Post by Dr. Bill Z on Dec 4, 2013 2:48:13 GMT
Many have asked me about all the different treatments for Autism and why some work and why some do not.
The answer is that Autism has so many different causes that result in a stereotypical set of behaviors. This point became so clear when I saw my first patient with Fragile X. This child, with a known diagnosis, had the same mannerisms as my son including the "I have to go to the bathroom" mantra every time he got stressed. When you realize that Fragile X results in a lack of connectivity in the brain due to poor growth of neuronal connections, then it becomes clear why the child has certain behaviors. When we don't know, we continue to look and try different things. Who is to say one type of therapy or treatment will work and one will not. It is key to try to find a root cause, however, it is unfortunately uncommon that a cause is found and the guessing continues. So why do some treatments work without knowing the cause? You don't need to know the cause to know that there is a lack of connectivity. The goal is to help the brain find connection in a sea of disconnection. In patients that have suffered a stroke this takes place by continued attempts at movement and even patterning the movements if the patient can not perform the movement on their own. Therefore some of the best treatments are "patterning the movements" or behaviors that are lacking. This may be done by acting out the behavior for the child or showing the child a video of someone else acting out the behavior. There are many accepted methods such as applied behavior analysis (ABA) that have been carefully studied and shown to provide results. The basis of ABA training is rewarding desired behaviors and suppressing unwanted behaviors. I have personally seen many variations and inventive enhancements of this method that are tailored to the child. In some cases the child is given an opportunity to lead the training. Sometimes it has been found very helpful for the child to see the behavior exhibited either recorded or played out by a family member or therapist. Although this may seem foreign, the disorder is unlike anything that is truly and fully understood. We must keep in mind that these special kids often harbor special talents and understandings that we are not always aware of.
The answer is that Autism has so many different causes that result in a stereotypical set of behaviors. This point became so clear when I saw my first patient with Fragile X. This child, with a known diagnosis, had the same mannerisms as my son including the "I have to go to the bathroom" mantra every time he got stressed. When you realize that Fragile X results in a lack of connectivity in the brain due to poor growth of neuronal connections, then it becomes clear why the child has certain behaviors. When we don't know, we continue to look and try different things. Who is to say one type of therapy or treatment will work and one will not. It is key to try to find a root cause, however, it is unfortunately uncommon that a cause is found and the guessing continues. So why do some treatments work without knowing the cause? You don't need to know the cause to know that there is a lack of connectivity. The goal is to help the brain find connection in a sea of disconnection. In patients that have suffered a stroke this takes place by continued attempts at movement and even patterning the movements if the patient can not perform the movement on their own. Therefore some of the best treatments are "patterning the movements" or behaviors that are lacking. This may be done by acting out the behavior for the child or showing the child a video of someone else acting out the behavior. There are many accepted methods such as applied behavior analysis (ABA) that have been carefully studied and shown to provide results. The basis of ABA training is rewarding desired behaviors and suppressing unwanted behaviors. I have personally seen many variations and inventive enhancements of this method that are tailored to the child. In some cases the child is given an opportunity to lead the training. Sometimes it has been found very helpful for the child to see the behavior exhibited either recorded or played out by a family member or therapist. Although this may seem foreign, the disorder is unlike anything that is truly and fully understood. We must keep in mind that these special kids often harbor special talents and understandings that we are not always aware of.