Care and intervention methods for autistic children

Because autism is a pervasive developmental disorder, it is not limited to a specific area, but represents a comprehensive disorder in all aspects of human psychological life. While doctors have not yet found an effective treatment, psychologists, educators, physical therapists, speech therapists, psychomotor therapists, etc. have participated in the treatment and have brought about many encouraging results.

The following are some methods that have been applied in the treatment of autistic children in the world and in Vietnam.

I. Medical - Biological Methods

1. Use of pharmaceutical chemicals

The first thing to say is that medication is not intended to cure autism because there is no specific medication, medication is only used to treat symptoms. Autism syndrome includes many different symptoms and these symptoms vary from child to child. When a child is given medication, the goal is to treat one or more related symptoms. Mainly when using medication, doctors aim to treat and reduce the symptoms: hyperactivity, inattention, stereotyped behavior, self-destructive behavior, aggression, excessive anxiety, sullenness, difficulty sleeping. In addition, vitamin B6 and magnesium are also used in the treatment of autistic children...

However, there is currently no specific medication for autistic children. Medications are only to support the treatment of individual symptoms of autism.

2. Detoxify the system

Based on the view that children with autism are caused by mercury poisoning and by the method of eliminating the system to eliminate mercury. This method is considered effective based on the treatment experiments of some groups of doctors in the US. However, up to now, this method is still not considered an orthodox method, because the mechanism of disease as well as the mechanism of curing the disease by the method of mercury detoxification has not been proven.

3. Diet

There is a hypothesis that autistic children are caused by disorders of some endocrine glands in the body, lack of vitamins, and allergies to some substances introduced into the body from the outside. According to some authors of this hypothesis, autistic children need to have the chemical composition of the substances supplied to the body strictly controlled. Therefore, dieting is the top measure of this method. The substances that the authors propose are: milk and dairy products, sugar, flour, etc.

This is still considered a hypothesis because there is no scientific work that has been definitively confirmed on this issue.

4. Physical therapy

This method aims to help children activate some motor organs that are not active or are poorly active in autistic children. In daily activities, many of the children's motor organs function normally, but autistic children do not want to move those organs due to autism; physical therapy is the best way to help children activate these organs. The motor activities that children often encounter difficulties with are: cross-movement of the legs and arms, movement of the speech organs, fine motor movements of the hands, and some children have difficulty with visual movements when perceiving objects and phenomena in the world.

Physical therapy also helps eliminate typical stereotyped behaviors of autistic children, instead enhancing positive behaviors that are appropriate to the situation and social activities of autistic children themselves.

5. Acupressure

According to the definition of the Japanese Ministry of Health, acupressure is a technique using the thumb, other fingers and palm, with the help of any instrument (mechanical or other) to apply pressure on the patient's skin. The purpose is to correct dysfunctions, create excitement, maintain health and treat some specific diseases.

This method is widely applied to autistic children in Japan, China, Korea, Taiwan, Hong Kong and Vietnam. Some parents believe that when autistic children are combined with many methods, including acupuncture and acupressure, they make clear progress, they can say some words and cooperate more with adults, and play more with other children. This is the most difficult method to scientifically prove in the group of medical and biological methods. Therefore, this method has not been scientifically proven.

6. Nerofeedback

Neurofeedback (NFB), also known as neurotherapy, neurobiofeedback or electroencephalographic biofeedback (EEGBF) EEG is a therapeutic technique that provides immediate feedback on brainwave activity, as measured by electrodes on the scalp, typically displayed on a video screen. The goal is to allow conscious control of brainwave activity. If brain activity changes in the direction desired by the clinician, a positive "reward" is given to the individual, and if brainwave activity is negative, either negative feedback or no feedback is given (depending on the protocol). Rewards can be as simple as a change in the pitch of a sound or the complexity of a certain pattern of activity in a video game feature. The experience can be called a controlled regulation of bodily states.

This method can actively support when wanting autistic children to interact with stimulation in treatment.

7. Hyperbaric oxygen (HBO)

HBO is a medical treatment in which the patient is placed in an environment of almost 100% pure oxygen at a pressure greater than 1.4 atmospheres. In addition to breathing, the amount of oxygen permeating the skin and dissolved in the plasma will increase 22 - 30 times compared to the oxygen in normal human blood. Hyperbaric oxygen has both therapeutic and nursing effects. HBO has two effects: reducing the size of air bubbles found in vascular occlusion diseases such as decompression sickness, gangrene or increasing oxygen in all tissues in the body. If the patient is given pure oxygen at a pressure of 3 atmospheres, the amount of oxygen dissolved in the blood will be more than 20 times greater than normal.

This method is being used to treat autistic children quite commonly in Ho Chi Minh City.

8. Stem cell therapy

Stem cells are typically very early stage cells that have the ability to divide to create more stem cells, or under the right conditions can turn into other specialized cell types such as nerve, muscle, skin, liver, etc. Stem cells are the body's master cells, with the potential to become many different types of tissue. Stem cell storage opens up new ways to repair and replace diseased or damaged tissues in the body.

