Dr. Jung Jin
To summarize, treatments for autism spectrum disorders (ASD) can be categorized into two main types: educational interventions and medical interventions. However, the reality is that ASD interventions can be very diverse, mixed, poorly evaluated, difficult to choose from, and even "blind".
ASD interventions are designed to reduce the problematic behaviors of children with ASD, improve their ability to care for themselves and their quality of life, and provide training and support to the child's family.
Mainstream intervention methods for ASD are not new to the industry and the parent community in China. Some of the popular ones are Applied Behavioral Analysis Therapy (ABA), Structured Education (TEACCH), Decompositional Tactics Teaching (DTT), Critical Skills Training (PRT), Social Emotional Communication Model (SCERTS), Relationship-Based Developmental Model (RBDM), Early Denver Model, and so on and so forth, just to name a few. In addition, there are alternative therapies, traditional medical therapies, and some self-derived approaches. Examples include music therapy, sensory integration training, transcranial magnetic stimulation, hyperbaric oxygen, acupuncture therapy, acupoint burrowing, dietary modification, dietary supplements, animal therapy, and so on. If you look on the Internet, there is a plethora of methods that claim to be effective, and there are even some religious/faith-based therapies.
Faced with all these therapies, it is difficult for parents to know which is the most appropriate intervention for their child with ASD, and which ones are reliable and scientific. The truth is that there is no standardized evaluation of the efficacy of all of these approaches and their efficacy, which varies from person to person and cannot be generalized.
The authoritative U.S. website evaluating these approaches mentions that there are methodological problems with ASD intervention studies to date that prevent clear conclusions about efficacy. It has been complained that although many interventions have positive evidence that some treatment is better than no treatment intervention, systematic evaluations have shown that the quality of these studies is generally poor, that their clinical outcomes are mostly experimental, and that there exists very little evidence of the relative effectiveness of the treatment programs (Krebs 2010).
That said, I believe that relatively intensive and sustained special education and behavioral therapy early in the life of a child with ASD can, to varying degrees, improve the child's "problem" behaviors and promote his or her social and manipulative skills. Research also supports that the integration and flexible use of these approaches can improve symptoms, reduce or mitigate the severity of "problem" behaviors, and improve adaptive behaviors in children with ASD.
Recent research does suggest that children with ASD who receive positive, science-based interventions may improve to the point where they are no different from normal children, and that the earlier the intervention, the greater the likelihood of this.
There is no denying that the cost of interventions for children with ASD is high, and the trend is for them to become more expensive, which is a heavy burden for any family with a child with ASD. Even with partial government support, it's a drop in the bucket, but it's better than nothing.
Even in developed countries, the cost of treating a child with ASD is prohibitively high, and long-term rehabilitation and indirect costs are even more expensive. In the United States, the average lifetime cost for someone with ASD born in 2000 is about $4.39 million, of which about 10% is spent on health care, 30% on rehabilitation, education and other care, and 60% on lost labor productivity. A study in the UK put the lifetime cost of treatment for people with ASD with and without mental retardation at ￡1.8 million and ￡1.16 million, respectively, taking into account estimated inflation in 2005/06.
Some children with ASD are gradually being integrated into the general education system, driven by the concept of inclusive education, but the road is bumpy and expensive. For example, in the 2011-2012 school year, the average cost of educating a student with ASD in a U.S. public school was double or more than the cost of educating a regular student.
Access to timely, legal treatment for each child and family with ASD is complex and limited, depending on where they live and their age, as well as parental awareness and attention, family income, and health care resources. State discount subsidies, too, vary by region. The involvement of health insurance in ASD rehabilitation, although desired by the public, is not easy to implement.
According to a 2008 U.S. study, families of children with ASD lost an average of 14% of their annual income.
A 2008 U.S. study found that families with children with ASD lost an average of 14% of their annual income, and the problem of caring for children with ASD greatly affects the employment orientation of parents, some of whom quit their jobs to raise their children with ASD full-time. This situation is also very common in our country. Nowadays, the problems of post-intervention, vocational training and residential care for children with ASD also involve thorny and urgent issues such as marriage, sexual needs and inheritance. There is an urgent need for all sectors of the community and the government to anticipate and provide effective support for the construction of appropriate service mechanisms.
For all children with ASD and their parents, the principles of early detection, early diagnosis and early intervention are worth following.
Educational interventions aim not only to help children learn basic general knowledge, but also to improve their functional communication and autonomy, as well as to improve their social skills such as ***same attention, ****enjoyment behaviors, symbolic play, altruistic behaviors, to reduce disruptive behaviors, and to apply the skills learned to new environments.
I understand that there is an overlap and integration of the previous interventions in terms of content and procedures, and parents shouldn't be overly obsessed with which one to choose. There is no such thing as the best, only the most appropriate. Also, it's never too late to start ASD intervention. Claims that intervention around age 3 or 4, or before, is critical are not valid.
An organized overview of the current principles of intervention is as follows, and is part of the ****ing knowledge of the international community.
1. Do not wait for a definitive diagnosis before making an aggressive early intervention.
2. Intervention training of a certain intensity. As recommended by the American Academy of Pediatrics, intervention training for ASD should be at least 25 hours per week for 12 months per year.
3. A low teacher-student ratio is desirable, with relatively specific teachers being responsible for training fewer children.
4. Encourage family involvement, including training and instruction of parents in appropriate techniques.
5. Encourage socialization with children of the same age and active inclusion in the group.
6. Positive effects of mainstream interventions, and vision-based training.
7. Make physical boundaries as clear as possible so that the child's attention is relatively focused and rules are predictable.
8. Systematic interventions are evaluated in a timely manner and adjustments are made as needed.
9. Medical interventions, such as medication, as needed.
Evaluation of the efficacy of various approaches is a challenging issue. Inconsistencies in evaluating and quantifying efficacy lead to inconsistent results that can be difficult to interpret for parents, and a 2009 Minnesota study (Moore TR, 2009) found that parents followed behavioral treatment recommendations significantly less often than medical recommendations, and that parents preferred reinforcing behaviors to punitive recommendations.
In addition, the evaluation of the efficacy of various approaches can be challenging.
In addition, I believe that with the development and popularization of computer technology, computer-assisted training is a worthwhile and effective way to support and intervene in ASD. Not only do they enjoy and excel at computer operations and programming, but they may also be able to enhance their life skills with the help of robotics, mobile device technology, and virtual reality tools. At the very least, young people with ASD may be able to socialize with others through the Internet, and they may be able to support themselves by starting their own media outlets to connect with the outside world and provide appropriate services. For example, they can provide programming, graphic design, advertising design, data processing, copy editing, painting, online shopping, and so on, for a fee to their employers.
#Autism# #ASD#