demonstrate that this particular treatment works – this may show promise many years in the future, but at this stage it is extremely experimental
Son-Rise – similar to DIRFloortime and RDI in that parents become therapists and engage at child’s level of interest – opposes itself to behavioral therapies, such as ABA – attempts to build relationships between autistic child and caregivers – very time consuming (requires home volunteers or at least one stay at home parent) and very expensive – program may not always be implemented in the same way every time, which impedes research – reliable research very limited, but there seems to be some positive anecdotal evidence (although that can be said for just about all of these programs)
Visual Therapy – addresses areas of focus and concentration, among others – sometimes claimed to help general learning problems or other areas, such as ADHD – various approaches addressing visual deficits in autism go by monikers such as visual therapy, vision training, developmental optometry, and visual management training – these address eye tracking, aim, depth perception, visual perception – multiple groups have condemned behavioral vision therapy as scientifically unproven, including the American Academy of Pediatrics, and U.K. College of Optometrists
Sensory Integration Therapy – used to treat Sensory Processing Disorder, and often used in addressing sensory issues common in autism – these sensory issues include hypersensitivity, and sometimes hyposensitivity, to light, sound, and touch – Sensory Integration Therapy is usually done by occupational therapists, and includes activities such as deep pressure, bouncing, swinging, and systematic desensitization – very popular, with adherents espousing several studies that support it – unfortunately, there seem to be more studies showing mixed or no benefits
SCERTS – stands for Social Communication, Emotional Regulation, and Transactional Support – Practitioners following the SCERTS model use a combination of techniques and strategies, many borrowed from other interventions, in order to meet the specific needs of the individual child – more child directed than ABA approaches, and so implements aspects such as following child’s lead, manipulating the environment, and communication temptations – emphasizes social-pragmatic language therapy – parents and professionals are trained to implement strategies as a team approach – independent research and reviews are extremely rare
Social Stories Therapy – can refer to these generally, or Carol Gray’s extensive program with tons of books and materials for sale – social stories provide an individual with information about those situations that he may find difficult or confusing – various situations are described in detail with the goal of the stories to increase the individual’s understanding of, make him more comfortable in, and possibly suggest some appropriate responses for the situation in question. – while the term “Social Stories” is actually trademarked, and refers to a specific program, many of these created by professionals and caregivers are offered free or for lower cost on the Internet and within applications for technology devices – these all seem to be useful as a tool for specific behaviors that can be used in addition to other strategies for other skills and behaviors
Ziggurat Model – uses checklists filled out by team members to determine underlying deficits of child with autism – team members are supposed to work on needs as determined by levels, starting with sensory and biological needs, then reinforcement, then structure and visual supports, then task demands, then skills to teach – seems complicated and jargon laden, with many new acronyms to learn – no apparent independent research or reviews
Note: These things change a lot. If you notice anything that needs updated, please email me at firstname.lastname@example.org.