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Health, Treatments & Nutrition for Children with Autism

Posted on January 4, 2019 by All In

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Therapies and Treatments

 

With a wide range of treatments and therapies available for autism comes another problem: they come in many different names and acronyms, making it confusing and difficult for parents to identify the right ones for their child. While it may be overwhelming at first, it is important to note that every child’s case is unique, and so are their needs and rate of growth.

 

In order to decide on a treatment option, it is necessary to first understand the challenges that your child is facing. Communicating with your therapist is also key, as therapists often are the first line of defense when it comes to treatments.

 

While one treatment may work for one child, it may not work for another. It is important to also review treatment through published research, to determine the effectiveness of various treatments as proven medically.

 

In this section, we share with you existingtreatments and support strategies available for children with autism.

 

Intensive Treatment that Tackle Core Symptoms

 

Applied Behavior Analysis (ABA)

ABA helps children with autism pick up skills and discourages negative behaviors at the same time. Each skill is broken down into small steps which are taught using prompts. Each time the child achieves the desired outcome, he/she is given positive reinforcement, such as verbal praise or candy. As the child successfully masters each small step, the step is gradually eliminated as they practice the skill. ABA intervention is tailored to each child’s interests, preferences, skills and needs. The ABA program will also change as the child develops, as his/her needs changes. Here is a list of the different ABA programmes:

  • Discrete trial training (DTT) uses simple lessons and positive reinforcement. It involves intensive learning of a particular behaviour called a “drill” – a kind of repetition. The child is tasked to complete a task many times in the same way, to master a skill. This repetition approach also helps to strengthen long-term memory.
  • Pivotal response training (PRT) focuses on developing motivation. It relies on naturally occurring teaching opportunities. Four pivotal areas have been identified: (a) motivation, (b) child self-initiations, (c) self-management, and (d) responsiveness to multiple cues.
  • Early intensive behavioral intervention (EIBI) is best for children under age 5. Many studies have shown that early intervention helps children with autism to perform better than their peers.
  • Verbal behavior intervention (VBI) focuses on language skills, designed to motivate a child to learn a language by associating a word to its meaning.

 

Although there are different types of ABA, all of them follow these three processes:

  • An antecedent: A verbal/physical stimulus e.g. a command or request. This may come from the environment or from another person.
  • A resulting behavior: The subject’s response or lack of response to the stimulant in the antecedent process above.
  • A consequence (which depends on the behavior): The consequence can include positive reinforcement of the desired behavior or no reaction for incorrect responses.

 

Treatment and Education of Autistic and Related Communication-handicapped Children (TEACCH)

This treatment uses visual cues such as picture cards to help the child easily understand daily activities such as getting dressed, and as a result, respond appropriately. Information is broken down into smaller steps so he can learn it easily.

 

Developmental, Individual Differences, Relationship-Based Approach (DIR)

Also known as Floortime, DIR is a completely child-led approach, where the adult follows the child to objects or destinations that has caught his/her interest. This approach aims to enter the child’s world so as to provide emotional connection and to share his/her enjoyment and frustrations.

 

Relationship Development Intervention (RDI)

The RDI is a behavioral treatment that aims to help individuals with autism foster personal relationships.

It focuses on six goals:

  1. Emotional Referencing: The ability to learn from emotions and understand experiences of others;
  2. Social Coordination: The ability to control behavior in order to participate in relationships appropriately;
  3. Declarative Language: Self-expression through language and non-verbal cues;
  4. Flexible Thinking: The ability to adapt accordingly;
  5. Relational Information Processing: The ability to put things in context;
  6. Foresight and Hindsight: The ability to anticipate future possibilities based on past experiences.

 

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Support Strategies for Symptoms Associated with Autism

 

The Picture Exchange Communication System (PECS)

This is also a visual-based intervention, but it uses symbols instead of picture cards. It is best used for children with little or no verbal ability to communicate using pictures. The PECS program is done by teaching the child to exchange a picture for an object. The child then slowly learns to use these pictures and symbols to form sentences.

 

Speech & Language Therapy (SLT)

SLT is designed to help a child with his speech and targeted at the social value of language. The therapy differs from children to children, depending on their aptitude for the spoken language. The goal may be to master the language or to learn signs and gestures to communicate.

 

Occupational Therapy (OT)

OT aims to help the child gain independence and participate in activities. Some skills that OT aims to foster include daily living activities such as dressing and brushing of teeth, motor skills such as writing or cutting with scissors, awareness of body in relation with others and visual skills such as reading.

 

 Sensory Integration Therapy (SI)

SI Therapy is used to help identify disruptions affecting a child’s brain processes such as touch, smell, sight, movement and sound. It is usually used together with the Occupational Therapy (OT). SI does not teach higher-level skills, but is used to enhance the child’s senses, so that he/she can be more receptive to acquiring higher-level skills. SI therapy may include equipment such as slides, trampolines and swings.

 

Physical Therapy (PT)

Focuses on problems with movement, targeting motor skills such as running, walking, jumping and sitting. Once a child’s movement challenges are identified, physical therapists design activities that target specifically at those identified areas. Examples of PT include exercises and assisted movement.

 

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Public and Private Medical Support Available in Singapore

 

In the table below, we have listed some of the available centres in Singapore which provide medical support for autism.

You may also want to read our article on assessing service providers to guide you as you decide on a suitable centre for your child’s therapy.

