Core Interventions for ASD are those developed
specifically as treatment for behaviors and symptoms
associated with ADS.
Related and additional therapies include those
therapies not exclusive to Autism, but may also be used
to treat many other disorders.
Given the communication problems inherent in ASD,
speech-language therapy plays an integral part in the
Speech Therapy can be provided in the home, school or
Speech Therapy is provided by a certified Speech-
Language Pathologist or an SLP assistant under the
supervision of a certified SLP.
Diane Sisk M.S. CCC-SLP, Mobile, AL
working with Grace on speech.
Children with ASD can present with communication skills
ranging from non-verbal to verbal communication.
Communication problems most associated with ASD
Perseveration (repetitive verbal and physical behaviors)
Echolalia (immediate and/or delayed “echoing” of
words, music, phrases or sentences)
Hyperlexia (precocious knowledge of letters/words or a
highly developed abilitiy to recognize words but without
Dactolalia (repetition of signs), pronoun reversals,
inappropriate responses to yes/no questions, and
difficulty with “wh” questions
Significant deficits in social skills and pragmatics
The Speech Pathologist will provide a comprehensive
diagnostic assessment including: receptive and
expressive language, articulation, oral motor skills,
feeding/swallowing, social skills and play skills,
pragmatics, fluency and vocal production.
Receptive Language – the understanding of spoken or
written language including naming objects, actions,
adjectives, prepositions, and people.
Expressive Language – the production of language
including sentence structure, verb tenses, regular and
irregular plurals, and length of utterance.
Articulation/phonology – includes developing speech
Oral-Motor Skills – includes improving the range, rate,
complexity, strength and coordination of oral motor
Feeding and Swallowing – includes ability to close lips,
manipulate food with tongue, chewing patterns, and
safe swallowing, and toleration of differences in
temperature, tastes, textures, smells and consistencies.
Social skills/play skills – includes appropriate social
language, ability to read facial expressions, ability to
understand social cues/body language, and play skills
such as sharing, turn-taking, and playing independently
and with others.
Pragmatics – the use of language in social context.
Cognition – the mental processes of knowing, including
awareness, perception, reasoning, and judgment.
Alternative or Augmentative Communication- the use of
any device, techniques, symbol system, or combination
of these to support or enhance communication skills.
Sign Language – use of ASL alone or paired with
Picture Exchange Communication System (PECS) – the
use of picture symbols to communicate wants and
needs. The student is taught to initiate communication
using these symbols and then skills are expanded to
the use of sentences. Many children who use PECS
later develop some verbal skills and move on to the use
of speech as the primary form of communication.
Communication Boards – developed with either
picutures, photos or real objects that the child points to
or removes from the board to communicate.
Other communication devices – designed to allow the
user to create longer messages. These devices can
also act as a universal remote which allows the user to
operate electronic devices in the environments such as
TV, lights, etc.
Total Communication – system that pairs simultaneous
production of speech with manual signs, augmentative
devices or symbol systems. The child is encourage to
use words and phrases that he/she is capable of and to
use the signs and symbols to communicate what too
difficult to produce verbally.
SPEECH THERAPY RESOURCES
Ohio’s Parent Guide to Autism Spectrum Disorders –
Ohio Speech-Language Association: www.oslha.org
Arkansas Speech Language
Speech and Hearing Association of Alabama:
“Writing and Developing Social Stories: Practical
Interventions in Autism” by Caroline Smith available at
Little Pilgrims Labeling DVD Series
Physical Therapists(PT) are specialists in sensorimotor
development, muscle and joint function, posture,
balance and coordination, and gait and functional
mobility. They are knowledgeable in the use of orthotic
and prosthetic devices and assistive technology.
PT’s identify movement problems and determine what
may be interfering with the ability to develop age-
appropriate gross motor skills.
PHYSICAL THERAPY CONTINUED
Physical Therapists help young children with ASD by
assisting them in walking, running, jumping, pedaling,
and catching. They also assist preschoolers and
school-aged children in becoming safe in their daily
environments, such as using stairs and climbing.
PT’s are very important in helping ASD children acquire
the skills necessary to play on playgrounds or
participate in physical education or sports.
Physical Therapy may work closely with the
occupational, sensory integration, or speech therapists.
Occupational Therapy focuses on an individual’s ability
to perform daily life tasks or occupations that give life
Performance areas include:
*activities of daily living (grooming, hygiene, dressing),
feeding, eating, socialization, functional communication
and functional mobility
*work and productive activities and home management
(meal preparation, shopping, or clothing care)
*play or leisure activities
Following an evaluation, OT intervention is targeted
towards those areas that are interfering with the child’s
ability to function.
Targeted tasks may include: handwriting, improving
hand-eye coordination, buttoning, tying shoes, getting
dressed, and eating.
Intervention with autistic children often includes a
sensory-integration approach. This focuses on
controlling sensory input during specific activities.
Sensory Integration will be discussed in more detail in
the next section.
