It has been discussed for a long time whether or not autism spectrum disorder can be completely prevented and whether there is a treatment method that can achieve 100% improvement. Although many mental health professionals and researchers have mentioned and recorded cases with 100% recovery results, autism is basically spectrum disorder and it is different in each individual. However, it is possible to minimize the effects of autism with good treatment and good therapy.
Individuals with autism spectrum disorder need therapy and treatment processes that will last for years. The main objective of this process is to enable the child to acquire the skills that he/she cannot learn on his own. However, there are also treatments where the effects of autism are reduced and the individual’s communication problems can be solved. Although these treatments are controversial, they are known to be effective in the short and long term.
It is very important for children with autism to be diagnosed at an early age, preferably before the age of 3. Because the earlier a child with autism starts to receive special education, the faster the child can progress. Special education should be provided to children with autism at least 20 hours per week, preferably 35-40 hours per week, and specially prepared for children with autism.
In addition to special education, the most important therapies given to support special education are language-speech therapy and occupational therapy. In many developed countries, such as the USA and Canada, language-speech therapists and occupational therapists are employed in schools in order to provide support to children from various disability groups, particularly those with an autism spectrum disorder.
The financing of these therapies is covered by the state or government itself. Speech therapists and occupational therapists offer counseling services to children and provide counseling services to parents and families of those children.
Speech therapists use a variety of therapies to improve language and communication skills in children with autism. The main objective of these therapies is to provide them with the communication skills that will enable children with an autism spectrum disorder to communicate in all environments.
For this purpose, it is aimed to provide a better understanding of the conversations directed at them, to express themselves in a more understandable way, and to acquire the skills of starting and maintaining a conversation.
Occupational therapists carry out various therapies in order to improve the daily life skills, social skills and adaptive behavior of children with autism and to reduce behavioral problems of them. The most common method of occupational therapists in children with autism is sensory integration therapy.
Sensory integration therapy assumes that there are some problems with the ability to sense, process and interpret the information provided by sensory organs in children with autism. Therefore, by eliminating these problems and improving the ability of sensory integration, it aims to increase mental functions and to reduce behavior problems. Sensory integration activities usually carried out by occupational therapists, include, for example, brushing the body, compressing the knees and elbows, swinging in the hammock, etc. There are also applications called a sensory diet. An example of a sensory diet could be a body sock or weighted vest.
Sensory integration has been widely used in the field of autism since the 1970s. However, it does not yet have a sufficient scientific basis. A comprehensive research review points to the lack of convincing experimental research findings.
In addition to special education, some therapy and psychiatric treatment methods can be used in children with autism. However, the use of different therapy and treatment methods does not reduce the need for special education. Therefore, what kind of therapy or treatment is taken, every child with autism must receive special education first and foremost. Other methods may help with special education, but none can replace private education.
Selection and Evaluation of Methods in the Treatment of Autism
The education, therapy and treatment methods used in the field of autism are very diverse and new ones are being added every day. The benefits of an education, therapy or treatment method should be demonstrated by scientific research results. However, any scientific research on a method cannot show that the method works or does not work. In order for the results of scientific research to show the effects of a method, it must have two characteristics:
- Research should be experimental. Experimental research is conducted by providing experimental control and providing the cause-effect relationship.
- Research should be published as an article in a peer-reviewed scientific journal. Peer-reviewed scientific journals are scientific journals that apply to the referees of more than one expert for the publication of each article.
Psychiatric Treatment for Autism
In order to be able to apply a definite treatment, it is necessary to eliminate the negative and continuous behavior of individuals with autism. Individuals with autism spectrum disorder are prone to anxiety and panic attacks. In addition, lack of communication and lack of appropriate behavior causes children to show reactions that can reach anger attacks or even tantrums. In order to get a positive result and to move forward, it is necessary to avoid such reactions.
The first step in the treatment of autism spectrum disorder is psychiatric and neurological treatment. In order to prevent anger and anxiety attacks of children with autism, medications may be used in various dosages. It will be necessary to ensure that these drugs have not overdosed. However, neurological and psychiatric treatments alone are not enough to eliminate autism.
The aim of the treatment is not to cure the individual completely, but to ensure that the therapies can continue without any problems. Because of the wide range of psychiatric drugs and which drug effects which children more effective, that the doctors can decide, however, it is absolutely necessary to apply this therapy method in consultation with the doctor.
Various psychiatric medications are used to reduce behavioral problems such as excessive mobility, anger, and obsessions of children with autism and to increase their attention. Physicians, children’s mental health professionals and pediatric neurologists who evaluate the child in terms of drug treatment, decide on medication and apply this treatment.
Which of these drugs and which dosages should be used is of great importance. For this reason, the effects and side effects of the drugs should be closely monitored by specialist doctors. Therefore, children who are treated with medication should be taken to be checked once or twice a year.