Some believe that autism is caused by a defect in a certain genetic system, and the authors of this theory hope that when the gene map is completely decoded, it will be the only chance of successfully treating autism.

9. Occupational therapy

Gross motor

It is an easy and simple form of therapy, with the purpose of enhancing the ability to activate behaviors, improve physical strength, reinforce positive behaviors, reduce negative behaviors, improve the ability to concentrate, and is a necessary stage before implementing a special education program.

. Exercise

This program creates imitation, peer interaction, social awareness, physical fitness, and good support for special education.

In addition, other methods such as massage, acupuncture... are also used in the treatment of autistic children.

II. Psychological and Educational Methods

1. Psychoanalytic therapy

This method mainly involves playing and talking, aiming to help children and their families release the stress accumulated in the past, and restructure the child's personality. In psychoanalytic therapy, it will help improve the family atmosphere, help everyone understand reality and accept reality better, and everyone will be happier in communicating and caring for children. This helps autistic children improve communication situations and form mutual contact. Encourage children to cooperate in all family, school and social activities; from there, the child's autism condition will gradually improve.

2. Psychomotor method

A method to stimulate children to activate their behavior. The dominant view of the method is: The movement (activity) of the body will lead to the agility of the nervous system and affect psychological development, the more the movement of the body increases, the more the movement of the mind will increase; the development of movement will gradually develop the mind. At the same time, the development of the mind will lead to the development of movement. This method helps children with psychological difficulties to be able to coordinate scattered mental functions, directing children to psychological activities that are meaningful for the child himself and for those around him. The child's ability to cooperate is increased when applying the method.

3. Speech therapy and speech therapy methods:

This is the most common intervention method for autistic children. Autistic children have difficulty communicating; this is greatly influenced by language and speech. According to speech therapists, if autistic children can speak, it will greatly affect their future development. Speech therapy is a particularly important part of therapy. Therapy is usually applied to each child individually, taking place from one to two weeks at a time and sometimes lasting for many years. The goals and methods are designed based on the child's language ability.

4. Role-playing games

This is a situational acting, the actor must imagine himself as another character, expressing sadness, anger, happiness... as prescribed by the role. For example: practicing being an MC, musician, police officer, teacher, doctor... Role-playing games demonstrate a high level of cognitive development, if children do this method well, their integration opportunities are almost normal, and they can participate well in social life and the community.

5. Special education methods

In most countries around the world today, special education for autistic children is a common practice. Because autistic children have developmental disorders, they have many disabilities: intelligence, communication, emotions, feelings, language, self-service, etc. Through education, children will understand and have social integration skills, enhance communication skills, help perceive surrounding objects and phenomena, understand and care about the emotional behavior of others, and increase the ability to integrate into the community.

In countries with developed education systems, autistic children are often educated earlier than normal children. The current trend is to educate autistic children immediately after diagnosis. Education depends on the child's cognitive and behavioral abilities; goals, programs and methods are all designed based on the child's intellectual level.

6. Therapy through arts such as:

- Music therapy

Like other current therapies, music therapy cannot cure autism. The goal of music therapy is to reduce adverse behaviors and enhance social interactions through music.

- Drawing and Sculpting

This is a creative activity, easy to do, not too concerned about the right or wrong of the product, promoting the child's ability to freely imagine. Through drawing and modeling, children can improve their fine motor skills, hand-eye coordination, helping them gradually master the fine motor skills in learning to write and other delicate operations. In addition, this activity helps children practice the ability to concentrate, mastering behaviors consciously.

- Poetry, nursery rhyme

Because autistic children have the ability to remember mechanically rather than remembering meaning, teaching them to read through nursery rhymes is valuable. With the rhythm, melody, rhyme, simple, bright and easy-to-understand words of nursery rhymes, it will help children absorb more easily. This is a form of free learning without pressure.

Drawing and sculpting help improve fine motor skills in autistic children. Photo: Internet

7. Group method:

Autistic children have serious deficits in communication and social interaction, group methods help children integrate with children of the same age with the aim of stimulating children to interact with other members. Through group play, children understand the behaviors and rules of the group. The activities of the members are the factors that stimulate children to perceive and imitate, the verbal and non-verbal messages transmitted in the group affect each member, attracting members to participate in activities. Autism is improved when autistic children gradually play and interact with other members in the group.

8. Labor therapy method:

Occupational therapy guides children to perform daily tasks at home or in the place where they are raised. Usually, children help people do tasks that are suitable for their abilities and health. Through this activity, children can understand exactly the objects and phenomena of the natural environment, which has great significance for the future of children when they enter an independent life, taking care of themselves, when there is no longer special care services like when they were young.

9. Hydrotherapy

Water is very close to humans, in addition to the function of nourishing the body, water also helps people in psychosocial activities. Most children love water and play with water, through hydrotherapy children will have good awareness of body sensations, skin sensations, balance, perception... Water is one of the materials that stimulates the perception of children in general and autistic children in particular.

