Understanding autism therapy services

What Is Autism?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), lists its diagnostic criteria for autism spectrum disorder as social communication issues such as social reciprocity, trouble identifying and responding to non-verbal cues, developing and maintaining relationships, and restricted and repetitive patterns of behavior/interests, as well as sensory issues (hearing certain noises, only being able to wear certain fabrics, having texture issues with food, walking on one’s toes, hand flapping, rocking back and forth). 

These symptoms occur on a spectrum, so each person with autism will have a distinct set of strengths and challenges.

Some autistic children have developmental delays in which they develop language skills at a later date than their peers. They may also be developmentally advanced by being hyperlexic, or being able to read at levels far above what’s expected of those their age. Though there is not an official “cause” of autism, there is reason to believe that a genetic component is involved.

There are considered to be three different levels of the autism spectrum. They are:

• Level 1: Individuals who are considered to be “level 1” are considered to be “high-functioning.” This would apply to the old “Asperger’s syndrome” diagnosis. They tend to need little to no support in navigating their lives, perhaps needing some guidance on how to handle situations or skill development, then ultimately being okay on their own.
• Level 2: Those who are level 2 are those who need little to a moderate level of support in navigating their lives. They may navigate school well in an academic sense but struggle when out at recess when things are less structured. They tend to be aware of themselves as being different than their peers. They might want friendships but struggle more than the average person in making and maintaining those relationships. 
• Level 3: Those who are level 3 tend to be what most people stereotypically think people with autism are like: they need a lot of support to navigate their lives. They tend to be “lost in their own world”, and may not be interested in making friendships or spending time with others outside of their own family. They tend to be the most rigid in their play and get upset when that structure or play is interrupted. They struggle the most when there’s no routine in place or if things change unexpectedly.

There can also be a degree of anxiety that accompanies autism, as navigating the world with a high degree of sensory attunement, need for routine, and social challenges can be overwhelming and scary. 

Ultimately, autism is a neurological difference that has been seen throughout history. It is important to note what autism is not: Autism is not a disease. It isn’t caught or contagious, nor does it get progressively worse. Though there are skill deficits, it is not an “issue” to be cured or healed. 

Types of Autism Therapy

The nature of therapy when working with people on the autism spectrum depends on the individual’s strengths, challenges, and needs. Those with severe skill deficits (i.e. level 3 or those with higher needs) tend to benefit from behavior therapy the most, as it helps them learn important skills. 

Many clinicians, especially those working with children, will first complete a functional behavior assessment (FBA) in order to determine the function of the unwanted behaviors, or why they do what they do. Then, they will determine what type(s) of therapy will be most helpful and effective.

The first-line version of therapy is applied behavior analysis (ABA). The main idea of ABA is to develop antecedent (what we do before the behavior occurs) and consequence (what we do to encourage or discourage the desired behavior) strategies to help those with autism learn skills to navigate their lives more effectively. 

However, there’s been a lot of criticism of ABA in recent years. It tends to be more rigid than the average therapeutic model, which has led some to fear it can turn people into “robots” as ABA doesn’t always generalize the learned skills outside of the particular session or setting. Many adults with autism who went through ABA as children reported that it discourages them from being themselves and instead teaches and rewards them to “mask” or blend in with others. 

This is why it’s important that clinicians who utilize ABA explain both their methods and their end goals to the child as well as the family, making them aware of the process and what it’s meant to do. ABA is still a useful tool for skill development that can help people with autism walk through life with less difficulty.

The other commonly used type of therapy for autism is traditional talk therapy. The main focus of talk therapy will be teaching skills and making therapy concepts concrete and relatable to everyday life for the client. Talk therapy can be challenging for people with autism, as pertinent concerns may not consistently be at the forefront of their minds from week to week. As such, the therapist may bring in other supports, like a partner or family member, to support the individual’s progress.

What Is the Most Effective Therapy for Autism? Choosing the Right Therapy Approach for Autism

The “right” type of therapy for treating autism depends on the needs of the individual. For clients who exhibit more severe behaviors, such as self-injurious behaviors (i.e. head banging, pulling off skin), ABA can be very helpful in teaching replacement behaviors such as pounding on Play-Doh or using a fidget cube. Having someone present to help support the client and their family when a meltdown occurs can also be beneficial and help them learn how to handle future meltdowns.