The focus of OT in the school is upon educationally
relevant goals and associated with curriculum
OT in the schools requires consultative approach in
working with the entire educational team to ensure that
accommodations and interventions will be implemented
OT AREAS OF INTERVENTION
Fine-Motor control/written output –
fine-motor strengthening and coordination
specially lined paper,
use of keyboard,
extended time, shortened work load,
use of note-taker or adapted software programs.
Visual-Motor and Visual-Perceptual skills –
address the student’s ability to control eye movements
smoothly shift focus,
track objects across midline, and
perform the visual motor control needed to read text
Use of slant boards,
paper windows, and
guided and colored transparencies.
OT AREAS OF INTERVENTION
Postural Stability and Control – Occupational
Therapists may also help students in maintaining
efficient seating postures (dynamic seating with therapy
ball, camping pillow or a Move ‘n Sit Cushion.
Sensory Integration was first researched by A. Jean
Sensory Integration is a process used by the brain to
locate, sort and make sense out of incoming sensory
Ayres described sensory integration dysfunction as a
“traffic jam” in the brain. Some bits of sensory
information get “tied up in traffic” and certain parts of
the brain do not get the sensory input they need to
EXAMPLES OF SENSORY INTEGRATION
Extreme sensitivity to noise, touch smell, or taste
Need for bear hugs due to a hyposensitive
These hypersenstive and hyposensitive reactions
impact the child’s ability to function independently in
many areas of life (peer interaction, attention at school,
and daily living activities.
THE SENSORY SYSTEMS
Proprioception – the sensation from joints, muscles,
and tissues that lead to body awareness. These
sensations occur when lifting, pushing and pulling
heavy objects as well as engaging in activities that
compress or pull apart the joints. This is the sense that
allows a person to guide his arm or leg movements
without having to observe the movement to make sure it
Vestibular – the sense of movement, centered in the
inner ear, obtained by spinning, swinging, and any type
of body movement or change in head position. This
system coordinates the movement of one’s eyes, head,
and body and tells the body where it is in space. The
vestibular sense in central in maintaining muscle tone,
coordinating two sides of the body and holding the
head upright against gravity.
Tactile – the sense of touch, the sense obtained by
providing a variety of input from textures, temperature
Auditory – the sense of what we hear. It is closely
connected to the vestibular system. The auditory input
is obtained by listening to various types of music or
natural sounds. Some auditory input has been shown
to have a calming and organizational effect. Music
containing 60 beats per minute can have such an
auditory response. Music with an irregular beat and
contrasting volumes tend to be energizing.
Visual – the sense of sight can be used to calm or alert
the nervous system. Visually busy or “cluttered”
environments can interfere with some children’s ability
to concentrate and learn.
Olfactory – the sense of smell can also calm, stimulate
or send a child into sensory overload.
Taste – The sense of taste is obtained by the use of
sweet, salty, crunchy, soft or chewy foods. This sense
can also calm, alert, or organize the nervous system.
THE SENSORY DIET
Following an evaluation of a child’s sensory processing
abilities and needs, the OT will work with parents,
teachers, slp’s and other professionals to develop a
The sensory diet is a carefully designed program that
provides the sensory input a child’s nervous system
needs to stay focused and organized.
Components of a sensory diet may include brushing,
swinging, heavy work (lifting, carrying), swimming,
wearing weighted vests, wrist or ankle weights, wearing
earphones, tactile play, trampoline jumping, chewing
hard and or crunchy objects.
The Wilbarger Protocol is a system of tactile and
proprioceptive input using a soft bristle brush to
provide carefully controlled sensory input, always
followed by a deep pressure/joint compression system.
While this protocol has been anecdotally reported as
effective in regulating sensory processing for some, if
done incorrectly, it can have harmful results. This
procedure should only be used by professionals trained
and under the supervision of a trained occupational
OCCUPATIONAL THERAPY RESOURCES
“The Out of Sync Child” and “The Out of Sync Child
Has Fun” by C.S. Kranowitz
“Asperger Syndrome and Sensory Issues: Practical
solutions for making sense of the world” by Myles,
Cook, Miller, Rinner and Robbins
Action Based Learning: www.actionbasedlearning.com
The American Occupational Therapy Association:
Brain Gym: www.braingym.com
Junction of OT Function: http://junctionof-ot-
OT RESOURCES CONTINUED
The Kid Foundation: www.spednetwork.org
Occupational Therapy and Autistic Children:
Occupational Therapy Innovations: www.ot-
The Ohio Occupational Therapy Association:
OT Exchange: www.OTExchange.com/
SI Focus magazine: www.SIFocus.com
Ohio’s Parent Guide to Autism Spectrum Disorders:
Some children with ASD experience visual-perceptual
Visual Perception is the means by which a person
becomes aware of his body’s relationship to external
space, or the relationship in space between one object
and another (Kranowitz, 1998).
Vision Therapy is a process of retraining the visual-
perceptual system so it functions with optimal
The process of Vision Therapy follows a sequence of
steps aimed at improving the visual system.
