Current Strategies for Coping with Autism

Current strategies for coping with autism

Written byColinBrennan, NetDoctor journalist

People with autism have several changes in their brains leading to three main areas of profound impairment. This means they have difficulty communicating, find it hard to develop relationships and have limited imagination particularly when it comes to looking at ideas from other people's point of view. This can lead to a strangely literal mind set. For example, a young man with autism was asked: 'Can I see your ticket?' by an inspector on a train. He replied: 'No, it's in my pocket.'
Although autism has always been thought of as a life-long condition for which there is no cure, in recent years the position has become much more blurred. It is now recognised that the problem extends on a spectrum from those who are profoundly handicapped to individuals who are hardly more than 'odd,' in total about 500,000 people.
For this reason, experts now talk of autistic spectrum disorder (ASD) and it is recognised that Asperger's syndrome, where people appear extremely obsessive, is simply a milder form of autism. People who have apparently recovered from their autism cause further confusion. These are immensely brave people who learn, usually after hugely difficult experiences, to operate in the community, hold jobs and have careers. They are, however, still autistic and rarely form relationships. As one successful autistic woman put it: 'I get on fine at work but nobody ever asks me to the pub afterwards.'
Cures for autism?
Since its definition in 1942, autism has been dogged by a series of new 'cures' which have seemed to offer real hope only to fall down when subjected to the rigours of scientific research. Now there are a number of treatments, which help some but not all children and adults with autism.
Among them is the TEACCH Programme. This stands for Treatment and Education of Autistic and Related Communication Handicapped Children/Adults and is based on the simple fact that people with autism of all levels of ability find it easier to process visual rather than spoken or written information.
It is used not only in education but also in providing a structured life especially where choices are necessary. Rather than asking an autistic person whether they fancy a swim or a walk in the park, if a photo of each activity is held in front of them, even if they have virtually no language skills, they can point to one photo or the other. Not only do they have the satisfaction of making a choice, they are also quite clear what is going to happen next. This is important in dealing with behavioural problems.
Another system called SPELL aims at providing a structured environment, a positive attitude with realistic expectations, empathy, seeing the world from the autistic person's viewpoint and low arousal, an environment and lifestyle that reduces stress and anxiety.
The Lovaas Method for children involves the parent or teacher getting into the child's mind, making contact and finding ways to interact and communicate. PECS is a picture exchange communication system.
Dr Rita Jordan, located at the Department of Psychology at the University of Birmingham and joint editor of Autism, the International Journal of Research and Practice, says that parents of children diagnosed as autistic should consider going on the National Autistic Society Early Bird Programme. This will not only offer immense emotional support but it also helps parents chose between methods of education and treatment. Early intervention cannot cure autism but can minimise the build-up of secondary behavioural problems.
'Whether they are children or adults,' Dr Jordan told NetDoctor, 'it is necessary to understand and respect the person with autism. Their anxiety and stress need to be reduced before their style of communication and learning can be seen. Parents and carers are always very concerned about difficult behaviour but this will disappear when the person is understood and doesn't have to resort to acting out.
'Sticking to one treatment approach is not always the best idea. A method that works now may not be suitable in the future. Better communication is always the aim. The quality of life of an autistic person depends on their tolerance of others and the tolerance of other people towards them. To gain this they must be able to communicate,' she said.
A recently discovered intervention for autism is 'Auditory Integration Training (AIT)'. This involves listening to specially adapted music through headphones for two half-hour sessions a day for 10 days with a weekend break in the middle.
The theory is that autistic people hear some sounds too well and some too faintly. The distortions in their hearing are analysed and the music adapted to retrain the ear. This, in turn, improves speech and behaviour.
The 'Option Method' is an intensive home-based programme, which involves the use of a large number of volunteers. It is founded on the success of an American couple who claim their son recovered from autism.
The hormone, secretin, is naturally present in the pancreas and a deficiency is thought to signify digestive problems. Patients on the autistic spectrum have been injected with secretin for these digestive problems and initially they seemed to improve their social and language skills. The results indicated that secretin might offer a cure to at least a subgroup of autistic people but recent studies, however, cannot repeat the earlier success and do not show an effect.
At present neither the Medicines Control Agency in the UK nor the Federal Drugs Agency in America has approved secretin for use in autism. Although secretin is also expensive and it is difficult to verify its authenticity, there are still people who believe it plays a role in the treatment of autism. As the hormone is not licensed for this purpose, the doctors involved with the families of children taking secretin are working covertly.
An intriguing way of helping those with autism is known as facilitated communication. A facilitator lightly holds the hand or arm and the autistic person moves a finger forward to select a letter on a keyboard and spells out their thoughts and wishes. The facilitators are always quite sure that the choice of letter belongs to the autistic person. The increased communication helps to gain the trust of the autistic person and helps remove their inappropriate behaviour.
Autism and food intolerance
Another new treatment, which is gaining strength, is dietary modification. Consultant paediatrician, Dr Michael Tettenborn, of Fimley Children's Hospital, claims there is a link between autism and food intolerance, which in some patients may also involve the yeast infection candida. Following treatment for the candida and an elimination diet, he has successfully treated several patients and has seen them largely overcome their autism. The regime needs strict medical supervision, says Tettenborn, and patients sometimes get worse before they get better.
Professor Jonathan Brostoff, Professor of Allergy and Environmental Medicine at University College, London, said: 'The logic is that when the digestion breaks down wheat and milk, the tiny proteins called peptides can pass into the bloodstream of individuals who have a damaged gut that becomes leaky. The peptides act like opiates which turn off the brain and cause autism.'
A new boarding school near Newbury, Berkshire, Prior's Court School, has devised specialised educational methods which includes a strenuous exercise regime inspired by the highly successful 'Daily Life Therapy' approach used by the Higashi Hope Foundation in Japan and the United States. The school offers a highly structured programme to its students with many group oriented activities
Vitamin therapy has been use for autism since the 1960s. It has been strongly advocated by the American psychologist Dr Bernard Rimland of the Autism Research Institute, San Diego, California, who also founded the American Society of Autism. Studies have been done and although the results have not been very encouraging, they have helped some people. The vitamins suggested are vitamin A, vitamin B6 and vitamin C. The food supplement dimethylglycine and the neurotransmitter serotonin have also been tried with erratic results.
Many people with autism are given drug therapy despite an absence of proof of beneficial effects. Professor Michael Rutter of the MaudsleyHospital, London, reviewed the findings in 1999 and 'reaffirmed earlier conclusions that there is no drug that produces major behavioural improvements for autism'.
Caution required
Dr Rita Jordan urges carers and parents to be careful when choosing treatment methods for people with autism. 'Understanding the person is of primary importance,' she says. 'The more unpleasant the procedure the more carefully it must be thought through. The ends do not always justify the means. Some treatments used in the past have bordered on the abusive.
'When children are involved, I always tell the parents to have fun. Even if the treatment doesn't help relieve the autism, if the child has enjoyed it, that can't be taken way.'
Useful links from the Autistic Society

Important facts about autism and Asperger syndrome:
Diagnosis: a brief guide for health professionals:
Summary of information for health professionals on the NAS site: