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Essays About Autism

What makes a good autism essay topics.

When it comes to writing an essay on autism, it's important to choose a topic that is not only interesting but also relevant and impactful. The topic you choose can make or break your essay, so it's crucial to select one that is both engaging and thought-provoking. Here are some recommendations on how to brainstorm and choose an essay topic, what to consider, and What Makes a Good essay topic.

When brainstorming for autism essay topics, it's important to consider the audience and the purpose of the essay. Think about what you want to achieve with your essay and who will be reading it. Consider the impact you want to make and the message you want to convey. It's also important to choose a topic that is manageable and can be effectively explored within the constraints of the essay.

A good autism essay topic should be relevant and timely. Consider current issues and debates surrounding autism and choose a topic that is both current and significant. It's also important to choose a topic that is unique and original. Avoid cliché topics and instead focus on something that has not been extensively explored or discussed. A good essay topic should also be specific and focused. Avoid broad and generic topics and instead narrow down your focus to a specific aspect or issue related to autism.

Best Autism Essay Topics

The impact of early intervention on children with autism
The role of sensory processing in autism
The link between autism and genetics
The portrayal of autism in popular media
The challenges of parenting a child with autism
The benefits of music therapy for individuals with autism
The use of technology in autism interventions
The importance of inclusive education for children with autism
The impact of autism on the family dynamics
The experiences of adults with autism in the workplace
The connection between autism and co-occurring conditions
The role of speech therapy in treating autism
The challenges of accessing autism services in rural communities
The intersection of race and autism diagnosis
The potential of animal-assisted therapy for individuals with autism
The link between autism and mental health
The experiences of girls and women with autism
The impact of autism on social relationships
The role of advocacy in the autism community
The potential of alternative therapies for individuals with autism

Autism essay topics Prompts

Imagine a world where autism acceptance is the norm. How would society be different?
Write a letter to a parent of a newly diagnosed child with autism, offering support and guidance.
Create a fictional story that explores the experiences of a teenager with autism navigating high school.
Imagine a future where a cure for autism is discovered. What are the potential implications and consequences?
Write a reflective essay on your own experiences with autism, whether as an individual on the spectrum or as a caregiver or advocate.

Choosing a topic for an autism essay can be a daunting task, but with careful consideration and creativity, you can choose a topic that is not only engaging but also impactful. Whether you're exploring the latest research on autism interventions or delving into the personal experiences of individuals with autism, there are endless possibilities for compelling and thought-provoking essay topics. So, take your time, brainstorm, and choose a topic that will captivate your audience and leave a lasting impression.

Leo Kanner's Theory of Autism: a Historical and Theoretical Overview

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The Definition and Characteristics of Autism Spectrum Disorder (asd)

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Apllication of Cognitive Theories When Working with Individuals with Autism Spectrum Disorder

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The Story of a Child with Autism in Naoki Higashida's Book

Gluten-free and casein-free diet for children who are diagnosed with autism spectrum disorders (asd), floortime model in autism spectrum disorder treatment, body awareness difficulties of individuals with autism, autism spectrum disorder and inseparability of social networking and technology use, review on the animal assisted therapy of autism spectrum disorder (asd), coming of age in "the curious incident of the dog in the night-time", social effects of christopher's perceived disability, the father's truth or lies in "the curious incident of the dog in the night-time", instructional strategies for students with disabilities, temple grandin – a woman who has not given up, the way temple grandin saw the world, temple grandin: a woman who used autism to her advantage in the agriculture industry, temple grandin – a woman with autism who has made a change, debate on vaccination and autism, perception of facts and truth in "the curious incident of the dog in the night-time", an overview of aspergers syndrome, swimming for children with autism, autism spectrum disorder and the role of vitamin d receptor polymorphism, the effectiveness of advancing employment of individuals with autism and intellectual disabilities.

Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication.

Trouble with social interaction, verbal and nonverbal communication, and presence of restricted interests and repetitive behavior.

Autism spectrum disorder has no single known cause. Given the complexity of the disorder, and the fact that symptoms and severity vary, there are probably many causes. Both genetics and environment may play a role.

Autism is about 4 times more likely in boys than girls. Autism affects children of all racial, ethnic, and socioeconomic groups. Autism can be reliably diagnosed by age 2, but children may be diagnosed at earlier ages. ASD affects about 1 in 68 children Visit disclaimer page in the United States.

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165 Autism Essay Topic Ideas & Examples

Struggle with writing a research paper topics on autism? We’ve got your back covered! Below, you will find a list of 147 topics about autism as well as autism research paper examples!

🏆 Best Research Autism Topics & Essay Examples

👍 good autism essay topics, 💡 psychology research autism topics to write about, ⭐ simple & easy autism essay titles, ❓ research questions about autism.

