With the rise in Autism Spectrum Disorders for children aged 7 - 17, (the CDC now officially pegs the number at 1 in 68, although their recent studies put the numbers as high as 1 in 45), there has also been significant growth and development in treatment and intervention options within family-choice private programming.
The official working definition of Autism Spectrum Disorder can be found in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5), (reprinted with permission on Autism Speaks website). The updated DSM-5 has officially dropped both Pervasive Developmental Disorder (PDD) and the Asperger’s designation, re-categorizing each under the Autism Spectrum Disorder umbrella, which is further designated by levels of severity (Level 1 “requires support,” Level 2 “requires substantial support,” and Level 3 “requires very substantial support”). For individuals with deficits in social communication, but whose symptoms do not meet the criteria for an Autism Spectrum Disorder, they may be evaluated for a social (pragmatic) communication disorder. While it’s certainly possible for a person to be diagnosed with only Autism Spectrum Disorder, it’s also not uncommon to see Anxiety, Depression, ADHD, and/or specific learning disabilities associated with an Autism diagnosis.
Because of the range of services needed for a student on the Autism Spectrum, and because there may (or may not) be associated emotional or behavioral challenges, there is also a range of programs to provide targeted support and intervention. Programs may include an ABA approach, a behavioral modification approach, cognitive-behavioral therapy (CBT), insight-based (psychodynamic) therapy, relationally based therapy, or simply a coaching model. Matching clients strengths, level of insight, intrinsic motivation for change, and their range of presenting issues with a program’s offerings is a key element in choosing an effective intervention.
Out-of-home interventions can be relatively short term, such as a wilderness therapy program, or a higher level of care like stabilization in an assessment center or hospital setting. These settings can often lead to longer term residential placements. A program may be designed, from the ground up, to work specifically with clients on the Autism Spectrum, or a program may work with a wider range of issues which may include Autism. There are speciality treatment programs that are generally clear about what Autism Level they work with best, and while the majority of programs on All Kinds of Therapy generally work only with Level 1 Autism (“requiring support”), there are also a number of programs which also work with Level 2 Autism (“requiring substantial support”).
What do you do as a parent? Ensuring that the program truly understands the unique presentation of Autism is important, as seemingly identical misbehaviors from an “autistic” or “neurotypical” client often originate from fundamentally different places, and as a result, require fundamentally different responses in order to promote behavioral, clinical, and pro-social growth and development. This includes understanding the unique pragmatic, sensory integration, and set-shifting support students on the spectrum may need, as well as providing mechanisms to help students who struggle with “black-and-white” thinking and other challenges with cognitive rigidity. In some programs this support comes entirely from the staff, while in other programs the social milieu and peer culture is an important element in the intervention.
Choosing the right intervention or support model for an adolescent or young adult with Autism Spectrum Disorder can be a daunting task, and many families choose to engage the support of an Educational or Therapeutic Consultant, who may also recommend a complete neuro-psych assessment in order to further their understanding of a client’s strengths and needs. These professionals can help families navigate the wide range of programming which is available, and help a family match a program’s specific supports and interventions with their loved one’s social, emotional and behavioral needs. Be sure to visit any program (residential or day) before you enroll your teen or young adult.
At the end of the day, “Once you have met a child with autism, you've met one child with autism,” said Marcia Rubinstein, MA, CEP (and Dr. Stephen Shore).
About the Author
Jake Weld holds a masters degree in education and has over twenty years of experience in traditional, LD, and therapeutic schools, adolescent and young adult programs, and conventional, wilderness, and residential settings. He has served as the Executive Director of a therapeutic boarding school, the Assistant Headmaster of a specialized LD boarding school, and as the Academic and Program Director of various schools and programs. He is currently the Director of Admissions and Business Development for Mansfield Hall, a specialized college support program in Burlington, VT, and Madison, WI.