What is the Treatment for Autism?

Introduction

Treatment options for autism have developed rapidly over the past two decades. Knowing what support is available helps parents work out what is best for their child and the needs they have right now. This article explains the main options, and when each one may be the most helpful for an autistic child or adult.

Treatment for autism isn’t about changing who your child is. Autism is a lifelong difference in how the brain works, which is also why autism can’t be cured, and doesn’t need to be. Good support helps with communication, wellbeing, daily life and any co-occurring conditions, so your child can feel understood and live a full, happy life.

Autism Spectrum Disorder

So what is Autism Spectrum Disorder? Autism is a neurodevelopmental difference that affects how a person communicates, connects with others and experiences the world. Many autistic people also have repetitive behaviors, deep interests, a strong need for predictability and sensory differences. Some of these are strengths, and some can make everyday environments harder.

Autism comes from a combination of genetic and environmental factors, which is why it looks so different from person to person. This complexity is also why claims about autism prevention should be read with care. There is no single picture of how autism affects someone, so it is assessed and diagnosed using a combination of diagnostic tools and criteria.

How Is Autism Treated?

There is no single treatment for ASD, and no medication that treats autism itself. Instead, autism is treated (supported) with a mix of therapies and strategies chosen for each person’s needs. These often include:

• Early intervention, ideally starting as soon as concerns are noticed
• Speech and language therapy, including alternative ways to communicate
• Occupational therapy for sensory, motor and daily living skills
• Psychology for anxiety, emotions and relationships
• Parent coaching, so support continues at home every day
• Medication for co-occurring conditions such as ADHD, anxiety or sleep problems, when needed

The best plans start with your child’s strengths and interests, look at what in the environment can change, and treat behavior as communication.

Understanding Autism Treatment Options

Because autism looks different in every person, there is no standard treatment either. Treatment plans vary a lot, because a person may need little support in some areas and a lot of support in others. Knowing the treatment options that are available helps parents tailor support to their child’s individual needs, which makes it more effective.

Autism Treatment Options

#1 Early Intervention

Early intervention means support that starts before preschool age, often around the age of 2 or 3. Research suggests that accessing support as early as possible is linked with better long-term outcomes for autistic children. One reason is that a young child’s brain is still developing quickly, so it is especially open to learning.

Early intervention often involves a multidisciplinary team of specialists who work together on different goals for the child. Each specialist has their own area of expertise and works alongside the others. Some of the specialists you might see on a multidisciplinary team are:

• Speech and language pathologists
• Pediatricians or psychiatrists
• Behavior therapists
• Occupational therapists

Early intervention can start before a formal autism diagnosis. The observations and recommendations from early intervention can then be shared with the diagnosing professional to help with the diagnosis process. If your child has just been diagnosed, our guide to what to do after an autism diagnosis can help you plan.

#2 Speech and Language Therapy

Speech and language therapy usually starts with assessments to find the areas where support will help most. The areas this type of therapy may assess and support include:

• Verbal and non-verbal communication
• Expressing needs and wants
• Understanding language
• Social communication
• Articulation

Speech and language pathologists can also work on physical skills, such as strengthening the muscles in the mouth, jaw and neck to support clearer speech. Speech therapy also covers skills that other therapies work on too, such as understanding emotions, body language and conversation. Finally, speech therapy is where children with autism can access augmentative and alternative communication (AAC), such as picture systems and speech-generating devices, so they can communicate freely. All communication counts, whether it’s speech, signs, gestures, pictures or a device. Our guide to speech therapy for autistic children explains what sessions usually involve.

#3 Behavioral Therapy

Behavioral therapy is based on the principles of applied behavior analysis (ABA), an approach to understanding why behavior happens and how the environment affects it. There are different types of ABA-based support, depending on the needs of the child. Some of these include:

• Positive Behavior Support (PBS)

  PBS looks for the function or reason behind a behavior, then changes the environment to meet that need. It aims to teach children with autism other ways to communicate their needs, so they rely less on behaviors of concern to tell us something is wrong.

• Early Intensive Behavioral Intervention

  Individualized plans with structured teaching for very young children with autism, often focused on communication, play and daily skills. This is often done one-on-one or in small groups.

• Pivotal Response Training (PRT)

  PRT takes place in natural settings, like home and play, rather than in a clinic. It follows the child’s interests and focuses on pivotal skills, such as motivation and starting interactions, that help many other skills develop.

• Discrete Trial Teaching (DTT)

  DTT is a common ABA practice where the therapist teaches specific skills in a structured, step-by-step way. It uses positive reinforcement to encourage new skills.

Applied Behavior Analysis has changed a lot in recent years. Good practice has moved away from punishment or removing preferred items, and focuses instead on positive reinforcement and a trusting, understanding relationship with the child. Many autistic adults have raised concerns about older, compliance-focused ABA. If you choose behavioral support, look for a program that is play-based and child-led, respects stimming and your child’s need for breaks, and never aims to make your child look “less autistic”. Support should only target behaviors that are causing real harm or distress, while respecting and empowering your child.

