Autism is a controversial diagnosis, as its incidence has increased tremendously over the last few decades, and because its criteria are widely debated. Some clinicians believe that the ability to communicate verbally at a functional or near functional level rules out autism; others diagnose autism more readily, despite DSM guidelines. In addition, new behavioral treatments (especially if applied during childhood) have shown great success in improving the social behavior of autistic individuals, whereas in the past autism was seen as, at best, manageable with intensive support and structure, its symptoms essentially fixed. Finally, the causes of autism are essentially unknown, although there seems to be a strong genetic component. Several advocacy groups have insisted that chemicals in childhood vaccines are responsible, but a great deal of research does not support this, and leading medical groups, including the AMA and CDCP have ruled out this theory. Still, the increase in autism diagnoses does coincide with an increase in the use of certain chemicals in vaccines, and the theory remains popular, neither proven nor disproven.
Ordinary therapy is not usually indicated for autism; in fact, talk therapy would be relatively impossible for autistic children, and only useful with higher functioning adults or with clients diagnosed with Asperger’s disorder. This disorder is sometimes called “the little professor” syndrome, as children with this diagnosis do not show the intellectual delays associated with autism, and, unaware as they are of social cues, may tend to show-off their knowledge, in addition to becoming extremely interested in one or two areas of knowledge, another symptom of autism spectrum conditions.
A good therapist can identify the signs of autism, help rule out other possible causes of the child’s behavior (perhaps with the assistance of other professionals), and refer the child to a specialist in behavioral therapy, most commonly Applied Behavioral Analysis, the approach with the most proven success. Adults with autism, especially milder forms, and children and adults with Asperger’s may benefit from talking therapy in order to overcome social isolation, though they are unlikely to seek such help as this situation usually does not bother them – it bothers their families.
David, 12, was diagnosed as autistic as an infant, but his intellectual skills indicate he has Asperger’s. He wants to sit by his computer all day, and cannot get along at school. Even in a special school, he is isolated from the other children, and constantly brags about his supposed intellectual superiority. He has a good if bizarre sense of humor, but no clue how to get along with other people. His parents bring him to therapy in the hopes of “normalizing” his behavior “just a little bit”, and, thanks to David’s fair intelligence and his desire “to stop getting beat up” his therapist is able to make some progress, helping David understand that he can choose to get along with others, that others may offer him something enjoyable sometimes, such as a joke or new computer game, and how to begin learning social cues and speaking appropriately with others. The therapist also helps the parents set realistic goals for David, and continue teaching him social skills at a reasonable pace.
Jaycine, 39, is autistic and lives at home with her aging mother. The two come to therapy, but Jaycine cannot participate much, as she is almost completely nonverbal, and is uninterested in any relationship but the one with her mother, on whom she is entirely dependent. The therapist helps the mother identify her choices, and when the mother decides it is time for Jaycine to move out, refers the family to a group home, and helps Jaycine’s mother work through feelings of guilt and grief.
Last updated: 05-02-2014
Autism Spectrum Articles