How Autism Is Treated

Lisa Jo Rudy

July 30, 2016 at 4:01 AM·11 min read

From Behavioral Therapies to Medications and Lifestyle

Medically reviewed by Steven Gans, MD

Every child diagnosed with an autism spectrum disorder (ASD) has different needs, so the treatment plan needs to be individualized. Since autism is not an illness and therefore can't be "cured," the goal is to help a child acquire and hone communication, interpersonal, and behavioral skills to better navigate daily life and, whenever possible, function independently.

This may involve a variety of different therapies, including speech therapy and social skills therapy, as well as prescription drugs to help manage issues with focus and commonly co-occurring mental illnesses. Lifestyle modifications and practices can help reinforce the goals of therapy at home.

This article looks at the various treatments that may be used with an autistic child. It also explores the role that complementary and alternative therapies may play in the treatment plan.

Specialized Therapies

The cornerstone of autism treatment is a variety of therapies that address specific traits, such as repetitive behaviors, obsessive interests, neurodivergent (unusual) responses to sensory stimuli, and difficulties with social interactions and communication.

Early Intervention

The early diagnosis and treatment of autistic children is important—ideally at the earliest age possible—as there is evidence that the earlier children receive appropriate interventions, the better the prognosis.

Developmental Approach

Developmental therapies aim to improve specific skills, such as language or physical skills. The treatment plan often involves more than one of the following therapies:

Occupational therapy: The aim is to help an autistic child manage everyday life. Occupational therapy helps to improve practical skills like independent dressing, eating, grooming, or using the bathroom. Or, it may be focused on mastering fine motor skills like writing, coloring, and cutting with scissors.
Physical therapy: This includes activities and exercises that build motor skills and improve strength, posture, and balance. Doing so can help a child, for instance, play with other kids more easily.
Play therapy: This uses play to develop relationships and build social and communication skills by building upon a child's own interests.
Recreational therapy: This is used to improve motor skills and emotional well-being with indoor activities (like puzzles and cooking) or outdoor activities (like horseback riding and hiking).
Relationship development intervention (RDI): This involves activities that increase motivation, interest, and the ability to participate in social interactions.
Sensory integration therapy: This helps autistic children to avoid excessive reactions to sounds, sight, and other stimuli (referred to as sensory overload). It can also help children who are hyporesponsive, which means they have lower than expected responses to stimuli.
Social skills therapy: This teaches children how to interact appropriately by sharing, collaborating, taking turns, asking and answering questions, and using other essential social skills. This is usually done in a group setting.
Speech and language therapy: If your child is nonverbal, this may focus on achieving basic communication skills. If they are verbal, it may focus more on speech pragmatics (or the ability to use language in a social setting).

Behavioral Approach

Behavioral therapies aim to teach skills, reinforce positive behaviors, and sometimes modify behaviors that interfere with functioning.

One of the oldest and most researched behavioral therapies is applied behavior analysis (ABA). It is a system that rewards a child for desired behaviors, and, rather than offering consequences for undesired behaviors, offers no reaction and no reward.

There are two styles of teaching used for ABA:

Discrete trial training (DTT): This breaks down specific activities, such as brushing one's teeth, into their simplest parts. Each part is practiced and then integrated into a string of activities.
Pivotal response training (PRT): This is done in a natural setting and teaches "pivotal skills" from which other skills can be learned. Examples include teaching a child how to initiate a conversation or ask for something that they want rather than skipping ahead inappropriately.

Applied Behavior Analysis

Applied Behavioral Analysis (ABA) is considered a gold standard of autism therapy but it is not without controversy. Supporters find the techniques are successful in modifying behaviors and limiting certain autism traits. Opponents question ABA, though, because of the emphasis on "fixing" behaviors in people rather than helping them flourish within their own autism experience.

Educational Approach

One of the most commonly used educational approaches to ASD is Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH). It is an individualized "whole-life" program built on the idea that autistic people thrive on consistency and visual learning.