Autism Spectrum Disorder (ASD) Autism is a serious disorder that has the potential to disrupt the success of people living with it. This is to mean that the theory of causation regarding autism is not complete as yet.
Autism Spectrum Disorder in a Child At the moment, M.is more verbal with his parents and siblings and reacts adequately to them, especially in repeated day-to-day situations.
How Does Having a Child With Autism Affects Parents’ Lifestyle? The creation of a system of psychological, pedagogical and social support can reduce the risk of a complete family life dedication to a child with autism.
Autism. Child and Family Assessment The other common disorder associated with autism is that of mutism whereby it also lies under the category of speech disorder and in many cases it is difficult to be diagnosed and at the same […]
Autism: Characteristics, Prevalence and Interventions The symptoms of autism are noticeable in the early years of childhood. Occupational therapy is one of the non-educational interventions used to assist kids with autism.
“Let Me Hear Your Voice: A Family’s Triumph Over Autism” by Catherine Maurice The book was published in 1994, and it was a success as parents of autistic children were waiting for someone to prove that autism was not an incurable disorder.
Inclusion Curriculum for Children With Autism In the given paper, the issue of children autism, the developmental issues that autism triggers and the educational prospects for children with autism are going to be considered.
Bright Not Broken: Gifted Kids, ADHD, and Autism It is possible to state that the book provides rather a high-quality review of the issues about the identification, education, and upbringing of the 2e children.
One-To-One Programs: Supporting Autistic Children The purpose of conducting this essay will be to examine the educational intervention of one-to-one support programs during normal school times within a mainstream classroom and also to discuss the challenges faced by teachers and […]
Impact of Autism Disorder on Adolescents This essay discusses the impact of autism disorder on adolescents in the community and a nursing intervention that can be used to assist adolescents in becoming prominent society members.
Progression of Reading Ability in a Child Diagnosed With Autism The battery of assessments and interviews with parents on the participant’s socialization and early reading ability indicates the study applied the Psychometric and Social Contextual approaches.
Analysis of Behavior of Preschool Age Child With Autism The child’s behavior in the video differs from that of a mentally healthy child, and these differences lie in the child’s other emotional state and degree of interest in talking to people.
Autism and Disability Advocacy People with autism can contribute to the diversity of disability culture by expanding understanding of what disability is and how it can be accepted.
Autism Spectrum Disorder Diagnosis According to DSM-5, to fit the diagnostic criteria for ASD, a child must have evident deficits in three major areas of social communication as well as 2 out of the 4 restricted or repetitive behaviors.
Thinking in Pictures: Autism and Sensory Problems The chapter “The Squeeze Machine: Sensory Problems in Autism” in Grandin’s Thinking in Pictures presents a series of life perspectives of various individuals, including her own, regarding the sensory problems they experienced. They postulated that […]
Therapeutic Programs for Children With Autism in K-12 Institutions In the paper, the gaps in the research of effective treatments for children with ASD are explored, after which the efficacy of a multi-system aquatic therapy and standardized equine-assisted therapy program is argued.
Societal Issue Research Project: Autism Spectrum Disorder The first factor is the significant risk that the genetics of siblings who had ASD diagnosis will increase the chance of the disorder.
Child-Centered Play Therapy and Autism The purpose of the discussed research was to investigate the effects of CCPT on the sample of children with autism, establishing and describing the connection between CCPT and social and emotional growth.
Children With Autism Spectrum Disorder: The Training Program for Caregivers The latter means that many caregivers take care of children with ASD, hence the importance of equipping them with the necessary skills for effective and smooth parenting and coping with various difficulties.
Autism Spectrum Disorder’s Impact on Child’s Learning In regards to the public-school setting, standardized testing demands youngsters to grasp and react to spoken as well as written communication at an anticipated pace and level.
Laboratory Diagnosis of Autism Spectrum Disorders The purpose of my study is to discover which of these methods is more accurate, with the reason being the importance of early diagnosis of ASD, which leads to better treatment outcomes.
Autism and Related Cognitive Concepts It has been suggested that children with autism show a general deficit of cognitive skills in multilevel planning and in the regulation of behavior.
Bullying and Autism Spectrum Disorder In fact, bullying as a social phenomenon can be characterized as a social and interaction issue; therefore, it is possible to analyze the connection between autism and acts of bullying and inappropriate behavior.
Face Emotion Recognition in Autism Phenotype One critical aspect of social communication is the capability to apprehend the emotions and intentions of another person. In conclusion, Autism Spectrum Disorder makes the interpretation of facial expressions difficult.
Misrepresentation of Autism in the ‘Music’ Film While the film was not centered on the topic of autism as its message, the stereotype-heavy portrayal and a lack of research make it a harmful piece of media.
Autism Spectrum Disorder Prevalence and Impact in Society It has therefore been impossible to determine the level of increase in autism cases that is as a result of improved diagnostic measures and that which can be attributed to the real increase in autism […]
Autism Spectrum Disorder: Diagnosis, Impact, Treatment The main diagnostic element for ASD is the evidence of difficulties, either in the present or past, which are different across the age groups.
Autism and Vaccination Refusal Management Among Somalian Parents Somalian parents in their community in Minnesota refuse from their children being vaccinated, as they believe that vaccination causes autism.
Everyone Has the Power to Effect Positive Change Within the Autism Community This paper presents what is autism, how every one reacts to the problem, what is the difference between the rich and the poor in their response towards the problem.”Autism is one of five developmental disorders […]
Reducing Off-Task Behaviors Using a Token Economy System in Children With Autism Token economy is a strategy of positive reinforcement that can be provided to children in the form of tokens for completing the assigned tasks.
Autism Spectrum Disorder: Key Points The requirement to meet these needs is supported by the fact that the rate of students with ASD is high: according to the Australian Institute of Health and Welfare, more than 83 per cent of […]
“Theoretical Aspects of Autism” by Helen Ratajczak On the whole, it is possible to say that the standards set by Austin Hill cannot be always met, in part because the physiological aspects of this disease have not been fully investigated.
Dr. Temple Grandin’s Argument on Visual Thinking and Autism A more in-depth analysis of visual activities can reveal the all imagery can be mentally processed and modified by children so that images are rotated and analyzed to make the brain map expand.
Intellectual Disability: Autism In their adulthood, and because of the communication issues that most individuals with autism tend to have, they will naturally have difficulty in finding and keeping jobs.
Hyperbaric Oxygen Therapy for Children With Autism On the positive side, it fastens the production of different types of reactive oxygen used in the body. It is arguable that the size of the samples used in the study was small.
Analysis of Children Autism in “The Black Balloon” It is imperative to note that Charlie’s emotions are not regulated and as such, manifest in immature behaviors such as flapping of his hands.
Occupational Therapy for Children With Autism The main reason for the appearance of autism is the disturbance of the development of the patients brain which results in the appearance of various symptoms.
The Mitochondria and Autism – Results and Main Function The results are important in health because children with autism were more probable to have dysfunctions and abnormalities of the mitochondria such as over replication and deletion of mitochondrial DNA compared to those without the […]
Autism Etiology, Symptoms, Beliefs, and Management To date, debate on the cause or etiology of autism still remains divided, with extant literature demonstrating that “although many hypotheses have been proposed, a singular or specific combination of causes has yet to be […]
Quantitative Assessment of Neuromotor Function in Adolescents With High Functioning Autism: Critique The study authors did not give the benefits and/or risks associated with the study participation. The authors indicated that the ZNA was appropriate for collecting the data because it could measure the 11 parameters of […]
Critical Appraisal on the Impact of Autism Spectrum Disorders on the Family: A Qualitative Study of Mothers’ Perspectives The study researchers established the significance of the study by outlining the social and financial implications of taking care of children with ASD.
Autism: External Forces, Causes and Treatment The increasing prevalence of Autism in the United States and across the world is attracting great attention from the healthcare sector to design critical programs tailored to stem the disorder in terms of prevention, treatment, […]
The Importance of Services for Children With Autism The plea of the majority of Americans for the reverse of healthcare budget allocation is well because it is wrong to interfere with services offered to children with autism. With childcare initiative in place, the […]
Autism: General Information and Treatment She argues that the treatment of autism is through scientific proven medication that aids in controlling aggressive behaviors and that Trisperidone is the commonly used antipsychotic.
The Issue of Autism: Task-Group Project The role of B.N.in the meeting can be seen as a summarizer, providing a summary of the minutes of the previous meeting.
Concepts of Autism and Williams Syndrome The disorder manifests itself in the early years of a child’s life, with long-lasting effects that are not curable but controllable and easy to deal with on condition that, the concerned parties take the necessary […]
Autism Programs to Enhance Students’ Outcomes In addition to social and behavioral challenges, ASD typically hinders a learner’s ability to gain and process the necessary academic information.
Autism Program’s Impact Across Contexts In other words, a detailed overview of the issues that administrators face when designing the program and which the teachers have to deal with when addressing the needs of children with autism must be carried […]
Autism: Teaching Plan for Taking All the Features Into Account For the first child, caregiver training was done at child’s bedroom, and for the second child it was done at living room, and for the third child with severe mental retardation it was carried out […]
Education Considerations for Students With Autism Two articles under consideration consider the opposite views regarding the education of students with autism; on the basis of the information obtained from these articles, it can be stated that none of the perspectives is […]
Developmental Psychology: Autism and Vaccination Vaccination of infants is widely used today as the pattern of endemic diseases can be explained in terms of interplay of social, physical and biological factors in an area that is conducive to a continuous […]
Social Work Methods to Treat the Child Who Is Suffering From Autism This is a clear indicator that alcohol intake by the family is costing the members and it is an issue that needs to be looked into.
Autism and Immunization: Vaccines and the Changing Epidemiology The interest and attention invoked by this paper were largely due to the fact that it appeared to provide a biological means through which MMR vaccine resulted in autism.
The Autism-Vaccine Debate, Arguments, and Research Autism is defined by the Autism Society of America as ” a complex developmental disability that typically appears during the first 3 years of life and is the result of a neurological disorder that affects […]
Autism Spectrum Disorder and Interventions However, the negative side of it is that such an intervention is limited to those patients who are verbal and have limited vocabulary.
Autism: Symptoms, Forms, Diagnostic Instruments Autism is basically a developmental disorder of the human brain that its first symptoms are initially manifested in infancy and it follows a steady cause without relapse.
Autism Spectrum Disorder Features in Children One of the causes for the appearance of these issues is an inborn disability that might presuppose the need for specific methods to educate a child and guarantee a chance for integration with society.
Autism Occurrence by Measles Vaccine Status The organization of information in the text follows a logical format by introducing the background for the vaccine, incorporating the issue of ASD connection, and leading up to the primary research question.
Parental Report of Vaccine Receipt in Children With Autism Spectrum Disorder In the introduction, which is the first section, the study’s research problems and their significance to nursing are stated. The discussion section covers how the authors relate the findings to the research objective and the […]
Teenagers With Autism Disorder Autism is seen as a spectrum disorder since its severity and symptoms vary greatly among affected individuals – from mild and occasional to persistent and interfering with all aspects of life.
Impact of Autism Spectrum Disorders on Life However, between the ages of two and three, his lack of verbal activity and inability to “echo” simple sounds and syllables were found to be very concerning by the family.
