Autism: Intervention & Inclusivity

April 3, 2017

For every school in the world, chances are high that at least one attending child has been (or could be) diagnosed with Autism Spectrum Disorder (ASD). Many regular schools struggle with the challenge to include those children into their daily routines, while others have special personnel, training and facilities to accommodate them. If autism isn’t properly diagnosed or teachers aren’t properly trained, autistic children might be seen as merely lazy, inattentive, clumsy or stupid, resulting in frustration and insufficient encouragement of their interests and abilities.

Naturally, prerequisites such as this are dependent on the country, environment and available funds–many countries have organizations focused on autism such as the Autism Society of America or the British National Autistic Society, who are good contact points for parents, while others lack the necessary infrastructure and governmental support. Therefore, it is difficult to give umbrella advice regarding the education and integration of autistic children, as there is enormous diversity across the spectrum, from children able to attend regular schools without too many problems to those benefiting more from residential schools, special schools or home education. These differences continue into adult life: lots of people on the autism spectrum are able to go to college and find employment on their own, while others may need to live with their families or in assisted living, work in sheltered workshops or not at all.

Intervention Approaches

While the exact causes of autism are still unclear, there are a lot of intervention approaches that have been empirically validated and show verifiable results, often resulting in dramatic gains in skills and skill retention, sometimes even bringing children to a point where they no longer fulfil the criteria for an ASD diagnosis and could be considered non-autistic. The main challenge is often the limited access to interventionists and therapists, a lacking infrastructure and the decision for one of the available approaches, which can prove quite difficult.

Different experts may recommend different (and often conflicting) interventions: while psychiatrists tend to prescribe medication such as risperidone, psychologists may prefer therapy while behaviour therapists suggest approaches such as ABA. There are different models, and not all of them will be a perfect fit for any given child: it is imperative to first evaluate the person at hand, their specific localization on the autism spectrum, their characteristics, peculiarities, needs and interests, before the decision for one or more intervention approaches is made. It is also important to provide some sense of structure and not make the child suffer in a tug-of-war between specialists, teachers and parents about different approaches.

Applied Behaviour Analysis & Secondary Measures

One of the most widely employed therapeutic tools is Applied Behaviour Analysis (ABA). It deals directly with the behavioural symptoms of autism by first assessing and subsequently trying to reduce them through operant conditioning and the positive reinforcement of desirable behaviour, normally in conjunction with speech and occupational therapists. Other approaches such as TEACCH are geared more toward structuring the day-to-day life and the environments of autistic people and toward improving their quality of life. TEACCH (Treatment and Education of Autistic and Related Communication Handicapped Children) uses structured teaching together with visualization, bringing to the foreground the high competency in the processing of visual information that many autistic people possess; it is a flexible, holistic amalgamation of different techniques and best-practice methods that take into account not only specific behaviours, but a broader context.

It is beyond the scope of this text to explore ABA, TEACCH or any of the other intervention approaches (for example SPELL, CBT or SCERTS) in depth: it also wouldn’t be very useful, as not all approaches are available everywhere or compatible with every child. Furthermore, since it is in many cases impractical (for a variety of reasons, often including financial ones) to leave children in the care of specialists for most of the day or week, another crucial aspect is parenting instruction. There is strong evidence to suggest a link between parental behaviour and stress on one side and behavioural problems of the children on the other–this actually goes both ways in that parents of autistic children tend to experience significantly more stress (and marriages tend to break apart more often) than parents of neurotypical children. Parents should be involved as advocates and as participating partners in the education of their children: there is a lot that can be done by interventionists, therapists, teachers, schools, support groups and larger organizations, but the parents’ active participation is indispensable.

There is also a host of secondary measures that can be taken to improve the life of autistic children, such as music, massage, riding or dolphin therapy, as well as other, more controversial intervention approaches, such as attachment therapy, facilitated communication (through tablets or computers), hyperbaric oxygen therapy or daily life therapy.

Skills Development

What goes for the early years and school education is just as valid for later adult life: every person with ASD is different and requires a tailor-made approach that factors in their specific strengths, interests and situation.

As two of the main symptoms of autism are narrow interests and repetition, it is in many cases possible to encourage their aptitude in a specific field, and there are agencies that specialize in finding work for people with ASD on the primary job market or exclusively hire them as employees, often in the IT sector. There is the common generalization that people on the autism spectrum are predisposed toward “systemizing” rather than “empathizing”, which supposedly makes them more suitable for “technical” jobs (IT, engineering, mathematics etc.) than those interacting with or researching other humans. This might certainly be true for many, but it is important not to underestimate the diversity of people with ASD–there are autistic people studying and teaching literature, doing a PHD in music or pursuing a multitude of other interests.

There are many organizations working in the field that offer assistance and information online and in person, and the best recommendation for parents, friends, family members and caretakers can only be to get in touch with them, to consult specialists, read up on ASD and pay attention to the specific child. Autism is a condition that can cause many difficulties in growing up and everyday life, but there are a lot of working intervention strategies that have proven to lead to huge improvements, and people on the autism spectrum can be, with a little effort, included and integrated into their community and society with very satisfying results.



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About the Author
Dennis Mombauer

Dennis has close to a decade of experience working in research, and management and administration in the private sector as well as two years in coordination in the development sector. His research focuses on ecosystem-based adaptation, sustainable development, climate migration, and other topics related to climate change. He has published articles about these topics in numerous places, for example Earth Island Journal, Mongabay, The Environmental Blog, Daily FT, and Colombo Telegraph. He holds degrees in Education, English Studies, and Philosophy from the University of Cologne, Germany, and has additional qualifications in GIS mapping, video editing, translation, and publishing. ‍