Management Autism

1 management

1.1 education
1.2 medication
1.3 alternative medicine
1.4 cost

management


a three-year-old autism points fish in aquarium, part of experiment on effect of intensive shared-attention training on language development.

the main goals when treating children autism lessen associated deficits , family distress, , increase quality of life , functional independence. in general, higher iqs correlated greater responsiveness treatment , improved treatment outcomes. no single treatment best , treatment typically tailored child s needs. families , educational system main resources treatment. studies of interventions have methodological problems prevent definitive conclusions efficacy, development of evidence-based interventions has advanced in recent years. although many psychosocial interventions have positive evidence, suggesting form of treatment preferable no treatment, methodological quality of systematic reviews of these studies has been poor, clinical results tentative, , there little evidence relative effectiveness of treatment options. intensive, sustained special education programs , behavior therapy in life can children acquire self-care, social, , job skills, , improve functioning , decrease symptom severity , maladaptive behaviors; claims intervention around age 3 years crucial not substantiated. available approaches include applied behavior analysis (aba), developmental models, structured teaching, speech , language therapy, social skills therapy, , occupational therapy. among these approaches, interventions either treat autistic features comprehensively, or focalize treatment on specific area of deficit. there evidence intensive behavioral intervention (eibi), intervention model based on aba 20 40 hours week multiple years, effective treatment children asd. 2 theoretical frameworks outlined childhood intervention include applied behavioral analysis (aba) , developmental social pragmatic models (dsp). 1 interventional strategy utilizes parent training model, teaches parents how implement various aba , dsp techniques, allowing parents disseminate interventions themselves. various dsp programs have been developed explicitly deliver intervention systems through at-home parent implementation. despite recent development of parent training models, these interventions have demonstrated effectiveness in numerous studies, being evaluated probable efficacious mode of treatment.

education

educational interventions can effective varying degrees in children: intensive aba treatment has demonstrated effectiveness in enhancing global functioning in preschool children , well-established improving intellectual performance of young children. similarly, teacher-implemented intervention utilizes aba combined developmental social pragmatic approach has been found well-established treatment in improving social-communication skills in young children, although there less evidence in treatment of global symptoms. neuropsychological reports poorly communicated educators, resulting in gap between report recommends , education provided. not known whether treatment programs children lead significant improvements after children grow up, , limited research on effectiveness of adult residential programs shows mixed results. appropriateness of including children varying severity of autism spectrum disorders in general education population subject of current debate among educators , researchers.

medication

many medications used treat asd symptoms interfere integrating child home or school when behavioral treatment fails. more half of children diagnosed asd prescribed psychoactive drugs or anticonvulsants, common drug classes being antidepressants, stimulants, , antipsychotics. antipsychotics, such risperidone , aripiprazole, have been found useful treating irritability, repetitive behavior, , sleeplessness occurs autism, side effects must weighed against potential benefits, , people autism may respond atypically. there scant reliable research effectiveness or safety of drug treatments adolescents , adults asd. no known medication relieves autism s core symptoms of social , communication impairments. experiments in mice have reversed or reduced symptoms related autism replacing or modulating gene function, suggesting possibility of targeting therapies specific rare mutations known cause autism.

alternative medicine

although many alternative therapies , interventions available, few supported scientific studies. treatment approaches have little empirical support in quality-of-life contexts, , many programs focus on success measures lack predictive validity , real-world relevance. scientific evidence appears matter less service providers program marketing, training availability, , parent requests. alternative treatments may place child @ risk. 2008 study found compared peers, autistic boys have thinner bones if on casein-free diets; in 2005, botched chelation therapy killed five-year-old child autism. there has been research looking @ hyperbaric treatments in children autism.

although popularly used alternative treatment people autism, there no evidence gluten-free diet of benefit. in subset of people have gluten sensitivity there limited evidence suggests gluten free diet may improve autistic behaviors.

cost

treatment expensive; indirect costs more so. born in 2000, study estimated average lifetime cost of $4.11 million (net present value in 2016 dollars, inflation-adjusted 2003 estimate), 10% medical care, 30% education , other care, , 60% lost economic productivity. publicly supported programs inadequate or inappropriate given child, , unreimbursed out-of-pocket medical or therapy expenses associated likelihood of family financial problems; 1 2008 study found 14% average loss of annual income in families of children asd, , related study found asd associated higher probability child care problems affect parental employment. states increasingly require private health insurance cover autism services, shifting costs publicly funded education programs privately funded health insurance. after childhood, key treatment issues include residential care, job training , placement, sexuality, social skills, , estate planning.