Effective Intervention Program features
Interventions Supported by Research
Examples of Therapeutic Intervention Programs
Other Models of Intervention
Goals for Educational Services
Key Points and Next Steps

Other Models of Intervention

There is little rigorous research on interventions that fall within this category. That does not mean, however, that they do not produce positive results in some children some of the time. Without validation from multiple research studies it is impossible to verify the results and claims made by those who endorse these therapies. It is generally agreed that interventions should be used that have a reasonable chance of providing short- and long-term gain to a child on the autism spectrum.

Sensory Integration Therapy

Sensory integration therapy is an example of a very popular therapy for reducing emotional anxiety and related behavior due to a child's inability to properly process a variety of sensory information such as visual, auditory, tactile, touch, and balance information. Very few studies exist to support the specific benefits of this therapy, however, most occupational therapists and parents of children with autism will testify to its benefits.

The philosophy of sensory integration therapy says that by focusing a child on play that utilizes and thus stimulates all of the sensory-related neurological systems, children's brains will develop into normal healthy information processing entities. Sensory integration therapy emphasizes the neurological processing of sensory information as a foundation for learning of higher-level adaptive skills.

Auditory Integration Therapy

Supporters of auditory integration therapy suggest that music can stimulate the sound processing in the middle ear (cochlea), reduce hypersensitivity to noise, and improve overall auditory processing. Two philosophical approaches to auditory integration therapy exist: Tomatis and Berard (the latter is more common in the United States). With both techniques, music is introduced via earphones filtering out selected frequencies. Although improved sound modulation is one goal of treatment, other behaviors, including attention, arousal, language, and social skills, are also hypothesized to be enhanced.

Vision Therapy

A variety of visual therapies (including visual exercises, colored filters, i.e., Irlen lenses, and ambient prism lenses) have been used with children with autism in attempts to improve visual processing or visual-spatial perception. There are no known empirical studies regarding the efficacy of the use of Irlen lenses or oculomotor therapies specifically in children with autism. Prism lenses are purported to produce more stable visual perception and improved behavior or performance by shifting the field of vision through an angular displacement of 1 to 5 degrees (base up or base down). Results of only one study conducted on the efficacy of this therapy indicated some short-term positive behavioral effects with less improvement at later follow-up. Performance on orientation and visual-spatial tasks was not significantly different between conditions. Studies have not provided clear support for either its theoretical or its scientific basis.

Diet Therapy

The gluten and casein-free diet is popular among many parents of children with autism who report that by significantly reducing these two dietary substances, the behavior of their children has dramatically improved. The proteins found in wheat, rye, oats, barley and dairy products (Gluten and Casein) are not completely broken down in some autistic children and are thought to exacerbate autistic behavior. There is now ample experimental evidence supporting that, at least for some children with autism, a casein and gluten-free diet may result in a reduction in many behaviors associated with autism.

There is some evidence that the use of fish oils (omega-3 fatty acids) helps reduce depression and related difficulties in children with high functioning autism. Additionally, melatonin which is linked to the sleep regulation cycle, has had positive effects on facilitating sleep in children who have autism. The net effect, as can be imagined, is better regulation of emotion, attention, and behavior during the day.

In summary, education at home, at school, and in community settings remains the primary treatment for young children with autistic spectrum disorders.

The following factors have been found to be commonly shared among effective programs in serving children with autism (from : National Research Council, 2001):

Intervention Begins Early

All of the comprehensive programs described thus far emphasize the importance of starting intervention when children are at the earliest possible ages. Generally, for children who suffer from moderate to severe childhood autism, there is a small, but vital, "window of opportunity" in which they can effectively learn. This "window of opportunity" exists approximately between the ages of 2 and 7. Several of the comprehensive programs discussed previously were initially developed for elementary aged students and gradually applied to children at increasingly early ages (e.g., Douglass, Pivotal Response Training, TEACCH). Other programs were developed specifically for preschool-aged children (e.g., Denver, Individualized Support Program, LEAP).

Although several programs (e.g., Developmental Intervention Model, Young Autism Project) have accepted children at ages younger than preschool, only the Walden toddler program was specifically designed to address the needs of toddlers with autistic spectrum disorders. Questions of how best to modify well-established approaches to fit the needs of very young children and their families are critical in future planning as children are identified at earlier ages. Extension of services to children younger than preschool ages has sometimes been limited by funding mechanisms, which apply when children turn 3 years of age. In addition, a few approaches have established cutoffs for cognitive functioning that impose some limits on entry to intervention at the earliest ages. Despite policy and funding influences, all of the programs reviewed show recognition of the importance of early intervention by reporting outcome data on at least some children below the age of 3 years.

Intervention Is Intensive in Hours

All of the comprehensive program models that are introduced to provide a child's major educational program report children participating in from 20 to 45 hours of intervention per week. The programs usually operate on a full-year basis, across several early childhood years. Dr. O. Ivar Lovaas provided the most direct evidence of the importance of intervention intensity in a comparison of 40 hours per week of traditional behavioral intervention compared with less than 10 hours per week of the same intervention. These results have been challenged by several researchers who have found that 18-25 hours per week of child-specific intervention has produced positive results.

Intervention intensity cannot be simply measured in terms of hours of enrollment or even attendance in an intervention program. In other words, hours of participation do not directly translate to hours of time engaged in intervention. It has been argued that intensity is best thought of in the context of "large numbers of functional, developmentally relevant, and high-interest opportunities to respond actively."

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