Efficacy of Psychosocial Treatments for Autism

A central premise of developmental psychology is that early experiences can influence the genetically primed cascade of events involved in the maturation of neuronal circuits. Indeed, it is now recognized that all experiences leave their marks on the physical structure of synapses through the mediation of the biochemistry of synaptic plasticity. Autism is likely due to some interference of the normal developmental pathway of the nervous system, probably owing to a combination of genetic predispositions and environmental factors present during prenatal gestation or in the first years of life.

Applied Behavioral Analysis (ABA) is an early intervention for individuals diagnosed with autism that presumably targets synaptic plasticity through intensive behavioral modification with feedback control. ABA is not the only early intervention that appears to work (in some cases) for persons with autism. The Floor Time Model, developed by Dr. Stanley Greenspan, is based on providing positive behavioral feedback in naturalistic settings with the therapist modeling the movements and social encounter strategies of the person with autism as a means of engaging (in modern terms) the mirror neuron system.

A Boston Club held on April 27, 2009 titled “Efficacy of Psychosocial Treatments for Autism” focused on this area of inquiry. The purpose of this Boston Club was to examine other approaches to early intervention that might also work by engaging social patterning circuits in the brain. The Cornerstone Method of Reflective Network Therapy, discovered by Dr. Gilbert Kliman, requires far less time than ABA, and has proven particularly effective with children with mild to moderate autism. Their best results with children with autism have been with four times a week treatments of 15 minutes each, in a classroom setting, combined with weekly parent guidance.

Treatment and Education of Autistic and Communication Handicapped Children (TEACCH) is another well-regarded program model aimed at meeting the needs of autistic people by using the best available educational approaches for this population known thus far and providing the maximum level of autonomy. TEACCH emphasizes understanding the culture of autism, developing an individualized person- and family-centered plan for each client, structuring the physical environment, and using visual supports to make the sequence of daily activities predictable and individual tasks understandable.

Kira Apse, MS, The Autism Consortium

Deborah Flaschen

Matthew Goodwin, Ph.D., Massachusetts Institute of Technology

Alexandra Harrison, MD, Harvard University

Predicting and Improving Language Outcomes in Children with Autism
Ted Hutman, Ph.D., University of California, Los Angeles

Vanda Marie Khadem, JD, Autism Higher Education Foundation

Reflective Network Therapy: in-classroom treatment for preschoolers with autism spectrum disorders
Gilbert Kliman, MD, The Children’s Psychological Health Center, Inc.

Structured Teaching with Children and Adults
Gary Mesibov, Ph.D., University of North Carolina , Chapel Hill

Vicki Milstein, M.S. Ed., Brookline Public Schools

2009

The Nancy Lurie Marks Family Foundation, Wellesley , MA