Ask the Doctor: Autism Treatment

© Leroy Hamilton
© Leroy Hamilton

Recently, we covered the symptoms of autism spectrum disorders (ASD). I’d like to address treatment options. First, a few words about what causes it. ASD is not a single disorder, but a group of disorders. Hence, there is no single cause, but researchers believe it is likely a combination of genetic and environmental factors. There is no link between vaccines and ASD.
There is no single specific test to diagnose autism, although there are specialty screening tools such as the M-CHAT. Pediatricians and primary care physicians routinely include screenings for developmental delays in routine visits, and should refer to behavioral health specialists if there is any suspicion of ASD. Evaluation of ASD is completed by a multidisciplinary team which includes qualified physicians and psychologists, the family and other supports, such as teachers and social workers.
In 2012 Michigan was the 30th state to enact autism insurance reform, which ensures behavioral and other treatments through the age of 18. While there is no cure for ASD, there are treatments designed for specific signs and symptoms. Early identification and intervention are important. Interventions may be home-, school-, or clinic-based. Treatment should always be person-centered: there is no one-size-fits-all therapy.
Some evidence-based therapies behavioral therapies include Applied Behavior Analysis (ABA) and Early Start Denver Model (ESDM). These work with children and their parents or caregivers to understand behavior, how it is affected by the environment, and help to acquire new skills that improve communication, social interaction, and life skills.
Persons with ASD are often engaged in Occupational Therapy (OT) to teach them how to function and live as independently as possible. Activities learned include feeding, and dressing, as well as work or recreational activities. Speech therapy may be required to improve communication skills, including understanding speech, learning gestures or using picture boards, and improving speaking and swallowing skills.
Sometimes dietary approaches are useful. Children may be very sensitive to certain foods, such as gluten, or may need nutritional supplements. Always work with credentialed nutritionists and/or physicians before venturing into dietary changes. Medications may be helpful in addressing some core symptoms. For example, medications could address depression, poor attention, seizures, or hyperactivity. Regardless of the treatment option being considered, the goal is always the same: to maximize one’s ability to function.
Dr. Carmen McIntyre is chief medical officer at Detroit Wayne Mental Health Authority. If you have a question, please submit it to AskTheDr@ dwmha.com.

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