#4 Occupational Therapy

Occupational therapy focuses on executive functioning and daily living skills for people with autism. Occupational therapists (OTs) give children and families strategies that help build skills at home, at school and in the community. Some of the areas OTs focus on include:

• Daily living skills

  • This includes executive functioning (planning, memory, multitasking), tasks with several steps, hygiene, sleep, managing money and more.

• Play skills

  • Play and leisure activities, social skills, interacting with others and building relationships, imaginative play and cooperative play.

• Sensory processing

  • Understanding a person’s sensory differences and how they affect daily life, then adjusting the environment and finding sensory supports that help.

• Motor skills

  • Fine motor skills: handling objects, hand-eye coordination, using pencils, doing up buttons and zips, and coloring-in. This can include building hand strength to make fine motor tasks easier.
  • Gross motor skills: running, jumping, body awareness, overall coordination, climbing and so on.

Must Read: Fine & Gross Motor Skills Development Checklist for Age Level 2 to 5 years

• Organization

  • Life organization skills and managing the stress that comes with them. Making plans and supporting people to manage a job and other responsibilities.

As you can see, occupational therapy covers a broad range of areas. It can be provided at home, at school or in a clinic. OTs often run group sessions and are an important part of multidisciplinary teams supporting children with autism.

#5 Psychology

Many psychologists offer autistic people talk therapy, often based on cognitive behavioral therapy (CBT). Psychologists often adapt CBT to suit autistic clients and work on conditions that can co-occur with autism, such as anxiety. Psychologists are also involved in diagnosis and carry out assessments that inform diagnostic reports. Areas psychologists focus on include, but are not limited to:

• Managing stress and difficult interactions at school
• Anxiety and depression
• Perseverative behavior (repetitive behavior) that is causing distress
• Social understanding
• Managing relationships
• Working with parents and teachers on strategies for school success

Psychology support is often needed as autistic children move from childhood into adolescence, when social relationships become more complex. These demands can be overwhelming. Autistic and non-autistic people often communicate differently, and misunderstandings run both ways (sometimes called the double empathy problem), so autistic young people can be left feeling confused or left out.

Feeling misunderstood for a long time can contribute to co-occurring mental health conditions such as anxiety and depression.

#6 Parent Training

Autistic children face challenges every day in a world that isn’t built for the way they think, communicate and sense things. Many develop their own ways of coping. Some of these work well, while others can leave a child exhausted or get in the way of learning and connection.

Parent training (or parent coaching) helps parents understand the reasons behind their child’s behavior and how to respond. Behavior is communication, so when parents learn what their child is telling them, they can adjust the environment, meet needs earlier and create many more everyday opportunities for their child to learn, connect and feel safe. Hearing autistic adults describe their own childhoods can make this much clearer, which is the focus of our masterclass on autistic experiences.

Allied health therapy can be very helpful for a child, but it is often only weekly, which leaves a lot of time between appointments. Parent-led support means strategies are used every day, in the places your child already spends their time.

It is important to remember that not every parent has the capacity to take on more right now. Families are often already under a lot of pressure, and health professionals should respect this and offer support in manageable ways.

#7 Medications

There is no medication that treats autism itself. Some have been studied, such as oxytocin nasal spray, but none has been shown to change autism. Common practice in the treatment of autism symptoms and co-occurring conditions is to try non-drug support first. However, co-occurring conditions are common, so it is not unusual for children with autism to take medication to help with things like sleep, anxiety or ADHD.

Many families prefer not to use medication, and this is a choice that everyone working with the family should respect.

Medication for neurodevelopmental and co-occurring conditions is mainly prescribed by psychiatrists and some pediatricians. Medication may help with:

• Sleep

  • Sleep difficulties are common for children with autism. Melatonin is often prescribed to support healthier sleep for children with autism, alongside a calm, predictable bedtime routine.

• Anxiety and depression

  • Families may choose to try cognitive behavioral therapy with a psychologist before using medication for anxiety. When anxiety is very high, medication that acts on serotonin levels in the brain (such as SSRIs) is sometimes prescribed.
  • Antidepressants are sometimes also used for repetitive behaviors or an intense need for routine when these are causing significant distress, although the evidence for this in children is limited. Because of possible side effects, doctors usually only recommend this when the person’s distress is severe and limiting.

• Attention deficit hyperactivity disorder (ADHD)

  • Medications for the symptoms of ADHD are usually stimulants that improve focus and motivation. They can cause side effects such as nausea, reduced appetite and fatigue.

• Irritability and aggression

  • When distress is very intense and leads to aggression or self-injury, some antipsychotic medications may be prescribed to reduce the impact on the person’s relationships, learning and ability to take part in life outside the home. It is still important to look for the cause of the distress, such as pain, sensory overload or communication barriers.
  • Antipsychotic medications need close monitoring because they can have side effects such as weight gain, effects on puberty and raised blood glucose levels.

