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  • Print publication year: 2015
  • Online publication date: January 2018

11 - Psychological treatment of autism spectrum disorder

from Part 3 - Autism spectrum disorder
    • By Jo-Ann Reitzel, Clinical Director, Psychologist and Assistant Professor, McMaster Children's Hospital and McMaster University, Jane Summers, Clinical Supervisor, Psychologist and Assistant Professor, McMaster Children's Hospital and McMaster University, Irene Drmic, Postdoctoral Fellow, Holland Bloorview Kids Rehabilitation Hospital and the Hospital for Sick Children, Toronto, Ontario, Canada
  • Edited by Marc Woodbury-Smith
  • Publisher: Royal College of Psychiatrists
  • pp 201-236

Summary

In the past 60 years there has been significant progress in the identification, treatment and understanding of autism spectrum disorder (ASD) as a severe neurodevelopmental disorder (Rutter, 2005). The prevalence rates have increased dramatically over time and are currently 1 in 68 according to the US Centers for Disease Control and Prevention (Developmental Disabilities Monitoring Network Surveillance Year 2010 Principal Investigators, 2014). In DSM-IV-TR (American Psychiatric Association, 2000), ASD diagnoses consisted of four separate disorders that fell under the broad umbrella term ‘pervasive developmental disorder’. In DSM-5 (American Psychiatric Association, 2013), ASD is one disorder of varying degrees of defined severity that may coexist with other disorders, such as attention-deficit hyperactivity disorder and intellectual disability.

The core symptoms of ASD include social-communication deficits, such as difficulties in reciprocal social interactions, and restrictive and repetitive interests. The severity of social-communication difficulties and restrictive and repetitive interests may fluctuate from day to day, and may vary with age. There can also be a range of associated complex issues that may or may not fluctuate over the course of the life span. These include intellectual and learning difficulties, as well as social, emotional, behavioural and mental health problems such as depression and anxiety. Furthermore, ASD often affects the family, school and community.

There is no known cure or medication that modifies the core symptoms of ASD; however, with careful treatment planning and monitoring, problems arising from the core features of ASD and related difficulties can be managed and improved. Evidence-based behavioural and psychological therapies can modify and improve symptoms of ASD and problems associated with ASD (Maglione et al, 2012; Anagnostou et al, 2014). Psycho-social supports, psycho-education and training can be incorporated into treatment plans, depending on the strengths and needs of the family, as well as their levels stress, and their values and culture. In addition to intervention and psychosocial supports, some persons with ASD require assistance and supervision to help them and their family and carers address problems. The amount of support needed may vary. Even though there has been a steady increase in the awareness of the need for assistance, services and treatments, no one service or treatment package has been found to suit all.