Autism Should Not Be Viewed as a Disability A good example is that the treatment of autism as a mental disorder makes it possible for pharmaceutical companies and clinics to invent new health systems or procedures that will meet the needs of the […]
Autist Student’s Behavior and Remedial Plan In the process of reading, I would pay attention to the student’s concentration and ability to integrate what she was reading. She also took long in doing this and did not want to stop the […]
Autism Treatment, Its Methods and Results It was appropriate to focus on the use of the DSE intervention and examine if addressed most of the challenges facing many ASD patients.
Autism Spectrum Disorder: Programs Effectiveness The purpose of this PE, therefore, is to evaluate and analyze the efficiency of the programs implemented by the Day Support Services.
Students With Autism Spectrum Disorders The main goal of this paper is to present a review of relevant literature addressing the issue of helping college students with ASD prepare for workforce readiness and job placement.
Association Between Vaccination and Autism The study examined whether there is a link between the toxic effects of exposure to thimerosal-containing vaccines and the risk of developing ASD.
Olfaction and Autism Spectrum Disorder Relationship These findings reveal that the sniff test can reveal both the presence and severity of ASD in young children. The link between ASD and olfaction can be used in diagnosing young children with autism.
Abu Dhabi Autism Center The Abu Dhabi Autism Center has to operate within the laws and regulations of the Zayed Higher Organization for Humanitarian Care and Special Needs.
Applied Behavior Analysis Treatment for Autism It is the most commonly applied autism treatment remedy in the United States and several other countries in the world and the major method that schools and therapists embrace and use.
Inclusive Education: Child With Autism and Spina Bifida It is worth mentioning that Ted’s mother is willing to cooperate with teachers, and her participation can be of great assistance to the teacher.
Children With Autism’ Communication in Saudi Arabia Parents of children with autism in Saudi Arabia have complained that the government has neglected the needs of autistic children by failing to finance their education and research to detect the effectiveness of the digital […]
Autism Spectrum Disorders: Testing and Measurement It will begin with the rationale that explain why the issues are critical, followed by the reasons for unavailability of the solutions to the issues and the consequences of the issues.
Autism Spectrum Disorders and Educational Interventions From this point, this paper aims to discuss the definition of Autism Spectrum Disorders, examine the etiology and incidence of the disorder, focus on the prevalence of autism, and analyze the effectiveness of the DTT […]
Vaccines and Autism: Separating Facts From Fiction The advocacy groups say that thimerosal, a preservative used in vaccines, is toxic to the central nervous system and responsible for an alarming rise in rates of autism among children in the United States and […]
Lesson for Learners With Autism: Reflection Observation The essay identifies the instructional methods used by the teacher during the exercise. The teacher also guided the learners to solve the mathematical problems using different visual objects.
Autism Spectrum Disorder Concept Besides, Temple often explores her own experiences and attempts to understand the feelings of others that are unavailable to her by visualizing herself as other creatures people and animals.
Dubai Autism Center’ Quality Management TQM employs strategies and effective communication within the organization to incorporate the quality principles into the culture and activities of the organization to ensure that all the activities are geared towards satisfying the customers.
Video Modeling for Individuals With Autism The video model will be developed according to the needs of autistic children, with the focus on the role of visual and auditory stimuli in the teaching process.
The Effects of Vaccines on Autism From their study, the findings demonstrate that the presence of thimerosal is one of the causes of the disorder. It is imperative to state that they have used many studies that have indicated that there […]
Vaccination as a Cause Autism This paper borrows on the arguments of Monica Prasad and Washington and Haydn when they argue that the belief about vaccinations as a primary cause of autism stems from emotional, psychological, and behavioral barriers, as […]
Youth With Autism Disorder: Education and Employment This includes the communication patterns of the teenager, the extent of social relations and the unusual behavioral characteristics of the teenager in the environment.
Autism Children Education Inclusion Policy in Private Schools: Compulsory Enrollment Policy 2011 The following are the main areas will be addressed by the policy: Prohibited Private schools will be prohibited from ignoring the needs of children suffering from autism; they will be compelled by the act to […]
Autism: Pathogenesis and Intervention Similarly, a person with autism has to be trained on the process of communicating normally and forming a relationship with objects, events and people in their lives.
The Real Causes of Autism However, the main problem is that this association or correlation does not imply that autism is triggered by a vaccine. This is the main argument that can be put forward.
Applied Behavior Analysis and Autism The primary subject of this study is applied behavior analysis while the secondary subject is applied behavior analysis and its effects on autism in children.
Autism. Sensory Integration. Tactile Desensitization The poor development that is recorded at the early stages in life is likely to affect the development of different skills by the individuals even in the adult stages The signs that are associated with […]
Autism Effect on Children It is crucial to understand the behavior of children with autism in the school set up in order to understand how autism affects children and their social interactions. It is up to the teacher to […]
Autism and Its Effects on Social Interaction The article “Social Impairment in Children with Autism Spectrum Disorder” identifies the major challenges facing many people with autism. The authors wanted to examine the social problems and difficulties encountered by individuals with Autism Spectrum […]
Older Dads More Likely to Have Kids With Autism The author highlights autism as one of the main outcomes of late fatherhood following the release of the results of a study involving the counting of the mutations corresponding to a father’s age at the […]
Evidenced-Based Practice: Autism Management in Children Autism largely is connected to communication abilities of a child, a situation that later results into the child experiencing disability problems in effectively encoding and decoding communicative messages.
Miami Dance Project for Autistic Children For me, what the Miami dance project represents is in line with what is known as the concept of confidence building wherein through the development of certain talents children with autism will begin to have […]
Autism Spectrum Disorders and Family Impact One of the greatest fears of a parent with such a child is the fact that such a child would be taken care of until the advanced stages of their lives.
Program Models in Autism The DTT technique has been designed in such a way as to target the individual behavior of an autistic child using the available curriculum.
Autism Spectrum Disorder in Relation to Education Attending to students having ASD in the regular classrooms requires specialized teachers and supplementary staff in order to aid in the realization of the needs of the students having ASD.
Critical Analysis of Published Articles: Autism It was therefore the goal of the research to find out if the negative attitude of people towards autistic children can be altered to the benefit of the parents.
Autism in Saudi Arabia This support may come in the form of modification of the curriculum to cater for the special needs of the autistic children.
Analysis of Autism Disorder This disorder affects the brain of the child during growth so that it does not develop in the right way thus affecting the social and communication skills of the child. This is especially to the […]
Psychological Disorders and Their Treatment: An Overview of the Recent Progress and the Current Challenges in Treating Autism in Children In the given paper, the issue of psychological disorders is being addressed in reference to the ideas expressed in Chapter 11 “Psychological Disorders” in Carole Wade and Carol Tavris’s Invitation to Psychology.
Early Intervention for Young Adults With Autism This is due to unavailability of information on children development stages and the importance of early detection and intervention in the case of autism.
Different Behaviors in Children With Autism The purpose is to find out whether the co morbidity changes with the environment, and assess the influence that the environment has on the behavior of an autistic child.
Diagnosis and Treatment for Autism Disorder Children with autism are therefore able to reason and even interpret the feelings of other people but the challenge is to communicate the response to other people.
Autism: Qualitative Research Design Golafshani continues to argue that the use of the term “dependability” in qualitative studies is a close match to the idea of “reliability” in quantitative research.
Autism Spectrum Disorder However, the reality is that the number of children with autism and having high intelligence is insignificant. It is apparent that, in autism, a disorder is found in the structure of the brain.
Vaccines and Autism: A Critical Analysis of Thimerosal in Relation to Measles, Mumps, and Rubella The safety and efficacy of vaccines has been the subject of many studies in the medical field. The disorder was observed in one participant from each of the cohorts in the experiment.
How to Recognize and Teach Students With Autism If these groups of students have to be given directions that are more than three steps, the directions have to be written down due to their inability to remember sequences.
Autism and Visual Thought Suprisingly the quality of visual thinking according to Bogdashina is dependent on other factors like time and the state the autistic person is in.
Autism and Educational Process Owing to these adverse effects that can stem from autism and the shear prevalence of the condition in the country’s population, a lot of research effort has been dedicated to the early diagnosis and treatment […]
Do Vaccines Cause Autism? Thimerosal is alleged to increase the exposure of mercury in the vaccine to a substantiated high amount. In fact, the amount of antigens between children with autism and without is the same irrespective of the […]
Language Development Problems in Children: An Indicative Characteristic of Autism This is because it is a time when it is expected that a majority of the kids should be able to talk.
The Disease of Autism Origin The disorder is one of the new diagnoses of the autism. Other effects of the disorder are constipation and growth failures that may be a problem to the lives of the individual.
Autism Spectrum Disorder in Children and Its Impact on the Family Manning, Wainwright and Bennet argue that children with autism are faced with a big challenge because of the nature of the symptoms the disorder.
Autism’s Teaching Tips for Children and Adults The present description is concerned with the role of teacher in the better management of Autism in children. Further, assessment of the interactive and developmental skills is on of the important component in the teacher […]
How Christopher’s Autism Affect His Life In spite of the fact that the issue of autism is not clearly explained in the story, the condition of the narrator is referred to as high-functioning autism or Aspersers Syndrome on the cover of […]
What Are Autism Spectrum Disorders?
How Does Autism Affect the Person With It and Those Around Them?
What Are the Barriers of Learning for a Learner With Autism/Aspergers in Performing Arts?
Does Gluten Effect Children With Autism?
What Are the Causes of Autism?
How Does Autism Affect a Child’s Educational Performance?
What Can Autism Look Like and Things You Can Do to Spot It?
Can Children With Autism Develop a Theory of Mind?
Which Interventions Reduce Anxiety in Autistic People?
What Influence Has the Development of Autism Had on a Diagnosed Individual?
How Does Autism Affect the Development of a Child?
Are Huddles the Missing Piece of the Puzzle in Implementing Clinical Innovation for the Eating Disorder and Autism Comorbidity?
How Does Autism Start?
Can Mouse Imaging Studies Bring Order to Autism Connectivity Chaos?
How Does ‘Fake News’ Affect Autism Policy?
Are There Any Relationships Between Latent Toxoplasma Gondii Infection, Testosterone Elevation, and Risk of Autism Spectrum Disorder?
How Do People With Autism Experience the World?
Can Robotic Systems Promote Self-Disclosure in Adolescents With Autism Spectrum Disorder?
How Did the Media Perpetuate the Autism-Vaccine Scare?
Are There Cultural Differences in Parental Interest in Early Diagnosis and Genetic Risk Assessment for Autism Spectrum Disorder?
How Can the Therapist Help Autism Children?
Can Vaccinations Cause Autism?
Does Autism Spectrum Disorder Affect People All Around the World?
Is There a Correlation Between Epigenetics and Autism Spectrum Disorder?
How Does Autism Affect Regular Brain Functions as Well as Socialization Skills?
What Can Responses to Music in Autism Tell Us About the Nature of Musical Emotions?
Why Has the Incidence Rate of Autism Increased?
What Are the Most Effective Ways to Support/Provide Social Care For Autistic Adults?
Which Interventions Are Effective in the Development of Communication/Language Skills in Autism?
How Can Parents and Family Members Be Supported/Educated to Care For and Better Understand an Autistic Relative?
OCD Essay Titles
Socialization Essay Ideas
Psychotherapy Paper Topics
ADHD Essay Ideas
Down Syndrome Topics
Disability Essay Topics
Alzheimer’s Disease Research Ideas
Nursing Care Plan Paper Topics
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Chicago (N-B)

