From a parent or caregiver’s perspective, when a child is diagnosed with special needs, such as autism spectrum disorder, there are a slew of questions that immediately come to mind: What can I do to help my child? Will my child be dependent on me for life? Was there anything I could’ve done differently? While the potential answer to any of these questions is not short and simple, that doesn’t mean there isn’t a pathway to success.
Adding to the anxiety and confusion after a diagnosis are the misleading statistics, propagated by certain groups, implying that there has been an increase in autism diagnoses over the past several decades. Quite the contrary, as supported by another recent study, the perceived increase in the number of children on the autism spectrum is due to a refinement in diagnostic criteria over the past several years. Specifically, those who were previously diagnosed with the general classification of “intellectual disability” are now classified as “autistic.”
Furthermore, the cost of caring for and treating individuals with autism throughout their lives is projected to rise, the current cost of which equals the cost of diabetes and exceeds the costs of stroke and hypertension put together. Some of these costs include medical care, special education, residential and in-home support, transportation and employment assistance.
Despite certain groups sounding the alarm, research continues to demonstrate that access to intensive early intervention has been proven to ameliorate the prognosis and long-term functionality for people diagnosed with autism, reducing costs and increasing their independence across their lifetime. This includes services such as in-home behavioral therapy, in-school behavioral support, speech therapy, occupational therapy and social skills training.
Once a family secures access to some or all of these services, whether through insurance, government funding or private pay, the question remains how do these service providers determine how to help a child, and their family, through their various areas of need? From a behavioral perspective, numerous assessment tools are utilized to evaluate which domains, based on specific developmental milestones, a given child demonstrates excesses or deficits in. Some of these domains include communication skills, such as responding to name with eye contact and vocal requests; self-help skills, such as toilet training and feeding; play skills, such as following rule-based games and independent play; social skills, such as interacting in play with others and reciprocal conversation; independent living skills, such as use of money and meal preparation; and maladaptive behaviors, such as self-injurious behaviors, aggression and repetitive behaviors.
These aforementioned domains are just a snapshot of what interventionists look for and target for any given child, adolescent or adult diagnosed on the autism spectrum. These are in addition to what parents and caregivers have reported as their largest areas of concern. For example, an assessment may determine that a child has several areas of deficits including labeling objects in their environment and pretend play. However, at the start of services, the child’s mother reports that her child demonstrates aggression in the form of biting and hair pulling towards herself and their sibling on a daily basis, something not observed directly by the assessor. In this case, the priorities for this particular child’s intervention should be apparent.
When service providers are asked how they determine what to teach a child and when, there is never a clear-cut answer, as each intervention should be tailored to each individual’s, and their families, specific areas of need. There should never be a “cookie-cutter” intervention plan that is copied and pasted from another individual’s program.
It is by its definition and nature that autism spectrum disorder encompasses a “spectrum” of symptoms and presentations, and that each individual diagnosed possesses unique strengths and weaknesses, excesses and deficits. The earlier the intervention, and the stronger the collaboration between families, schools and service providers, the greater the indelible outcome for that individual will be.