TEACCH is used to promote communication and social skills, independence and coping skills, and skills for everyday life in the company of peers. Children are individually assessed to see where they are developmentally, after which the teacher adjusts the classroom structure to accommodate those needs.

Each child is provided with a tailored visual schedule of their daily activities (such as a wall chart). Verbal instructions are reinforced with visual instructions or physical demonstrations. As a child becomes more skilled, the environment becomes less structured to help them gain independence.

Prescriptions

Medications can help manage behavioral issues such as hyperactivity, the inability to focus, or self-harming behavior like head banging or hand biting. Medications can also help manage co-occurring conditions like anxiety, depression, or insomnia.

These medications can be used in autistic children or adults and may be covered by insurance.

Medications for Behavioral Issues

Certain types of antipsychotic drugs may be prescribed if an autistic child exhibits behaviors that are out of control or potentially harmful. These include aggression, irritability, or self-harming behaviors.

There are two second-generation antipsychotics (known as atypical antipsychotics) approved by the Food and Drug Administration (FDA) for use in autistic children:

Abilify (aripiprazole): Approved for children ages 6 and older
Risperdal (risperidone): Approved for children ages 5 and older

First-generation (typical) antipsychotics like Haldol (haloperidol), Prolixin (fluphenazine), and Thorazine (chlorpromazine) are sometimes used off-label in treating intense behavioral traits. Even so, they are used with caution due to a greater risk of long-term side effects like tardive dyskinesia (involuntary body or facial movements).

Medications for Depression, OCD, and Anxiety

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that can help treat depression and/or obsessive-compulsive disorder (OCD) in autistic children.

SSRIs approved by the FDA for use in autistic children include:

Anafranil (clomipramine): Approved for children 10 and older for the treatment of OCD
Lexapro (escitalopram): Approved for children 12 and older for depression
Luvox (fluvoxamine): Approved for children 8 and older for OCD
Prozac (fluoxetine): Approved for children 8 and older for depression, and 7 and older for OCD
Zoloft (sertraline): Approved for children 6 and older for OCD

A similar class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs) can be used to treat anxiety. Although not as commonly used in children, an SNRI such as Effexor (venlafaxine) may also be used off-label for depressive and anxiety symptoms in children.

Antidepressant Risks in Kids

The FDA advises parents and caregivers to watch for suicidal thoughts or behaviors in children on antidepressants. This is especially important at the start of treatment or whenever doses are changed.

Medications for Hyperactivity

Inattention and hyperactivity are common traits in autistic children. The drugs Ritalin (methylphenidate) and Adderall (amphetamine salts) are commonly used in children with attention deficit-hyperactivity disorder (ADHD) to manage inattention and hyperactive behaviors like excessive movement and impulsiveness.

The FDA has approved the use of Ritalin in children ages 4 and over and Adderall for 3 and older. There are extended-release versions of Ritalin such as Concerta (methylphenidate HCL) and extended release preparations of Adderall that can also be used.

Caution should be used when prescribing Ritalin or Concerta as these stimulant drugs can potentially cause irritability and make aggressive behaviors worse.

Medications for Insomnia

Medications may also be prescribed to treat insomnia in autistic children. This is important as poor sleep can affect a child's behavior and memory/learning skills, increasing the risk of aggression, irritability, hyperactivity, and depression.

Options for treatment include:

Melatonin: An over-the-counter supplement commonly used to treat insomnia
Remeron (mirtazapine): An antidepressant unrelated to SSRIs and SNRIs that can help treat sleep problems and irritability

Home Remedies and Lifestyle

The treatment of autism encompasses every part of a child's life. It requires adjustments at home to accommodate the child's needs and limitations. At the same time, by limiting autism traits through treatment, the stress on the family can also be reduced.

At-Home Therapies

At-home therapies are encouraged for families living with ASD. Some are simply extensions of what is used in classroom or clinical settings, such as play therapy or speech therapy.