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Interventions for students with autism in inclusive settings: A best-evidence synthesis and meta-analysis

Affiliations.

1 Department of Special Education & Multiple Abilities.
2 Department of Special Education.
PMID: 30869925
DOI: 10.1037/bul0000190

Students with autism spectrum disorder (ASD) are increasingly educated alongside typically developing peers in regular education environments. These students have impairments that may hinder their success in inclusive school settings and require individualized supports to improve outcomes. The purpose of this meta-analysis and best-evidence synthesis is to examine the characteristics of interventions for students with ASD in inclusive settings, offer quantitative analysis of intervention effects, examine potential moderating variables that influence outcomes, analyze the social validity of these interventions, and provide recommendations for practice and future research. The 28 included studies met the What Works Clearinghouse standards for group design and single-case design research. Studies focused mostly on social communication skills, produced moderate to large effects, and were generally found to be socially valid. Function-based interventions, visual supports, self-monitoring strategies, and peer-mediated interventions resulted in mostly large effects, and teacher delivered interventions produced the largest overall effects. More high-quality studies for students with ASD in inclusive school settings are needed to advance evidence-based practice for this population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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v.11(1); 2019 Jan

Where is the Evidence? A Narrative Literature Review of the Treatment Modalities for Autism Spectrum Disorders

Srinivas medavarapu.

1 Neurology, The Icahn School of Medicine at Mount Sinai, New York, USA

Lakshmi Lavanya Marella

2 Family Medicine, Medstar Shah Medical Group, Fort Washington, USA

Aneela Sangem

3 Pediatrics, Bronx Care Hospital, New York, USA

4 Pediatrics, Developmental Neurology Associates, New York, USA

The most important thing about autism spectrum disorder (ASD) is that there is, in fact, no cure for this disorder; however, currently, there are many claims of pharmacological and dietary therapies and behavioral interventions that are said to improve outcome or even lead to “cure” or “recovery.” It continues to remain a challenging condition for children and their families. Research conducted on many of these treatment modalities is limited and, consequently, sufficient evidence does not exist to support their use. The primary aim of this paper was to search for the evidence of the efficacy of each treatment for autism till now. We reviewed different treatment modalities and randomized clinical trials on each treatment to look for the evidence. Although there are interventions that may be effective in alleviating some symptoms and improving skills that help autistic persons lead more productive lives, proven benefits were observed only with applied behavioral analysis (ABA) and some psychopharmacologic agents.

Introduction and background

Autism spectrum disorder (ASD) is a biologically based neurodevelopmental disorder characterized by impairments in two major domains: 1) deficits in social communication and social interaction and 2) restricted repetitive patterns of behavior, interests, and activities. ASD encompasses disorders previously known as autistic disorder (classic autism, sometimes called early infantile autism, childhood autism, or Kanner's autism), childhood disintegrative disorder, pervasive developmental disorder-not otherwise specified, and Asperger disorder (also known as Asperger syndrome).

According to the Centers for Disease Control and Prevention (CDC), ASD is a common disorder affecting 1 in 68 children, 1 in 42 boys, and is typically first recognized in early childhood [ 1 ]. Scientists are uncertain about the etiology of autism, but it is generally accepted that ASD is a multifactorial disorder, in which both genetics and the environment play a synergistic role.

ASD is a lifelong disorder that not only affects the patient with the condition but also their loved ones who must find ways to cope with the disorder. As a lifelong disorder with behavioral impairments, parents of children with autism tend to become frustrated and distressed by the lack of evidence-based treatment and medication available for treatment. This forces parents to become desperate for any intervention that will improve their child’s condition. Families of autistic children commonly turn to unproven alternative therapies that claim to be effective. There has been much controversy regarding the choice of these treatments for ASDs.

The creators of many treatments, both new and established, make impressive claims that are not supported by any form of controlled research. Furthermore, there are many educational professionals, who work with autistic individuals, who are reluctant to inform patients and their families about these “pseudoscientific” practices. Consequently, this places a huge burden on the families of autistic children, who are desperate for some kind of miraculous intervention. The families, who most often are not educated in research conducted in the field of autistic treatments, are easily misled. As a result, these families spend valuable time and money on unproven therapies rather than focusing their resources on therapies backed by extensive research, which have been proven to help autistic children.

The most important thing to note about ASD is that there is, in fact, no cure for this disorder.

Materials and methods

The article and data collection for this study was done using research journals and databases such as PubMed, Google Scholar, BioMed Central, EBSCO, Scopus, Web of Science, and MEDLINE. The reviewed articles were published from 1986 to the present time (Figure (Figure1). 1 ). During the search process, the following key phrases were used: autism spectrum disorder treatments, evidence-based treatments for autism, clinical trials on treatment of autism, and randomized control trials. Approximately 1500 articles were published between 1986 and 2018. The inclusion criteria were as follows: scholarly articles, randomized clinical trials on different treatments, articles and data were in English language, and articles were not limited to a specific geographical location. Approximately 130 articles were selected and carefully examined based on the relevance of their content to the topic of our study. Some of the references of these articles were also used in our work based on their relevance to our topic. These articles included different types of clinical trials like randomized trials, double-blind trials, open-label pilot studies, and randomized placebo-controlled studies. The following journals were used: Journal of Autism Developmental Disorders, Journal of Pediatrics, The New England Journal of Medicine, Journal of Psychopharmacology, Journal of Child Neurology, and American Journal of Psychiatry.

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Various biological and non-biological therapies that have claimed to improve outcome but have no proven benefits were analyzed in this review (Figure (Figure2 2 ).

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Categories of various treatment modalities with proven and unproven benefits.

Biological therapies with no proven benefits

Chelation is the process of eliminating harmful minerals, such as mercury, from the body. This type of therapy works with agents such as 2, 3 dimercaptosuccinic acid (DMSA) or 2, 3 dimercaptopropane-1-sulfonate (DMPS), which are administered to the individual. These agents bind to heavy metals and facilitate elimination.

Chelation therapy has become a popular intervention as a potential treatment for ASD. There have been suggestions of an association of autistic symptoms with environmental events and exposures. An example of such an association is with thiomerosal, an ethylmercury derivative, which is used as a preservative. Numerous studies done have concluded that there is no relationship between thiomerosal-containing vaccines and ASD [ 2 ].