 

ClinicTherapies ProvidedAddressNotes
Applied Behaviour Consultants Singapore

94236248
admin@abccentersingapore.com
ABAPhoenix Park Office Campus
318 Tanglin Road Unit 01-57 to 59 S(247979)
3 Board Certified Behaviour Analysts (BCBA’s) on site
Autism Recovery Network

63488005
info@autismrecovery.sg
ABA, VBI458A Joo Chiat Road
S(427671)
Places emphasis on VBI, instead of being an adjunct to ABA
Autism Partnership

64633095
josephinek@autismpartnershipsg.com
ABA491B River Valley Road #05-01/02
S(248373)
Places emphasis on research-based studies
AutismSTEP

64569950
info@autismstep.com
ABA, CBT, SLT9 Temasek Boulevard #29-01
Suntec Tower 2
S(038989)
Couples ABA with CBT
Kaleidoscope

64688991 / 64688039
OT, SLT, Creative Therapy, Psychomotor Therapy#07-05/06, The Grandstand
200 Turf Club Road
S(287994)
Offers Psychomotor Therapy (focuses on developing a child's motor skills through movement and play) and Creative Therapy (helps children with self-expression and motor skills as an alternative to counselling)
Lazarus

91764837
ABA272 Upper Bukit Timah Road #03-13
S(588212)
Focuses on ABA solely as this method has supporting scientific evidence
Olive Tree

62525200
SLT, OT, Music Therapy and others179A Thomson Road
2nd Floor Goldhill Shopping Center
S(307626)
Offers a wide variety of programmes, including social skills, school readiness programme, lifeskills programme
REACH

98587160
enquiries@reachtherapy.com
RDI1 Scotts Rd #24-10
Shaw Centre
S(288208)
Focuses on the RDI programme
Singapore Brain Development Centre

62884123 / 82820202
enquiry@brain.com.sg
SI and othersNovena Goldhill Plaza #01-11, #01-49 Goldhill Podium
S(903388)
Focuses on cognitive skills, listening skills and neuro-feedback
Autism Services, Neurobehavioural Clinic (Child), Child Guidance Clinic, Sunrise

6389 2200
imh_appt@imh.com.sg
Pharmacological Management, Intervention ProgrammesInstitute of Mental Health

Buangkok Green Medical Park,
10 Buangkok View, Singapore 539747
Provides evidence-based intervention programmes for children and adolescents with Autism Spectrum Disorders with co-morbid mental health disorders, such as Attention Deficit, Hyperactivity/Impulsivity, Anxiety, Depression, Obsessive-Compulsive Disorder, Tics Disorders and difficulties with emotional regulation
Autism Services, Neurobehavioural Clinic (Child), Child Guidance Clinic, HPB

6389 2200
imh_appt@imh.com.sg
Pharmacological Management, Intervention ProgrammesHealth Promotion Board Building

3 Second Hospital Avenue,
#03-01,
Singapore 168937
As above
thi!nk

68365536
info@think-psych.com
ABA, CBT, PECS123 Penang Road #03-13 Regency House Singapore 238465Psychological and counselling service that takes a developmental approach to behaviour management and intervention; Customised programme
Therapy Alliance

93289612
admin@therapyalliance.com.sg
SLT, OT, Art Therapy, Music Therapy60, Paya Lebar Road, #10-35
Paya Lebar Square
S(409051)
Set up by parents of a child with autism who put together a team of specialist therapists for SLT, OT and psychological services

 

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Nutrition Tips

 

Children with autism may face dietary limitations, which may result in nutritional deficiencies and cause weight loss, malnutrition and inadequate growth. They are often mild at the onset. The reasons for this challenge, specifically selectiveness in eating or unwillingness to try new foods, may stem from compulsive behaviors or motor and sensory challenges that restrict them from eating a variety of foods. For example, they may prefer smoother foodstuff because they have difficulty chewing and swallowing tougher food.

 

Parents may need to learn to manage this challenging behavior, instead of enabling them which may result in more severe feeding problems. Here are some ways to enforce good feeding habits in children with autism as taken from the Interactive Autism Network:

  • Try one mouthful of food every meal.
  • Make the food more palatable by adding condiments that the child likes e.g. ketchup or honey.
  • Change the texture of the food by chopping it into smaller pieces or turn them into puree.
  • Guide the spoonful of food to the child’s mouth by putting your hands over the child’s hands and provide positive reinforcement when the child accepts the food.
  • Remove reinforcement for undesirable behaviors. For example, do not attend to them if they are throwing a tantrum and rejecting the new food.

 

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Health-Related Myths About Autism

The lack of understanding about autism may cause misinformation about the condition. We hope to shed light by addressing the most common health-related misconceptions below:

 

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Additional Resources

 

National Autism Center

In depth parental guide to the list of treatment available, and a review of existing research and literature on the effectiveness of each treatment on children with autism

 

Wiley Online Library: Autism Research

A database of published studies by researchers.

 

Autism Resource Center

A non-profit organization in Singapore that caters to individuals with autism.

 

Kiasu Parents Forum

Forum for parents to discuss and seek firsthand information on autism in Singapore

 

TEACCH Autism Program

More information about TEACCH

 

RDIConnect

More information about RDI

 

SpecialCare Autism Insurance

Insurance for children with autism

 

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