Autism Spectrum Disorder
There are many factors that contribute to the long-term treatment outcome of a child with autism. Some of these factors can be controlled and some cannot.
Research has shown that children starting at the same age, with the same intensity, consistency of treatment, and same treatment choice, may have different treatment outcomes. This, we believe, is due to the level of developmental delay at prior to treatment as well as the cognitive ability of the child. Some children may learn very fast and others may take longer to learn the same skill. Some children may find it difficult to learn abstract concepts, while others may become fluent in all areas.
It has been well documented that children with ASD benefit the most in the early years. Early intervention is critical to ensure the maximum progress. This is not to say that older children do not benefit from treatment–they definitely can benefit from behavior intervention. However, as children get older the developmental gaps become wider and it becomes more difficult to catch up. Thus, it is recommended that intervention begin as early as possible.
Children with autism face the formidable challenge of not only trying to close the developmental gaps that already exist but also they need to keep up their learning pace with their peers to ensure that the gaps do not widen.
For example, a 4-year old child who has a 2-year delay in language has only been learning the equivalent of 6 months growth in language skills in a 12 month period. By comparison, a neurotypical child would have gained the equivalent of 12 months language growth in each 12 month period.
In order to close the development gap, the child with ASD will need to gain more than 12 months of language growth in a year. If the student caught up 1.5 years of language every year, it would then take him or her 4 years to finally catch up with peers. This then presents a real challenge.
Given the multitude of deficits that are often present with autism, it is critical that all areas are taught intensively and systematically. It is not unlike taking a child and training him or her to become an Olympic swimmer. Spending one hour a week on a major deficit areas is not going to produce the optimal increase in skills. Research has consistently shown that a high volume of hours is needed to maximize a child’s learning progress.
In order to maximize progress, it is critical that the whole treatment team provides service in a consistent approach. If the student is doing sign language in the morning and using pictures to communicate in the afternoon, it is likely to result in confusion on the part of the student.
If a number of practitioners are working together, it is then essential that they meet regularly to formulate a comprehensive plan so that the treatment can be consistent. This is also true for the consistency between parents and the treatment team. Parents need to be involved and develop knowledge and expertise in treatment so as to help their child learn and generalize skills.