Intravenous Immunoglobulins

Intravenous immunoglobulins (IVIG) consist of pooled antibodies separated from the plasma of multiple donors. The theory behind the use of IVIG is that there is a relationship between the development of the fetal brain and the prenatal immune response. A clinical trial concluded that the use of IVIG to treat children with autism should be undertaken with great caution and only under formal research protocols [ 3 ]. The study included 10 children - five had no detectable change in behavior, four had mild improvement in hyperactivity and attention span, but parents of the children felt that this change was insufficient to warrant continuation of the therapy. There was a significant improvement in only one child who reverted to his autistic state in time. Another clinical trial that evaluated the use of IVIG as an autism treatment was disappointing [ 4 ]. In 2006, the American Academy of Allergy, Asthma and Immunology examined the evidence and concluded that the treatment was “unlikely to be beneficial” for autism.

Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) is the medical use of oxygen at a level that is higher than atmospheric pressure. HBOT has been evaluated in some disorders of the central nervous system because of a related effect of increasing blood flow and or oxygen to the brain and decreasing inflammation. Since there have been hypotheses regarding brain and gut inflammation, brain hypoperfusion, and aberrant oxidative stress in ASD, there is increasing interest in using it [ 5 ]. An open clinical trial with 18 children with autism reported subjective improvements in several domains of autism [ 5 ]. Definite conclusions could not be made since it was an open-label study; it should, therefore, be interpreted with caution. A multicenter randomized, double-blind controlled trial was conducted to assess the efficacy of HBOT in children with autism [ 6 ]. The study concluded that the treatment group had significant improvements in overall functioning, social interaction, eye contact, receptive language, and sensory/cognitive awareness [ 6 ]. The study, however, did not measure the long-term outcomes of HBOT in children with autism; additional studies are needed for this. Another randomized, double-blind placebo-controlled trial concluded that HBOT does not result in clinically significant improvement of the symptoms of ASD [ 7 ].

Gastrointestinal Therapy

Diet – gluten free / casein free diet (GF/CF): It has been suggested that peptides from gluten and casein may play a role in the origins of autism; hence the elimination of these peptides may improve behavior in children with ASD. The GF/CF diet is a commonly used treatment for autism. The rationale for this is based on the assumption that children with ASD have gastrointestinal problems including a “leaky gut.” The peptide fragments caused by the breakdown of casein and gluten are casomorphins and gliadinomorphins, respectively. It is believed that these by-products act centrally as endogenous opioids. The Cochrane Collaboration did a review of GF/CF diets for ASD. However, only one trial fit the inclusion criteria and was included. It was therefore concluded that there was not sufficient evidence to advise the GF/CF diet in persons with ASDs. A double-blind trial conducted using 15 children with autism did not identify statistically significant findings [ 8 ]. However, some parents reported subjective differences.

Vitamin B6 / magnesium: Studies investigating the effects of vitamin B6 in improving the behavior of children with ASD have been reported for the last few years. The Cochrane Collaboration completed a study investigating the efficacy of combined vitamin B6-magnesium treatment in persons with ASDs [ 9 ]. They looked at three randomized, double-blinded placebo-controlled clinical trials completed between 1993 and 2002. The first trial using low dose vitamin B6 provided insufficient data to conduct an analysis. The second trial using high dose vitamin B6 did not demonstrate any difference in improving symptoms such as communication, social interaction, impulsivity, compulsivity or hyperactivity in the treatment and placebo group [ 9 ]. Another study reported improvement in IQ and social quotient in children treated with B6 and magnesium [ 9 ]. All three studies suffered from methodological deficits and small sample size. There is therefore not sufficient evidence to demonstrate treatment efficacy.

Vitamin C: The use of vitamin C in the treatment of ASD has not been a popular treatment. A pilot study done to determine the effect of a moderate dose multivitamin/mineral supplement for children with autistic spectrum disorder concluded that there were low levels of vitamin C in children with autism and that high-dose supplementation led to clinical improvements [ 10 ]. The study, however, had many limitations.

Omega-3 fatty acids: There is increasing evidence that a lack or imbalance of polyunsaturated fatty acids such as omega-3 fatty acids may contribute to neurodevelopmental problems. Three studies found that omega-3 fatty acids were low in children with autism [ 11 ]. Numerous studies have been conducted to determine the safety and efficacy of omega-3 fatty acids for ASDs. Six studies that were done satisfied all inclusion criteria. Three other studies reported improvements in language and learning skills, clinical observations of anxiety, a clinician-administered symptom scale, and parental observations of general behavior and health [ 11 ]. An open-label study done concluded that there were no significant improvements observed in using omega-3 fatty acid supplementation in young adults with severe autism [ 12 ]. Because five studies were significantly limited by the lack of a control group and the presence of only one small randomized control trial, there is presently insufficient scientific evidence to determine if omega-3 fatty acids are effective in the treatment of ASDs.

Probiotics and antifungals: Overgrowth of the fungi Candida in the intestine was hypothesized to be a cause of symptoms of autism due to an underlying immune alteration, antibiotic use, and the use of processed sugars, which increase the growth of yeasts. The use of antifungals as treatment was based on a report of presumed candidal overgrowth in two boys who had autistic behavior, regression of milestones, and intermittent ataxia. A possible explanation for this was abnormal absorption because of the effect of yeast on the intestinal membrane and toxic effects of the yeast metabolites. No further cases or studies are available. Probiotic agents such as lactobacillus and acidophilus have been used as treatments for autism based on the hypothesis that there is an imbalance in intestinal microbes in individuals with ASD. There is insufficient information about the efficacy to make recommendations for their use. No clinical trials to date have examined these treatments for ASD.

Dimethylglycine (DMG): DMG is a derivative of the amino acid glycine. The use of DMG as treatment was based on the hypotheses that it was thought to reduce the lactic acid build up during stress, reduce seizure activity, and enhance oxygen use during times of hypoxia [ 13 ]. Two double-blinded placebo-controlled studies did not demonstrate differences between DMG and the placebos [ 13 ]. There is insufficient information about the efficacy and safety to make recommendations about its use in children with ASD.

Secretin: Secretin, a gastrointestinal (GI) hormone, has been extensively studied as a pharmacotherapeutic agent in the treatment of autism. A two-part clinical trial using 56 patients reported significant improvements in language function, social interaction, and GI symptoms. Some of these patients were later involved in a double-blind trial [ 14 ]. The study concluded that although there were transient changes in speech and behavior, it produced few meaningful changes when compared to the placebo group [ 14 ]. Various double-blind placebo-controlled trials have been done that concluded that the substance was no more useful than a placebo [ 15 ].

Intranasal Oxytocin Therapy

In the last few years there have been many clinical trials on intranasal oxytocin. Few completed trials showed modest improvement in social function in ASD patients, but overall these trials showed inconclusive results. A double-blind, placebo-controlled trial in Australian University showed no benefit following oxytocin treatment. In this trial, 50 autistic male participants aged between 12 and 18 years were randomized to receive oxytocin or placebos. The primary outcomes were social responsiveness by caregivers and clinician-ratings. This trial showed no benefit and no side effects of oxytocin over placebos [ 16 ].

Non-biological therapies with no proven benefits

Auditory Integration Training (AIT)

The prevalence of sensory processing abnormalities in autism is relatively high. Language disorders in autism are often complicated by auditory problems such as hyperacusis. AIT involves listening to filtered, modulated music that presents sounds of varying volumes and pitches. It is typically administered in two daily half-hour sessions for approximately 10 days. The use of AIT in ASD is based on the theory that the continuous exposure to altered sound via headphones can functionally modify central auditory processing thus impacting language and behavior. Six randomized control trials were done, which were relevant [ 17 - 18 ]. Three of these studies reported improvement in overall autistic behavior [ 17 ]. Three did not show any benefit [ 18 ]. Scientific research has cast doubts on claims made for this as treatment of autism. The American Academy of Pediatrics has suggested that currently available information does not support the claims that AIT is an efficacious treatment and that their use does not appear warranted, except within research protocols.

Sensory Integration Therapy (SIT)

Unusual sensory responses are said to be common in children with ASD. Sensory integration therapy is intended to focus directly on the neurological processing of sensory information as a foundation for learning of higher-level skills. The goal is not to teach specific skills or behaviors but to allow the child to interact with the environment more adaptively by correcting fundamental sensory-motor dysfunctions underlying the disorder. The treatment involves engaging the child in full body movements that are designed to provide tactile, proprioceptive, gravitational, auditory, visual, and vestibular stimulation. The treatment is typically provided by occupational therapists. Two single case studies comparing SIT with no-treatment baseline among children with autism have shown beneficial effects [ 19 ]. The studies, however, cannot determine if the benefits were specifically produced by SIT. The efficacy of sensory integration therapy has not been demonstrated objectively in studies done during the last eight years.