Alternative and Supporting Treatment Methods in Autism
Gluten-Casein Diet
Gluten is a protein found in cereals and bakery products. It is found in cereal products such as gluten, wheat, rye, oats and barley, and bulgur and semolina made from these grains. Casein is the protein found in milk. It is found in all dairy products such as cheese, yogurt, buttermilk, etc.
The intestines of children with autism are extremely permeable. Therefore, it is assumed that gluten and casein proteins cannot be digested and this causes neural stimulation in the brain. Although this assumption is not scientifically confirmed, the gluten-casein diet (GFCF Diet: Gluten Free-Casein Free Diet) is widely applied to children with autism. In this diet, wheat flour is used instead of rice flour and corn flour. As an alternative to milk, products such as soy milk are preferred.
According to the observations of some parents and physicians, some of the children with autism who have a gluten-casein diet decrease their hyperactivity, increase perception and eye contact, and decrease in the digestive system and immune system problems. For example, on the Internet, there are parental explanations, often about how well this treatment works for their child. However, most of the studies on the positive effects of the gluten-casein diet on children with autism do not go beyond case studies.
It should be remembered that the gluten-casein diet causes serious protein, vitamin and mineral deficiencies. It is undeniable that cereals and milk, which are very important food sources, are especially important in children of growing age. Therefore, it should first be investigated whether the child has gluten-casein intolerance or allergies. If intolerance or allergy is determined, gluten-casein diet, such as any diet, should also be carried out with expert supervision and close follow-up.
Chelation Treatment (Removal from Heavy Metals)
It is thought that heavy metals with toxic properties such as lead, mercury, aluminum, arsenic may cause autism spectrum disorder. However, when the researches on this subject are examined, it is seen that this thought does not go beyond an assumption.
There is a group of researchers who assume that children with autism spectrum disorder have this condition because of the heavy metals present in their bodies. Although this assumption has been proven by various experiments, it has not been fully proved.
The metals in the body of the individual are excreted by digesting the plants, such as personals, or by other medical interventions. In addition, various drugs are used to remove metals by chemical means.
Mercury, which is one of the toxic heavy metals mentioned, is also present in measles-mumps-rubella (MMR) vaccines. To investigate the relationship between these vaccines and autism, 19 researchers from 13 different universities conducted research on hundreds of children with autism. The results of this study showed that there was no relationship between this vaccine and the emergence of autism symptoms.
Although there is no relationship between heavy metals and autism, chelation treatment is frequently used in children with autism. Heavy metals removal aims to remove toxic heavy metals from the body by herbal or chemical means.
Some plants such as coriander are generally used when chelation is done by herbal means. On the other hand, some drugs are used in the chemical throw of metal from the body. It is not known exactly how both the herbal and chemical metal pulse applications affect other systems in the body.
However, with these applications, very serious side effects can occur until death happen. Therefore, many health organizations, such as the American Academy of Pediatricians, warn that such treatments should not be performed unless they are very necessary.
As a result, the chelation treatment can only be recommended to children who have been proven to be affected by heavy metals and have properties that are appropriate to this treatment (eg, kidney, liver and bone marrow disease). In most children with autism, the presence of such a condition cannot be determined.
Since it is not a scientifically proven method, this method should not be considered as an autism treatment and should be avoided. However, it should not be forgotten that the application in question has the risks that may exist until death.
Neuro-Feedback
The aim of this method is to be able to normalize the brain waves different from normal with various exercises. Electrodes are placed on the child with autism’s head and the brain waves are transferred to a computer via these devices. The brain waves transferred to the computer are rendered as animation and watched to the child.
An individual with autism changes his/her mental activity while watching brain waves brought into an animation that he/she can perceive. The animation became a computer game. As brain waves become normal, points are earned in the game.
The child with autism can control the game with their brain while watching this animation in the computer game format. When the child concentrates their attention on the game, the brain starts to earn points in the game as the brain moves to appropriate electrical activity. When the child distracts, that one gets out of control.
It is proven by various laboratory studies that this method is an effective method. It is known that children with autism gain positive behaviors in long term applications. In addition, in two experimental studies published in the Research in ASD journal, it was determined that this practice in children with autism caused changes in brain waves and certain behaviors. When performed concurrently with integration therapies, it is known that children have a positive effect on their learning and skill development abilities.
In order to reach a final judgment, similar researches should be carried out and researches should be done with children with an autism spectrum disorder in different characteristics. More importantly, the positive effects of the results on daily life should be shown.
Vitamin-Mineral Support
It is thought that due to the assumption that the intestines of children with autism are excessively permeable and are very selective in nutrition, there may be a lack of many vitamins and minerals in their bodies.
The most important of these vitamins and minerals are vitamin B6 and magnesium mineral. Vitamin B6 deficiency was found to affect the functioning of the central nervous system in children. Magnesium is a mineral that promotes bone formation, maintains nerve and muscle cells, and enhances the functioning of enzymes in the body.