Others are specifically centered around home and family life, such as:

Floortime: This is when a parent or caregiver gets down on the floor to play and interact with the autistic child at their level. It aims to build a relationship that is respectful, playful, and joyful, encouraging back-and-forth interactions, both verbal and nonverbal.
Parent-child interaction therapy (PCIT): This is used to overcome disruptive and destructive behaviors that can undermine a family's quality of life. It is a structured practice that combines play and behavioral therapies to reinforce desired behaviors and avoid reactions to undesired ones.

Avoiding Sensory Overload

Also important is the need to avoid stimuli that cause sensory overload at home. These include sights, sounds, textures, and smells that can inadvertently cause distress, anxiety, and outbursts in autistic children.

It often helps to create a "sensory room" where a child can escape to self-soothe and gain control over their emotions. A sensory room can differ for every child based on what they find soothing and may include:

A weighted blanket
Tactile pillows
Sensory toys (like a weighted stuffed animal or a fidget)
Mood lighting or a sensory lamp (like a lava lamp)
Pale or neutral colors without excessive patterns
Soothing atmospheric sounds or music

Related: How to Create a Sensory Room

Complementary and Alternative Medicine (CAM)

There are few complementary or alternative therapies that have proven beneficial to autistic people. Several are not only ineffective but may be potentially harmful, including hyperbaric oxygen therapy, heavy metal chelation therapy, and antifungal therapy that some claim can "cure" ASD.

Similarly, diets thought by some to be useful for autistic people, including a gluten-free, casein-free (GFCF) diet or omega-3 fatty acids, have not been proven to have any measurable effect on ASD traits.

According to National Center for Complementary and Integrative Health (NCCIH), there are a handful of complementary therapies that may not be useful but are unlikely to do any harm, including:

Acupuncture
Massage therapy
Mindfulness-based practices, such as breathing exercises

Summary

The treatment of autism spectrum disorder (ASD) in children helps to improve communication and social interactions, lessen disabling behaviors, and overcome other challenges like anxiety, depression, hyperactivity, insomnia, and sensory overload.

Autism treatment often involves multiple approaches, such as behavioral therapies, developmental therapies, medications, and at-home practices.

Autism cannot be cured, but early intervention can help a child learn the skills needed to better navigate daily life.

A Word From Verywell

There is no single road map for treating autism. Finding the right solution takes perseverance and often requires a process of trial and error.

To help you through the journey, find a team of therapists and healthcare professionals with whom you can collaborate as a partner. Never forget that your insights and experiences are vital to making informed judgments. If needed, seek a second or even third opinion until you are fully comfortable with the treatment plan.

It is also important to build a support system of family, friends, and support groups to help you cope as a parent or caregiver. Doing so not only lessens the load emotionally but can help you normalize autism in your life.

Frequently Asked Questions

Can autism be cured?

No, an autism spectrum disorder (ASD) cannot be cured, but it can be treated. There are several behavioral interventions that can improve daily life. In older children and adults, there is less evidence of the effectiveness of the various behavioral and social interventions, which is why early intervention is so important.

What are the treatment options for autism?

Treatment options can include specialized therapies, medications to manage traits, and lifestyle modifications to avoid sensory overload. Specialized therapies are the cornerstone of treatment and include:

Speech therapy
Occupational therapy
Physical therapy
Social skills therapy
Behavioral therapy
Developmental therapy

What happens if an autistic person doesn't seek treatment?

If left untreated, autistic children may not develop essential social and communication skills and find it harder to navigate their adolescent, teen, and adult years. With that said, autistic people with low support needs may learn to overcome traits as they grow older.

Can children outgrow autism?

Research suggests that, yes, some children can outgrow an autism diagnosis. However, even though the person no longer meets the formal criteria for autism they still likely have learning, emotional, or behavioral problems that require ongoing treatment.

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