One intervention to help teach social skills is the Superflex curriculum. Superflex is a superhero-themed cognitive behavioral therapy-based curriculum aimed at helping children learn self-regulation skills, social skills, and flexibility skills. It places emphasis on awareness and working through the thoughts the child is having instead of just labeling them as “bad.” This curriculum encourages them to think flexibly to solve their problems so they get what they want without hurting themselves or others.

Talk therapy can also be very beneficial, as it encourages people with autism to learn self-reflection skills. It provides them with a safe space to process their thoughts and emotions without being judged or criticized.

Do Autistic Individuals Respond to Therapy?

Yes, therapy can be effective and helpful for individuals with autism. It may take some time to find someone they can have a strong therapeutic alliance and bond with, but having a strong connection with their therapist is a key component of autism therapy. Through establishing trust and understanding between the client and their therapist, true growth can take place. 

How Does Autism Therapy Work for Children?

Depending on the age and needs of the client, therapy will often function like it does for any other client. Part of the session will be consulting with the parents and providing them with ideas on how to respond to their child’s challenges, as well as helping the parents learn how to support their child in using their skills. 

Sessions then progress as usual with the client and therapist talking about challenges and the therapist teaching skills to the client. This may include helping the client recognize cues for identifying emotions — the physical sensations for feeling anxious, happy, or sad; recognizing non-verbals and how to appropriately respond to them; and problem-solving skills. If sessions are in person, they may play games to learn skills. Homework may be beneficial if the client is driven to continue practice outside of sessions.

How Can Child Therapy Help with ASD?

Although there is no “cure” for autism, there are ways that your child can learn to cope and work through their challenges to live a happy and full life. Early recognition and treatment may reduce the symptoms of these conditions as well as assist in their development and learning. When you choose to work with a licensed child therapist at Thriveworks, you can expect them to use a variety of methods to provide the best possible care to your child. Some methods may include:

1. Speech therapy – works with language development and clarity.
2. Play therapy – as we know some kids have a harder time expressing their emotions and thoughts through words, play therapy can be a great tool for them. It gives them the ability to show how they are feeling through toys, songs, dance, and more.
3. Art therapy – similarly to play therapy, art therapy gives kids the creative outlet they need to express themselves.
4. Floortime – it may be hard to get a child with ASD to connect with therapists or other helpers. Because of this, your child’s therapist will get on the floor beside them to catch their interest and meet them on their level, playing with them and interacting with them.

There are many different ways to connect with a child with ASD and their therapist can figure out what ways work best for each individual. We understand that every child is different. That’s why our child therapists at Thriveworks create individualized plans for treatment.

How Does Autism Therapy for Adults Work?

Therapy for adults with autism does not function any differently than it does for any other type of client, though it may be helpful to work with someone trained in ASD as a specialty who understands specific needs, especially if someone is level 2/3. 

Sessions might focus on learning how to be oneself across situations, or in other words, how to “de-mask.” Masking occurs when someone with autism has to hide their autistic traits in order to appear more neurotypical, often done in social situations as a way to fit in with people around them. This can help them in their interactions with others, but it’s important to know how to “de-mask” and be themselves.

Therapy may also be focused on helping the person learn new social skills, such as how to date, as well as how to communicate their needs in relationships. During sessions, clients might practice recognizing cognitive distortions — the bad thinking habits or patterns we all engage in from time to time — and learn how to dispute them. There may also be a need to refine coping skills so the client doesn’t struggle to cope or manage their emotions outside of sessions.

What Is the Goal of Autism Therapy?

Therapy goals are set individually but may include:

• Being more flexible.
• Navigating social situations more effectively by recognizing social cues and responding to them appropriately.
• Improving their relationships.
• Regulating themselves more effectively.

It might also involve teaching them how to appropriately advocate for themselves. Furthermore, parents should become more comfortable and confident in responding to their child’s needs and understand how to better support them by the end of services.

When it comes to autistic adults, the goal of therapy is more self-directed, though the end results are very similar. It may involve learning how to:

• Cope with less concrete systems and expectations at work.
• Regulate their depression or anxiety in a healthier manner. 
• Navigate their romantic relationship(s) and become a better partner. 
• Advocate for themselves.

Benefits of Autism Therapy

Autistic individuals benefit from therapy much like everyone else: It helps them learn new skills to help them navigate their lives more effectively. When autism therapy is executed effectively, clients will gain real insight about themselves and how they interact with the world, helping them live a happier, more fulfilling life.