The results of studies on the effects of vitamin B6 and magnesium supplementation on children with autism spectrum disorder’s behavior are in conflict with each other. While positive effects were reported in studies with low experimental control, research with high experimental control showed no effect. Therefore, there is a need for extensive and controlled experimental research.
Fungal Treatment
There is no experimental research showing that this method has positive effects on children with autism. Furthermore, experimental research has shown that this method has no positive effect on children with autism.
The possible correlation between some fungal species in the body and autism is a topic of debate in the medical world. Some doctors claim to help children with autism by reducing excessive amounts of fungi or related organisms. However, a number of studies showing the effects of fungal treatments on individuals with autism do not go beyond the case study.
Candida is a yeast-like fungus that normally resembles yeast. It is suggested that prolonged antibiotic therapy, hormone therapy or some drug therapies may cause the growth of candida and similar fungi in the body and related infections.
Any kind of excessive fungal growth can cause problems in various functions of the body. However, due to the presence of certain amounts of these fungi in the body of every human being, it is difficult to reveal the excess amount of mushroom with medical examinations. Drugs used in the treatment of overgrowth of the fungus have very serious side effects.
The use of some natural origin products, such as garlic extract and grape seed extract, is also thought to support fungal therapy. As the fungus is fed with sugar, yeast, and carbohydrates in the body, a diet without sugar, carbohydrates and yeast is recommended as well as drugs. As a result, there is no scientific basis for the application of fungicides with drugs or natural products in autism spectrum disorder.
HBOT: Hyperbaric Oxygen Therapy
Experimental research showing that this method has positive effects on children with autism has not yet been demonstrated or experimental studies have shown that this method has no positive effect on children with an autism spectrum disorder.
Hyperbaric oxygen therapy is a treatment that is administered in a pressure chamber by ventilating the patient at intervals of 100% pure oxygen. The aim of this treatment is to make the function of oxygen, which is taken to the lungs by breathing, by increasing the amount of oxygen in all body fluids and by performing the functions of the cells which cannot perform their duty due to oxygen.
This treatment method is widely used in the treatment of brain damage or burns all over the world. Although there has been widespread use in autism spectrum disorder, there is no experimental study showing that hyperbaric oxygen therapy works in autism spectrum disorder. Research does not go beyond a case study or uncontrolled study with a single group.
One of the recent controlled studies has shown that hyperbaric oxygen therapy is ineffective in children with autism. It should also be noted that excessive intake of oxygen may be harmful to the brain or ear.
Treatment Protocols
The most famous treatment protocol for the treatment of autism is the DAN protocol. The DAN protocol was initiated by Dr. Bernard Rimland who was the founder of the Autism Research Institute (ARI) in San Diego, USA, as well as the father of an autistic child.
The first research on autism begins with a detailed history and physical examination of the child with autism. Focused topics include problems related to immune weakness, recurrent infections, response to vaccines, food sensitivity, complications during pregnancy, pregnancy, and childbirth, digestive disorders, exposure to environmental toxins, chronic antibiotic use, candida or fungus.
These highly sensitive tests in the individual treatment plan include organic acids in urine, urinary peptides, amino acids, hair elements, essential fatty acids, liver detoxification profile, fecal analysis, intestinal permeability, immune functions, special allergy testing, electrodermal imaging, and blood allergy testing.
Major intervention approaches are as follows;
- Whole gluten-free (wheat, barley, rye, etc.), and casein-free diet (milk, ice cream, yoghurt, etc.)
- Secret food allergy testing and avoiding the allergic food
- Treatment of intestinal bacteria/yeast growth
- Heavy metal detoxification
- Vitamin, mineral, amino-belonging, and essential fatty acids supplements.
According to the DAN Protocol advocates, the dietary change applied to many patients diagnosed with autism spectrum disorder has provided significant benefits. The most commonly used diet in patients with autism is gluten and casein-free diet. According to a study carried out by the Autism Research Institute (ARI) on autism in 2,208, the gluten-free diet provided 65% difference in symptoms.
There is no scientific basis for treatment methods other than vitamins and minerals. Most of the reported efficacy findings are non-empirical studies based on subjective opinions of families, doctors or mental health professionals. In addition, the protocols for the treatment of autism have not been officially approved in some countries.
Therapy Methods for Autism Spectrum Disorder
In some cases, people with autism may need to take medication. The drug is used for other diseases that come with autism or which prevent education and therapies.
In addition to the treatment of autism, also various therapies have emerged. These therapies are intended to help the person with autism gain skills and communication skills. The main purpose of therapies is to help people gain skills. If autism is diagnosed in infancy and the therapy is started at this time, it is suggested that the person will be able to acquire motor skills and communicate in the growth process.
