By Hanna C. Rue, Ph.D., BCBA-D
In recent years, the number of diagnosed cases of autism and related disorders has increased dramatically. In 2000, about one in 150 U.S. children had an autism spectrum disorder (ASD); today, that number is one in 68 (Centers for Disease Control and Prevention).
While this rapidly growing statistic has focused attention on the education and treatment of children with autism, there is another cause for concern: More children with ASD means that in the coming decades there will be more adults with ASD than ever before.
Those of us who care for children and adolescents with ASD – families, teachers, physicians, and behavioral health professionals – need to educate ourselves about interventions and services available for adults on the autism spectrum.
Researchers at the National Autism Center (NAC), May Institute’s Center for the Promotion of Evidence-based Practice, recently released the results of a new study of interventions for individuals with ASD. This review is the second phase of the National Standards Project (NSP2), and its results, combined with the results of NSP1, represent the largest review of its kind. Together, these reports include data from more than 1,000 studies.
The expert panel that collaborated on NSP2 identified 14 “Established Interventions” for children and adolescents that are supported by reputable research, produce beneficial outcomes, and are known to be effective. They found only one such intervention for adults on the autism spectrum.
The good news is that there are more ASD interventions with solid scientific backing than ever before for children, adolescents, and young adults. That translates into more tools and options and information for families who need to make critical choices about how to best treat their children.
The not-so-good news is that NSP2 reviewers found only 28 articles with adults as participants that met the criteria for inclusion in NSP2. Those articles resulted in only one recommended intervention for adults.
Children, adolescents, and adults with ASD all
face challenges with communication, social skills, and problem behaviors. And after the age of 22, individuals with ASD encounter new challenges as they begin the transition from state-mandated educational services into adult programs. They often need help finding appropriate housing and services, securing meaningful work opportunities, and building a life integrated into the broader community.
How can we help them succeed in these endeavors? This is the challenge that those of us who care for and about them face on a daily basis.
The one intervention determined by NSP2 reviewers to be effective for adults, and nearly all of those classified as effective for children and adolescents, are behaviorally based, meaning they are grounded in the methodologies of applied behavior analysis (ABA), behavioral psychology, and positive behavior support.
The professionals who work with adults with ASD have witnessed first-hand the effectiveness of evidence-based interventions that can be tailored to meet each person’s unique needs. The specific behavioral interventions identified as having beneficial effects include; differential reinforcement schedules (focusing on reinforcing socially appropriate behaviors while decreasing inappropriate or challenging behaviors), prompting, and providing choices.
The NSP2 provides detailed descriptions of the techniques involved in each “Established Intervention.” The report is available as a free download from the NAC’s website at www.nationalautismcenter.org
Thanks to effective interventions and appropriate programs and services (such as day habilitation programs and supervised group homes), adults with special needs can achieve their maximum potential and live successful and meaningful lives.
Still, there is more to be done. Critical evaluation of vocational training, social skills, and continuing education programs are desperately needed to make appropriate individualized intervention recommendations. As the ASD population continues to age, elder care and managing health-related issues will also become priorities for many caregivers. Research must guide the intervention recommendations for the elderly with ASD.
Dr. Hanna Rue was the Chairperson of the National Standards Project, Phase 2, which was completed and published in April of 2015. She previously served as Executive Director of the National Autism Center, May Institute’s Center for the Promotion of Evidence-based Practice.
May Institute is an award-winning nonprofit organization with 65 years of experience in serving children and adults with autism spectrum disorder (ASD) and other developmental disabilities, brain injury and neurobehavioral disorders, and other special needs. For more information, call 800-778-7601.