Holding Therapy

Holding therapy has been proposed as a treatment for numerous childhood problems, including autism, since the 80s. The theory behind its use is that autism results from a lack of appropriate attachment of the child to mother. This defective bonding causes the child to withdraw, resulting in social and communicative deficits; therefore, if the mother provides the necessary physical contact required, the previously defective bond can be reestablished. The procedure is based on psychoanalytical theories of autism. No researchers have examined its efficacy.

Facilitated Communication

Facilitated communication is a technique where a trained facilitator physically guides the hand of a nonverbal child using an output device such as a keyboard, typewriter or similar device to spell. The use of facilitated communication in the treatment of ASD is based on the theory that persons with autism are nonverbal and that this technique allows individuals to overcome this condition and communicate appropriately. The procedure was initially heralded as a breakthrough in permitting communication between a parent and a previously uncommunicative child, and it, therefore, inspired great hope among family members especially parents of people with autism. However controlled studies demonstrated that if the facilitator guides the individual, then it is the facilitator and not the child that is the source of the typed information [ 20 ]. It has been officially refuted as a treatment modality by the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, American Psychological Association, and American Academy of Speech and Hearing.

Horseback Riding Therapy

The use of therapeutic horseback riding (hippotherapy) for children with ASD is based on the hypotheses that riding stimulates multiple domains of functioning such as social, cognitive, and gross motor [ 21 ]. In a nonrandomized study conducted, children with autism demonstrated improvements in distractibility, attention, and social motivation compared with controls [ 21 ]. The study had many limitations; therefore, further studies are necessary before this therapy can be recommended. It is important to note that horseback riding is associated with a risk of injury, so supervision is required at all times.

Dolphin-assisted Therapy (DAT)

Dolphin-assisted therapy has become an increasingly popular approach for intervention in children with disabilities including ASD. Dolphin-human interaction has been studied since the 1960s, and it has since been suggested that dolphins could help humans learn to communicate better with one another. The process involves swimming and interacting with dolphins typically in captivity [ 22 ]. Two peer-reviewed DAT studies that included children with autism were also methodologically flawed and plagued by several threats to both internal and construct validity. Two reviews of DAT concluded that there is no credible scientific evidence for the effectiveness of this intervention [ 22 ]. Science Daily published an article in December 2007 stating “Dolphin 'Therapy' A Dangerous Fad, Researchers Warn”.

Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation is an energy-based therapy that works through electromagnetic induction to stimulate nerve cells in the brain. The use of TMS in the treatment of ASDs is based on the hypothesis that autism is related to a disturbance in cortical modularity [ 23 ]. A study conducted revealed that there was an association between reductions in repetitive-ritualistic behavior in treatment subjects [ 23 ]. The study, however, had many limitations. Further studies are needed to determine the efficacy of TMS in children with autism.

Music Therapy

People with autism have impairments in social interaction and communication. The theory behind using music therapy is that certain processes that occur in musical improvisation may help people with ASD to develop their capacity for social interaction and communicative skills. Music therapy is usually provided as individual therapy for people with ASDs. A meta-analysis conducted (Cochrane Collaboration) of three small studies concluded that music therapy might help to improve the communicative skills of children with ASD. However, only the short-term effects were examined and therefore it is still unknown how enduring the effects are on verbal and non-verbal communicative skills. The effects on behavioral problems were not significant. Another randomized controlled study concluded that there was supporting evidence in music therapy promoting social, emotional, and motivational developments in children with autism [ 24 ]. However a small sample size was used in this study and the test power was low. Both studies should, therefore, be interpreted with caution.

Biological therapies with proven benefits

Psychopharmacologic Agent s

No single medication has been proven to “treat” autism; rather there are medications that alleviate the signs and symptoms associated with autism. Psychopharmacologic agents are a useful adjunct to environmental and behavioral interventions in children with ASD. A trial of medications may be considered if symptoms cause significant impairment in functioning but only after treating any medical causes, initiating educational and behavioral interventions, and modifying any environmental factors. Pharmacological interventions may be considered for maladaptive behaviors such as self-injurious behavior, aggression, repetitive behaviors, mood lability, sleep disturbance, anxiety, hyperactivity, irritability, inattention, destructive behavior or other disruptive behaviors. When considering the use of medications for target symptoms, the potential benefits and risks must be weighed on a case-by-case basis.

Risperidone (atypical antipsychotic): Risperidone is the most commonly used antipsychotic for the treatment of disruptive behaviors in children with ASD. It was the first drug to be approved by the US Food and Drug Administration (FDA) for the symptomatic treatment of irritability, deliberate self-injury, and aggressive behavior in children (> five years old) with ASD. The use of risperidone for treating symptoms of hyperactivity and disruptive behaviors in children is supported by randomized controlled trials [ 25 ]. Two open-label studies have suggested tolerance and long-term benefits in using the drug [ 26 ]. Weight gain was a significant side effect of the drug [ 25 ].

Aripiprazole (atypical antipsychotic): Aripiprazole has also been approved by the FDA for the treatment of irritability in autistic children aged 6-17 years. Two double-blinded randomized placebo-controlled trials were conducted using the drug for eight weeks [ 27 ]. The results demonstrated reductions in stereotypy, irritability, and hyperactivity in children aged 6-17 years with autism as measured by the Aberrant Behavior Checklist and Clinical Global Impressions-Severity scale [ 27 ]. Adverse effects included vomiting, somnolence, weight gain, and fatigue [ 27 ]. The drug was, however, generally safe and well tolerated [ 27 ].

Potential Psychopharmacologic Agent Therapies That Require More Research

Stimulants: Recent double-blind placebo-controlled studies indicate that stimulants such as methylphenidate improves symptoms of hyperactivity, impulsivity, and inattention in children with ASD [ 28 ]. However, the response rate is lower in children with ASD than it is in children with isolated attention deficit hyperactivity disorder and side effects are more frequent. The side effects of the drug include—but are not limited to—decreased appetite, tics, irritability, jitteriness, abdominal discomfort, increased blood pressure and heart rate. Studies of amphetamines in the treatment of attention symptoms in children with ASD are lacking.

Alpha-adrenergic agonists: Alpha-2 adrenergic agonists such as guanfacine and clonidine have been used to manage symptoms of hyperactivity, impulsivity, and inattention in children with ASD. Two small double-blind placebo-controlled studies using clonidine suggested that there were some improvements in reducing hyperactivity, irritability, stereotypy, outbursts, and impulsivity [ 29 ]. However, further studies are needed in a larger autistic population to determine the dose-response relationship [ 29 ]. Adverse effects included sedation and hypotension. Guanfacine was also shown to be moderately effective in reducing hyperactive symptoms.

Serotonin-specific reuptake inhibitors (SSRIs): Various SSRIs have been used in the treatment of target symptoms of ASD. A randomized placebo-controlled crossover study using fluoxetine in children with ASD showed beneficial results in reducing repetitive and other maladaptive behaviors [ 30 ]. A double-blind two-way crossover trial using the drug concluded that it was effective in the treatment of young children with autistic disorder [ 31 ]. A study done to review literature about the use of SSRIs in the management of functional impairments associated with autistic disorder concluded that benefits in using SSRIs to treat the functional impairments in autism had been seen [ 32 ]. However the response to therapy and adverse effects are individualized and at present evidence does not support selection of one SSRI over another for any impairment associated with autism [ 32 ].

Nonbiological therapies with proven benefits

Applied Behavioral Analysis (ABA)

Programs based on ABA, which is an intensive behavioral intervention, are currently one of the most popular interventions for autism. ABA is a method of teaching appropriate behaviors by breaking down the tasks into small discrete steps and training in a systematic and precise way. It is characterized by a discrete presentation of stimuli with responses followed by immediate feedback, intense reinforcement, data collection, and systematic trials of instruction. ABA is used to reduce any interfering maladaptive behavior, to increase and reinforce desirable adaptive behaviors, teach new skills, and generalize behaviors to new situations and environments. The theory behind using ABA is that children with autism have difficulty in learning through imitation and listening as their normal peers do. The highly structured format seems to meet the needs of those who have autism and who typically respond to directness and routine. The techniques can be used in different types of situations such as natural everyday situations (e.g., during mealtime at home or play), structured situations (e.g., formal instruction in a classroom setting), and in 1-to-1 as well as group instruction setting. Examples of different types of ABA include the following:

Discrete trial training (DTT): This involves a type of teaching that uses a trial which consists of five parts 1) cue, 2) prompt, 3) response, 4) consequence, 5) inter-trial interval to teach each step of a desired response or behavior. The lessons learned are broken down into their simplest parts with positive reinforcement being used to reward a correct response or behavior. Incorrect responses are ignored.