Sensory Integration Therapy
Sensory integration therapy assumes that there are some problems with the ability to sense, process and interpret the information provided by sensory organs in children with autism. Therefore, by eliminating these problems and improving the ability of sensory integration, it aims at increasing mental functions and reducing behavior problems. Sensory integration activities include; whisk the body, squeeze the knees and elbows, swing in the hammock. Also, there are applications called a sensory diet.
This method has been widely used in the field of autism since the 1970s. However, it does not yet have a sufficient scientific basis. A comprehensive review of the study points to a lack of convincing experimental research findings.
Auditory Integration Therapy
This therapy method was developed by Berard in France in the 1900s. At the beginning of the auditory integration therapy, the child is determined to be sensitive to which frequencies, and in the therapy sessions, these frequencies are removed from the headphones. There are studies that suggest that this method reduces hypersensitivity and behavioral problems related to some sounds, and there is also evidence that it does not work or increases behavior problems.
Sinha et al., who conducted a systematic review study in 2006 by re-examining the data of 6 experimental studies, concluded that there were various methodological problems in these studies. They, therefore, concluded that the effects of auditory integration therapy on children with autism are not yet scientifically based.
Music and Dance Therapy
Music therapy is the therapy method used by certified therapists through singing, playing instruments and accompanying music to dance. The benefits of music therapy in children with autism can be listed as follows:
- Emotional bonding: Activities in music therapy are expected to help the child develop an emotional bond with the therapist and others.
- Increase the use of verbal and physical language: Music is expected to increase communication requests.
- Reduction of behavioral problems: During the instrument use and dance, the child achieves visual, tactile and auditory stimuli together. It is thought that this stimulation may enhance the fine and gross motor development of the child, facilitate his / her awareness, and reduce inappropriate behaviors.
- Maintaining a sense of accomplishment: Playing, singing or dancing can help the child to experience a sense of accomplishment.
Most of the studies showing the effects of music therapy on children with autism are non-experimental studies. However, the positive effects of music therapy have been demonstrated by a meta-analysis.
Art Therapy
The aim of this course is to enable the plastic arts like painting, ceramics, sculpture to be self-expression of the individual and to provide emotional relief for the individual. In other words, art therapy seeks to ensure that the emotions and thoughts that the individual cannot express in other ways are revealed by artistic productions.
The main purpose is to create a safe and non-judicial environment in order to experience the aesthetic aspect. The nature of artistic activity involves effectively dealing with an object, taking risks and expressing the individual. Figures and volume are useful for cognitive development; colors, fragrances, and textures are beneficial to the senses; the overall process is assumed to be useful for physical coordination.
Thus, both aesthetic awareness and various skills are expected to develop. It is hoped that art will open the way for communication by encouraging the child.
Experimental research showing that this method has positive effects on children with autism has not yet been demonstrated or experimental studies have shown that this method has no positive effect on children with autism. Therefore, there is a need for studies investigating the effects of art therapy in children with autism.
Drama Therapy
The aim of drama therapy is to contribute to the emotional development and expression of people with autism spectrum disorder by using the activities in the performing arts. During drama therapy, inappropriate behaviors are tried to be transformed into various creative movements.
One of the benefits expected from therapy is to help the individual achieve his creative capacity. By using some game methods as a tool, it is attempted to develop relationships with people. Research on the effects of drama therapy in children with autism is needed.
DAT: Dolphin-Assisted Therapy
It is also known as interaction therapy with dolphins. It is widely used in many countries, especially in USA, Israel, Russia, and Mexico. The number of therapy centers opened for this purpose is increasing rapidly. In these centers, children with autism interact with the dolphins before entering the pier and then into the water.
There are several studies suggesting that dolphins therapy has positive effects on children from various disability groups and some of them have been carried out as experimental research. However, experts agree that all of these studies have serious procedural errors. Therefore, in scientific circles, the opinion that there is no reliable experimental study showing the positive effects of therapy with dolphins on children with autism is predominant.
In addition, the therapy activities carried out with dolphins have also reacted by environmentalist organizations. Many environmental organizations are strongly opposed to making money through dolphins and campaigning for the freedom of dolphins.
Hippotherapy
It is widely used in many countries, especially in Germany, with children from various disability groups. The main objective of this therapy is not to gain riding skills, but to enable the use of sensory and spiritual inputs to be provided by horseback riding.
The most common disability group directed by hippotherapy is children with cerebral palsy. On the other hand, hippotherapy with children with autism spectrum disorder is rapidly spreading. However, almost none of the studies published included children with autism. The results of studies conducted with children with cerebral palsy indicate that there are positive effects on some mental abilities. However, it is a fact that more controlled experimental research is needed.
In conclusion, it is impossible to argue that activities performed under the name of hippotherapy have a benefit beyond hobby in children with autism.
