RAZIA NISSAR
Counseling Psychologist and Registered Behavioral Therapist (USA)


The world commemorated World Autism Awareness Day on 2 April with the Member States of the United Nations once again reiterating their commitment to take measures to raise awareness about people with autism. Despite the passage of 15 years since it was adopted by the UN General Assembly in 2007, awareness of autism remains confined largely to the medical community, and among those involved in the well-being of the patient, including parents, relatives and caregivers.

Autism rights advocates have long contested the naming of this day as World Autism Awareness Day, claiming that the emphasis on raising awareness in society tends to perpetuate discrimination against autistic people, and help feed the perceived notion that people suffering from this disorder are different from ‘normal’ people. The proponents of this view would rather have the day renamed as ‘World Autism Acceptance Day’, so as to encourage acceptance of autism and contribute to lessening prevailing prejudices against this lifelong developmental disorder, rather than merely raising awareness about it.

Irrespective of whether the UN day is named ‘Autism Awareness’, or ‘Autism Acceptance’, what is more important is for society to have more empathy and understanding on this debilitating disorder. Here we look into various aspects of autism, or autism spectrum disorder (ASD) as it is often referred to, and take a more in-depth look at what is now a widely recommended therapy to ameliorate this disability.

Autism is a lifelong developmental disorder that includes differences or challenges in developing social communication skills, thinking, speech and intellectual ability, as well as fine and gross motor skills — skills that most of us do without giving it a second thought, such as standing, running, eating or brushing one’s teeth.

The symptoms of autism vary widely in type and severity and are usually seen in early childhood. Some common symptoms include repetitive movement, anxiety and atypical responses to sensory input like sound, smell or taste.

Early signs and symptoms of autism include:

  • No babbling or pointing by age 1
  • No single words by 16 months or two-word phrases by age 2
  • No response to their name
  • Loss of language and social skills
  • Poor eye contact
  • Excessive lining up of toys or objects
  • No smiling or social responsiveness
  • Unusual over or under responsiveness to sensory input such as touch, smell, taste, noise

It can be very tough for a parent to determine whether behaviors are symptoms of autism or just ordinary variations in development. How much is the lining up of toys excessive? How much desire for repetition is normal? There is also the possibility that some developmental differences are caused by non-autism-related issues. For example, not responding to a name could very well be a symptom of hearing impairment. Late talking could be due to aphasia or apraxia of speech.

To properly diagnose autism, professionals like developmental pediatricians and clinical psychologists use a set of specific tests that actually measure a child’s symptoms. They may also decide that the child should undergo further testing for hearing impairment or speech issues that are unrelated to autism.

Autism cannot be cured, so the goal is to help a person gain skills and better navigate daily life, including school, work, relationships etc. Every person with an autism spectrum disorder (ASD) has different needs, so the treatment options will always be individual. Treatments might include, but are certainly not limited to, behavioral therapy, occupational therapy and speech therapy.

Applied Behavior Analysis (ABA) is a relatively new type of therapy that teaches skills and proper behavior through reinforcement. It is commonly described as the gold standard for autism treatment and involves reinforcing desired behavior while discouraging unwanted behavior. To do this, therapists use rewards to encourage communication, language, and other skills.
In ABA, the therapist is not aiming to cure autism but to help parents empower their children to live fully and independently. ABA techniques not only focus on behavior but social and emotional skills as well, with the focus on teaching desirable behavior while reducing or extinguishing undesirable ones. For example, ABA may be used in autism to reduce tantrums, teach a child to sit quietly or use words to make requests. It can also be used to reward a child for simple and complex skills like brushing their teeth correctly or sharing a toy with a friend.

Some ways that ABA therapy can impact an individual’s life includes;

  • Acquiring and practicing social skills
  • Decreasing problem behaviors
  • Developing memory and cognitive abilities
  • Improving emotional connection with other people
  • Improving language and communication skills
  • Improving attention and focus
  • Learning daily living skills
  • Managing feelings of aggression and anxiety

ABA therapy has become a widely used treatment approach in the treatment of autism and other conditions. It has been linked to improvements in key areas including language, social skills and adaptive skills.

Studies have shown that long-term comprehensive ABA intervention treatment could help children with autism improve their daily living and real-life skills, as well as social skills, in addition to language development and cognitive skills. These interventions could also help reduce aggression and anxiety to children and adolescents.

Assessment is the first step of ABA therapy. During this stage, the child or individual will meet with a therapist who observes, provides demands, and asks questions about strengths, weaknesses, needs and goals. Direct and indirect assessments will be implemented to come up with a holistic perspective that will identify the gaps that are needed to be worked on about the child. From this information, the professional will develop an individualized treatment plan.

Skills acquisition and behavior reduction plans use different techniques to work towards the individual goals. Treatment sessions can sometimes be as short as an hour, but they often last for several hours at a time based on the prescription of a certified ABA professional such as Board Certified Behavior Analyst (BCBA).

Therapists may use different methods of ABA in treating patients. Some examples of ABA strategies include:

Discrete Trial Training (DTT): Also known as Lovaas Program, it breaks down lessons into simple tasks. Each task is rewarded with positive reinforcement for correct behavior. Three components of this process include:

An instruction; The response; and a corresponding Consequence

Early Intensive Behavioral Intervention (EIBI): This approach may be used in young children to teach social adaptive, communication, and functional skills. It is usually highly individualized, intensive, and comprehensive.

Early Start Denver Model (ESDM): This technique is based on ABA and is often used for children with autism between the age of 48 months to age 12. It utilizes play activities to help foster cognitive, social and language skills.

Natural Environment Teaching: After people have acquired skills through DTT, they then begin learning and practicing those skills in a more national environment. For example, a child may learn a specific skill and then begin practicing it at home or in school.

Caregiver Training: Involves offering support and training to parents and other caregivers and family members. Therapists teach parents and family members skills and strategies that will help maintain desirable behavior in the home, school, and community settings.

ABA Therapy can be used for a variety of condition including:

  • Anxiety disorders
  • Attention difficulty hyperactivity disorder (ADHD)
  • Autism spectrum disorder
  • Borderline personality disorder (BPD)
  • Developmental disorder
  • Obsessive-compulsive disorder (OCD)
  • Post-Traumatic stress disorder (PTSD)

A wide variety of activities are being pushed across the world to promote care, welfare, and inclusivity for children and adults with autism. By lighting it up blue on each World Autism Day, we can spark a ray of hope and promote awareness and acceptance of society towards individuals with autism.


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