Early intensive behavioral intervention (EIBI): This type of intervention is usually used for children with autism who are younger than 3-5 years of age.

Verbal behavioral intervention (VBI): VBI focuses on teaching verbal skills.

Pivotal response training (PRT): PRT targets areas such as motivation, responsivity to multiple cues, self-management, and social initiations. Any positive changes in behavior should have widespread effects on other behaviors.

The original study of ABA was conducted in 1987 and concluded that children who received ABA achieved significant gains in IQ scores [ 33 ]. Since then there have been numerous studies investigating the efficacy of ABA in children with autistic disorders. More recent studies have supported the use of ABA in autistic children. In 2009 a study was conducted on the comprehensive synthesis of EIBI for young children with autism based on the UCLA Young Autism Project model. The findings suggested that EIBI is an effective treatment on average, for children with autism [ 34 ]. It should be noted, however, that there were limitations in the study, which proves the need for further research. A review article concluded that there is a significant amount of scientific evidence in support of ABA treatment modalities for children with autism and it is therefore recommended for use. Meta-analytical methods for 22 studies suggested that long-term comprehensive ABA leads to (positive) medium-to-large effects regarding intellectual functioning, language development, acquisition of daily living skills and social functioning in children with autism [ 35 ]. Language-related outcomes were the most superior compared to other outcomes.

The National Autism Center’s National Standards Report considers intensive behavioral intervention to be an “established” treatment. It has been endorsed by some state and federal agencies, including the US Surgeon General and the New York State Department of Health.

A research paper in 2012 reviewed one randomized controlled trial (RCT) and four controlled clinical trials (CCTs) and concluded that there is some evidence that EIBI is an effective therapy [ 36 ]. But the same authors updated their paper in 2018 with recent RCTs and CCTs, which show that there is only weak evidence supporting EIBI [ 37 ].

Nonbiological therapies with possible benefits

TEACCH (Treatment and Education of Autistic and Related Communication-handicapped Children)

This is a method of structured teaching that was established in the 1970s by Schopler and colleagues. It includes important elements such as the organization of the physical environment, predictable sequence of activities, routines with flexibility, structured work/activity systems, and visually structured activities [ 38 ]. It also provides clinical services such as social play and recreation groups, parent support groups and training, diagnostic evaluations, individual training for high functioning autistic groups, and supported employment ( autismspeaks.org ). The children work in a highly structured environment and are assessed to identify any new skills, and work then focuses on enhancing them. The programs are conducted in a classroom setting or may be home-based. Two studies that were done comparing TEACCH interventions with public education interventions found significant differences in scores on Psychoeducational Profile-Revised (PEP-R) on follow-up testing [ 39 ]. Another study in 2009 concluded that the effectiveness of TEACCH was confirmed showing positive outcomes in the natural settings and revealing its inclusive value [ 40 ].

Developmental Models

Developmental models focus on teaching skills that are essential to the development of a child, such as emotional relationships, social communication, and cognitive abilities. They are based on developmental theory and then organizing a hypothesis with regard to the fundamental nature of ASDs and then addressing the deficit with the relevant approach [ 38 ].

Denver model: The Denver model uses interpersonal relationships, play and activities to remediate the main deficits in imitation, emotion sharing, the theory of mind and social perception in order to foster symbolic thought and teach the power of communication [ 38 ].

Early Start Denver model (ESDM): ESDM is an integrative program that utilizes a combination of relationship-based and developmental approaches plus ABA programs. It includes parents as therapists.

Several studies by Rogers et al. have shown improvements in motor, play, cognitive, and social skills in children who have been treated according to the Denver model. A randomized control trial of 48 children with ASD evaluating the efficacy of the ESDM concluded that there were significant improvements in adaptive behavior, language and IQ, and autism diagnosis compared to children who received only community intervention [ 41 ]. It was also noted that the ESDM group maintained its rate of growth in adaptive behavior and were also more likely to experience a change to pervasive developmental disorder, not otherwise specified as compared to the community intervention group [ 41 ]. Follow-up studies will be required to investigate whether the ESDM group would sustain their gains over a long term.

Developmental individual difference (DIR): DIR was developed in the 1980s by Dr. Stanley Greenspan. It focuses on “floor time” play sessions and other strategies that enhance relationships and emotional and social interactions in order to facilitate cognitive and emotional development. It also addresses deficits in motor planning and sequencing, auditory processing and language, visual spacing processing, and sensory modulation [ 38 ]. The parent or therapist engages the child at a level the child currently enjoys, enters the child’s activities, and follows the child’s lead. Further studies are needed to investigate the efficacy of DIR in children with autism.

Relationship developmental intervention (RDI): RDI focuses on doing activities that elicit interactive behavior that encourages the child to engage in a social relationship. This, in turn, allows the child to discover the value of positive interpersonal activity and thus helps him or her to become more motivated in learning the skills to sustain this relationship [ 38 ]. The children work in a one-to-one setting with a parent who has been trained in the process. A study evaluating the RDI program concluded that there were reductions in autistic symptoms and increased mainstream placements in an uncontrolled study of 16 children who received the intervention [ 42 ].

Responsive Teaching (RT)

Responsive teaching is an early intervention curriculum implemented by parents in order to address the language, cognitive, and social-emotional needs of young children with developmental problems. A study in 2005 reported significant improvements in cognition, communication, and social functioning in children with pervasive developmental disorders and developmental disabilities [ 43 ]. Parents were taught to use RT strategies to encourage children to acquire and use pivotal developmental behaviors. The children’s improvements were related to their own pivotal behavior and their parent’s responsiveness.

Picture Exchange Communication System (PECS)

Picture exchange communication system is an augmentative communication system frequently used in children with autism. Its primary purpose is to teach children with autism to initiate communication by handing a picture to a communication partner in exchange for the desired item. The picture may be used instead of or in conjugation with speech. A randomized control trial of 84 participants showed the modest effectiveness of PECS teacher training/consultancy [ 44 ]. The use of symbols in the classroom and the rates of the children’s initiations increased [ 44 ]. There was no evidence of improvement in other areas of communication and the effects were not maintained once active intervention stopped. Another study investigated the effects of PECS teaching to phase 3 on the communicative interactions between children with autism and their teachers. There were significant increases in communicative initiations and dyadic interactions between the children and teachers in the PECS group as compared to the control group [ 45 ].

Pivotal Response Training (PRT)

Pivotal response training is a behavioral intervention model based on the principles of ABA. The intervention focuses on the “pivotal” behaviors such as motivation and initiation of communication with others that in turn affects a wide range of other behaviors. The goal is to produce positive changes in the “pivotal” behaviors, which in turn leads to an improvement in social skills, play skills, and communication skills and allows the child to monitor his own behavior. PRT is also used to decrease self-stimulatory and disruptive behavior. It is usually provided by specially trained staff.

A study on the efficacy of PRT found that it was effective in producing positive changes in the social behavior of children with autism. Initiations increased with all peer trainers [ 42 ]. Due to its small sample size, the study should be interpreted with caution.

Caregiver-mediated Intervention

In this method caregivers actively coached the children everyday activities like watering plants, grooming, and helping with laundry. The intervention followed the JASPER (Joint attention symbolic play engagement and regulation) treatment [ 46 ]. A multisite, randomized, comparative study based on this method was conducted in 2014 on a significant number of low-resourced children who have ASD. In this study, 112 families were randomly assigned for intervention and the children were assessed for pre- and post-treatment social communication skills and followed up to three months [ 46 ]. The results showed significant improvement in outcomes of joint engagement and joint attention, symbolic play. The limitation for this type of intervention is that without active support to caregivers there is a difficulty to continue the interventions [ 46 ].

Parent-mediated Communication

In this method, parents are trained by the therapist with the aim to first increase parental sensitivity and responsiveness to child communication and reduce mistimed parental responses. A randomized control trial using the preschool autism communication trial (PACT), published in the Lancet, 2010, tests this method. This study recruited 152 children, of whom 77 were assigned the PACT method and 75 were assigned the usual methods of treatments. Autism symptoms improved in both groups and only marginally more in the PACT intervention group; so they concluded that they do not recommend this method to treat autism [ 47 ].