Mood stabilizers are also sometimes used alongside other medications. Always let the people working with your child know about any medication changes, because medication can have a big effect on how a child feels and behaves.

#8 Alternative Therapies

Many families look into alternative therapies to use alongside evidence-based support. These are often called complementary and alternative medicine, and many children with autism will have tried an alternative therapy in some form. The following are just some examples of alternative approaches that are commonly used.

Dietary interventions

Changing diet is a common alternative approach for people with autism, and research suggests about 25% of autistic people have tried some form of dietary change. This often involves removing certain foods or adding supplements.

Restrictive diets may remove processed and high-sugar foods, or foods containing gluten or casein. Supplements may include vitamins, minerals, amino acids, omega-3 and herbal compounds.

Dietary approaches for autism have been researched, but there isn’t strong evidence that they have a widespread positive or negative effect.

Because autism looks so different from person to person, it is hard to say whether dietary changes are appropriate in the treatment of autism. Many families try a change for a set period and look at the results before deciding what to do next. Talk to your GP or a dietitian before starting a restrictive diet or supplements, especially if your child already eats a limited range of foods.

#9 Sensory-based Therapies

Sensory integration therapy is a clinic-based approach with a strong focus on the relationship between the therapist and the child. It uses play-based movement activities to understand the child’s own sensory and motor needs. The aim is to help the child process and make sense of sensory information.

Activities in sensory-based therapy are sensory-rich and child-led, so therapists can see how the child responds to different sensations. This helps the therapist work out which supports may make different sensations easier to manage.

#10 Equine-assisted Therapy

Equine-assisted therapy for autistic people has grown in recent years. It uses a horse, and the relationship a person builds with the horse, to develop skills. Equine-assisted therapy is also used to support people with a range of other disabilities and conditions, such as head injuries, multiple sclerosis, cerebral palsy, stroke and mental health conditions.

Riding a horse provides rhythmic movement that supports coordination, balance and body awareness, with forward and backward swinging movements and plenty of sensory and motor input.

Equine therapy for autism

Equine therapy for autism often focuses on behavior and social communication. Research into equine-assisted therapy is continuing, but evidence for benefits to other skills, such as motor, cognitive and everyday skills, is limited and needs more investigation.

During a session of equine-assisted therapy, you may see:

• Therapeutic horseback riding: learning specific riding skills.
• Hippotherapy: a form of physiotherapy and occupational therapy that uses a horse’s movement to provide motor and sensory input, to support sensory processing and the skills needed for daily living.
• Activities on the ground, such as grooming and caring for a horse.
• Guiding the horse’s movements to work on specific goals, whether for physical therapy, speech and language development or sensory goals.

Equine-assisted therapy also helps a person build a relationship with the animal, supporting physical, cognitive, emotional and social wellbeing for people with diverse abilities.

Alternative therapies are often used by autistic people who have digestive issues, feeding difficulties or sleep issues, or for support with behavior. Always tell your child’s doctors and therapists about any alternative treatments you are using and the results you are seeing, so everyone working with your child is on the same page.

Must Read: The Truth About Autism Treatment Controversies

How to Choose the Right Treatment for Autism for Your Child

With so many options, it can be hard to know where to start. These questions can help:

• Does it start with my child’s strengths and interests? Good support uses what your child loves as a way in.
• Does it treat behavior as communication? Ask how the provider works out what a behavior is telling them before trying to change it.
• Does it look at the environment first? Sensory load, routines, demands and communication supports often make the biggest difference.
• Is my child happy to go? Your child should feel safe and comfortable with their therapists.
• Is it backed by evidence? Be wary of anything that promises dramatic results, or that is expensive, invasive or involves strict diets or supplements without medical oversight. Some so-called cures, such as Miracle Mineral Solution, are outright dangerous.
• Does it fit our family? The best plan is one you can keep up with. Strategies you use every day at home often matter as much as weekly appointments.

Conclusion

Above all, the treatment for autism is extremely diverse, and no single treatment suits every autistic person. Parents of young children who are in the early stages of diagnosis should look for early intervention from a multidisciplinary team, to support long-term outcomes and quality of life.

Therapies such as speech and language therapy, behavioral therapy and occupational therapy can help autistic people build the skills they need and make sense of the world around them. These therapies can offer strategies for self-regulation and calming, as well as coping skills and skills for daily living.

Psychology and talk therapy are also available to help treat people with autism who are experiencing co-occurring conditions such as anxiety and depression. Parent training is another important tool, helping parents and carers support their child’s wellbeing, social connection and communication.

Medication can help with sleep difficulties, anxiety, depression and ADHD, but it is important to discuss this option with a healthcare professional and consider other supports that could help first.

Starting medication can feel daunting, because it can sometimes affect behavior and mood in unwanted ways. Close monitoring is important to track any changes.

Overall, understanding the treatment options available for autistic people is essential for families and healthcare professionals. Working together on an individualized plan helps autistic people feel understood, heard and happy, and able to reach their full potential with a great quality of life.