10. Therapeutic picnics

This is an activity to change the environment, push children into a new environment, push the field of stimulation, increase curiosity to help collect information. In addition, this activity also clears up boring and repetitive activities and learning in a familiar environment. When going on a picnic, with typical activities, children can maximize all senses working at the same time, helping to develop awareness of the world and body sensations.

11. Sensory therapy

According to experts who study autism, most autistic children have more or less sensory disorders depending on different levels and in different senses. Some children only have disorders in certain types of senses, but it can also be in all senses. Disorders are common at two extremes: lack of sensitivity or oversensitivity, or too low or too high sensory threshold. Children can also lack sensitivity in one sense but have increased sensitivity in another. Sometimes, a child's sensitivity changes in the same sense at different times or in different circumstances.

12. Therapy animals

Also a means of therapy like objects, images or learning tools..., in the therapy of autistic children, therapeutic animals are qualitatively different from the above tools. The therapeutic tools are inanimate objects that are passively affected by humans, while animals have natural reactions that often do not follow human instructions. When humans interact with animals, it is a two-way interaction, animals can obey human wishes or can also disobey, this interaction takes place in a much richer direction when humans interact with objects. In the use of animals for therapy, not only do humans stimulate animals, but conversely, animals stimulate humans.

Therefore, using animals in therapy for autistic children with animal interaction helps children to be more open, limiting the fixation in the autistic state.

13. Psychological counseling

To provide parents with information about autistic children: intervention methods, care and education, care services, future responses, especially current updated information about autistic children. Through counseling, parents can feel comfortable, accept their child's condition, and help them choose appropriate services and treatment methods.

14. Therapeutic games

Playing is a major activity in the development of children's personality. If children lack playing activities or play activities do not take place according to the child's development rules, it can cause abnormal development in their psychological life. Playing helps develop cognition, perfect sensory organs, form social relationships... Autistic children, like other normal children, need playing activities.

15. Time segmentation method

With this method, children will have access to real objects and activities in daily life. The people who carry out this method are the ones who raise and care for the children. Every detail of the guidance work is carried out directly in the daily living environment. The materials for guidance are the living objects of the family or a facility for treating autistic children. The instructor will have to divide the time and daily activities to suit the personality and ability of each child. Dividing time and dividing each activity is the basic characteristic of this method.

16. Computer

Playing on the computer is the forte of autistic children, autistic children may not like many things in life but most autistic children like computers. Through visual stimulation, sound, color, sentence structure... to attract attention. Usually, through computers, children are stimulated to learn based on intellectual development software: learning math, learning letters, colors, shapes, training memory, imagination, reflexes, coping with situations... to improve children's cognitive abilities.

17. ABA method:

ABA is an acronym for Applied Behavior Analysis. This is the most popular method in treating autistic children. It is an application program to improve many aspects of autistic children: cognition, social relationships, language, self-service... These aspects of autistic children will be examined and observed very carefully; on that basis, the behaviorist will build a treatment strategy for each child (this method cannot be applied to many children at the same time), proceed to divide the analysis and the behaviors that the child needs to perform in the program; the behavior will be divided into small parts to make it easier to perform.

18. PECS method

PECS is an acronym for four words in English: Picture Exchange Communication System. Picture Exchange Communication System is a very important tool in autism intervention. In PECS, spoken language is replaced by the use of picture cards for communication. When autistic children do not have language or have limited language, pictures will help them request others and carry out other people's requests. Pictures at this time are the intermediary to convey information that takes place in the interactive relationship between autistic children and adults.

19. TEACCH method

TEACCH stands for Treatment Education Autism Children Communication Handicaps. TEACCH is an educational and teaching method for autistic children and those who have disorders in expressing thoughts and emotions and creating relationships with others. The areas that TEACCH focuses on when teaching autistic children are imitation, perception, gross motor skills, fine motor skills, eye-hand coordination, understanding skills, language skills, independence skills, and social skills.

20. FLOORTIME method

Floortime is applied right in the child's normal life, the instructor flexibly responds to developments that occur in the current relationship, motivating the child to actively participate in therapeutic activities.

Floortime recognises that each child has a unique set of challenges and therefore the intervention must also be unique. The Floortime approach focuses on helping children master relationship, communication and thinking skills.

21. COMPC (communication picture) method

This method first appeared in Australia, aiming to teach children how to communicate through images by taking pictures of children's interests, familiar images, and landscapes in places they have been. With pictures that children like and familiar objects will help children learn better.

22. PCS (picture communication symbols) method

This is a method introduced by an American named Johnson in 1981 with the aim of teaching children to understand communication symbols commonly encountered in daily life. This method is mainly applied to severely autistic children who are unable to speak.

The above are quite typical methods that have been and are being applied to autistic children. While science has not yet found the cause of autism in children and at the same time has not been able to come up with a single treatment method, the above methods are still considered a comprehensive method when intervening for autistic children.

TP (synthesis)