After six years, in 2016, they repeated the study again using the PACT method, and they observed a significant reduction in long-term outcomes and a significant reduction in symptom severity scores (effect size 0.55; 95% CI 0.14, p=0.004) [ 48 ]. This is the first study showing convincing benefits for autism patients, and this intervention mediated by parents was relatively inexpensive [ 48 ].

In 2015, two types of parent-mediated communication methods were tested in an RCT [ 49 ]: 1) a naturalistic, developmental, behavioral intervention (joint attention, symbolic play, engagement, and regulation-JASPER); 2) a parent-only psychoeducational intervention (PEI). In this RCT, 86 toddlers (range 22-36 months) with ASD participated, and results showed that the JASPER method had a significant effect on joint engagement comparatively over the PEI method [ 49 ].

Social ABCs by parents or caregivers [ 50 ]: This method consisting of a 12-week parent-mediated intervention was tested in 2017 in a randomized control trial on 63 autistic children in Canada. The results showed that using this method improved children's vocal responsiveness, children’s initiation to their caregivers, and social communication. The treatment group experienced a favorable response in these features: (1) child functional vocal responsiveness to parent prompts (R2 = 0.43, P < .001), (2) child vocal initiations (R2 = 0.28, P < .001), (3) parent smiling (R2 = 0.09, P = .017), and (4) fidelity of implementation (R2 = 0.71, P < .001) [ 50 ]. But this method showed improvement in only two skills (vocal responsiveness and parental positive effect), and hence this method needs more research.

Conclusions

Autism spectrum disorder is a pervasive developmental disorder with a multifactorial etiology affecting 1/110 children worldwide. It continues to remain a challenging condition for children and their families; however, significant advances have been made regarding diagnosis and management. It is important to realize that the etiology of autism is unknown and at present, there is no cure, although there are interventions that may be effective in alleviating some symptoms and improving skills that may help autistic persons lead more productive lives. Because of the substantial impairments in autistic children, family members desperately turn to complementary and alternative interventions that may or may not have been proven to work. It is extremely important as health care professionals to be educated about the complementary, alternative, and evidence-based interventions available, so that the families of autistic children can obtain the best and effective treatment for their children.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

Neurodiversity in higher education: a narrative synthesis

Published: 07 June 2020
Volume 80 , pages 757–778, ( 2020 )

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Lynn Clouder ORCID: orcid.org/0000-0002-3923-2920 1 ,
Mehmet Karakus ORCID: orcid.org/0000-0002-3628-9809 5 ,
Alessia Cinotti ORCID: orcid.org/0000-0003-3807-9220 2 ,
María Virginia Ferreyra ORCID: orcid.org/0000-0002-3998-1382 3 ,
Genoveva Amador Fierros ORCID: orcid.org/0000-0001-8905-2269 4 &
Patricia Rojo ORCID: orcid.org/0000-0002-8712-5417 3

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Neurodiversity is an umbrella term, including dyspraxia, dyslexia, attention deficit hyperactivity disorder, dyscalculia, autistic spectrum and Tourette syndrome. The increasing number of students with learning difficulties associated with neurodiversity entering higher education (HE) poses a shared and growing challenge internationally for teachers and institutional leaders. This narrative synthesis draws together a corpus of international literature on how neurodiverse students experience higher education and the ways in which higher education institutions respond to the cluster of neurodiverse conditions. A systematic review was carried out to search, retrieve, appraise and synthesize the available evidence to provide an original contribution to the literature and significant insights of worth to higher education internationally. An inclusive approach to data extraction was used to ensure that all the relevant studies were included. All stages of the review process, including the initial search, screening, sample selection and analysis, are described. Three main themes and 11 subthemes were identified. Although the majority of publications focus on either dyslexia, autistic spectrum disorder, or ADHD, some common themes are evident in student experience across learning difficulties associated with neurodiversity. Although support services and technologies are available to meet students’ specific needs, there is an apparent dislocation between the two. Fear of stigmatization and labelling worsens the divide between what is needed and what is available to ensure neurodiverse students’ success in higher education, where good intentions are evidently not enough.

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Common acronyms:

DCDDevelopmental coordination disorder

AD(H)DAttention deficit (hyperactivity) disorder

ASDAutism spectrum disorder

ASAsperger’s syndrome

SpLDsSpecific learning difficulties

LDLearning disabilities

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Writing interventions refer to effective and evidence-based instructional practices used to support individuals in developing varied elements of writing including but not limited to letter formation, handwriting, length of writing, sentence structure, and quality of writing. Writing interventions often target specific genres of writing ...
Effectiveness of interventions for children and adolescents with autism
Effectiveness of interventions for children and adolescents with autism spectrum disorder in high-income vs. lower middle-income countries: An overview of systematic reviews and research papers from LMIC ... included studies with various research designs. To integrate the findings, 22 (63%) provided only a qualitative synthesis, 5 (14%) only a ...
Behind the Scenes of Parents Nurturing a Child with Autism: A
Our study contributes to an understanding of how parents perceive challenges, making it easier to take necessary action to meet their needs and ease their burden of stress. A concerted effort is needed to coordinate services across all disciplines to address these challenges. Keywords: autism, parents, challenges.
How to Write a Synthesis Essay, WIth Examples
Structuring your synthesis essay by topic works best for more complicated ideas with different aspects that should be explored individually. Example outline: I. Introduction A. Thesis statement. II. Topic 1 A. Source A discussing Topic 1 1. A point or piece of evidence/data from Source A about Topic 1 2.
Informative Synthesis Paper autism spectrum disorder .docx
2 Autism Spectrum Disorder Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication. Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. . There is often nothing about how people ...
Assuming ability of youth with autism: Synthesis of methods capturing
A recent qualitative meta-synthesis on the first-person perspectives of individuals with ASD identified 33 research articles in the past 34 years (1980-2014) that have included the first-person lived experience of either children, adolescents, or adults (DePape & Lindsay, 2016).Although the objective of the synthesis was focused on the themes and narratives documented in the current ...
A Research Synthesis of Social Story Interventions for Children With
This article offers a synthesis of the available research regarding Social Stories and their effectiveness for educating children With autism spectrum disorders. In addition, future directions for research and implications for educators are provided. ... Mindblindness: An essay on autism and theory of mind. Cam-bridge, MA: MIT Press . Google ...
Exploring the Lived Experiences of Autistic Women: A Thematic Synthesis
Autism spectrum condition, henceforth referred to as "autism", is a neurodevelopmental condition characterised by differences in social communication and interaction, with restricted, repetitive behaviours (American Psychiatric Association [APA], 2013).The field of autism research has grown in both quantity and quality since Kanner's seminal paper first introduced the stories of 11 ...
Journal of Research in Special Educational Needs
A framework synthesis approach was taken, using the biopsychosocial ecological model (Kranzler et al., 2020) (School Psychology, 35, 2020 and 419) to map the experiences of individuals on the autistic spectrum, their families and professionals. ... Further support is provided for the applicability of ecosystemic models to the study of autism ...
Where is the Evidence? A Narrative Literature Review of the Treatment
Autism spectrum disorder (ASD) is a biologically based neurodevelopmental disorder characterized by impairments in two major domains: 1) deficits in social communication and social interaction and 2) restricted repetitive patterns of behavior, interests, and activities. ... In 2009 a study was conducted on the comprehensive synthesis of EIBI ...
The experience of seeking, receiving, and reflecting upon a diagnosis
Prevalence statistics for autism diagnosis vary between countries, some of this variation is explained by age at diagnosis and diagnostic methods (Parner et al., 2011). Given the differences in autism diagnosis between countries, this meta-synthesis exclusively investigates autistic individuals' experiences of the diagnostic process in the UK.
'A certain magic'
Autistic people often report negative social communication experiences which impact on areas of life, such as friendships (Billstedt et al., 2011; Seltzer et al., 2004), romantic relationships (Yew et al., 2021) and employment (Smith et al., 2014; Strickland et al., 2013).). 'Deficits' in social communication remain a defining feature within autism diagnostic criteria (American Psychiatric ...
Neurodiversity in higher education: a narrative synthesis
This narrative synthesis focuses specifically on intellectual impairment but adopts an alternative, nuanced term of 'neurodiversity,' an umbrella term, originally coined in relation to autism, for several conditions traditionally pathologized and associated with a deficit, including dyspraxia, dyslexia, attention deficit hyperactivity ...