Therapy activities are carried out in the office and
frequently reinforced with home activities.
There is some conflict between proponents of vision
therapy and many ophthalmologists, who claim that
vision therapy is not supported by scientific data.
Vision Therapist contend that while ophthalmologists
are experts in eye disease and surgeries, they are
under-informed in the area of vision therapies and the
benefits they can provide.
Interactive Metronome is an assessment and treatment
tool used in therapy to improve the neurological
process of motor planning, sequencing and processing.
It can be used by OT’s, PT’s, SLP’s, educators,
behavioral therapists and music therapists who are
trained in Interactive Metronome
Interactive Metronome provides a structural, goal-
oriented process that challenges the patient to
synchronize a range of hand and foot exercises to a
precise computer-generated reference tone heard
through head phones.
The client attempts to match the rhythmic beat with
repetitive motor actions. A patented audio-visual
guidance system provides immediate feedback
measured in milliseconds and a score is provided.
INTERACTIVE METRONOME GOALS
Increase focus attention for longer periods of time
Increase physical endurance and stamina
Filter our internal and external distractions
Improve ability to monitor mental and physical actions
as they are occurring
Progressive improvement of coordinated performance
COMPUTER BASED INTERVENTIONS
I. Fast ForWord -Fast ForWord software helps
EARLY PHONICS DIFFICULTY,
AUDITORY PROCESSING DISORDERS
II. The Fast ForWord program has been around
for over a decade and has helped over one
COMPUTER BASED INTERVENTIONS
Earobics is a powerful and transformative multisensory
reading intervention for raising academic achievement.
Earobics software provides individualized, explicit
instruction in all areas of reading, plus writing. As
students engage with the software, the program
automatically adjusts based on each student’s
Individual strengths and weaknesses.
COMPUTER BASED INTERVENTIONS
AUDITORY INTEGRATION THERAPY
Auditory Integration Therapy is a sound therapy
designed to retrain a disorganized auditory system and
improves hearing distortions and sound sensitivity.
Developed by Dr. Guy Berard
Participants listen through headphones to modulated
music therapy from an “AIT” device for 20 sessions of
30 minutes each for a total of 10 hours over 10-12 days.
Sessions are provided under the supervision of AIT
therapists or other AIT trained professionals.
Biomedical Interventions for ASD include the use of
medication, diets, and supplements to address
behaviors, cognition, and sensory needs.
There are many such interventions available. The
following is an over-view of the more well-known
A variety of medications have been prescribed for
individuals with ASD. Of course, no one medication is
effective for every individual with ASD
Neurologists, Psychiatrists, and other doctors may
prescribe medications to target the following
symptoms: hyperactivity, sleep problems, obsessive
tendencies, anxiety, aggression, and self-injury.
As a rule, medications are prescribed on a trial basis
with close monitoring of positive and negative effects.
NUTRITIONAL AND DIETARY
Individuals with autism may exhibit low tolerance or
allergies to certain foods or chemicals.
While not the specific cause of ASD, these intolerances
and allergies may contribute to behavioral issues.
As always, parents should not embark on any
intervention without the guidance of the child’s doctors.
Consultation with a gastroenterologist or nutritionist is
also a important step toward implementing any dietary
or supplementary program.
THE GLUTEN-FREE /CASEIN-FREE DIET
Proponents of this diet believe that some individuals
are unable to completely digest the protein in cereals
(Gluten) or in dairy products (Casein). The molecular
structure of the partially undigested proteins, known as
peptides, resembles opiates and are thought to have an
opiate-like effect on the brain and nervous system.
From this premise, it follows that long-term exposure to
these peptides can have damaging effects on the
developing brain and can also affect behavior, just as a
Beginning such a diet can be difficult because Gluten
and Casein are found in many, many prepared and
ready to eat foods.
Gluten is most commonly found in wheat, rye and
barley and some oats.
Casein is found in dairy products.
One obstacle is that the children who would benefit
from this diet often crave foods with Gluten and Casein
and are sometimes reported to experience withdrawal
It may take up to six months for gluten and one month
for casein to clear out of the system.
Advocates of the diet recommend trying it for at least a
year to give the best chance for improvement.
Calcium supplements may be necessary on this diet
Autism Network for Dietary Intervention:
CFCF Diet Support Group: www.gfcfdiet.com
This diet is a food elimination program developed by
Ben F. Feingold to treat hyperactivity.
This diet is free of artificial colors, flavors, aspartame,
three petroleum-based preservatives and certain
These additives, with the exception of salicylates are
made from petroleum and digesting them uses up the
PST enzyme, which is the main enzyme for
detoxification of the body.
Salicylates and phenols also depress the levels of PST
Removing these artificial foods from the diet allows the
people with marginal PST enzyme will have it available
to detoxify the body including the brain.
Proponents suspect individuals with ASD have a
marginal amount of the PST enzyme.
Feingold Association: www.feingold.org
SPECIFIC CARBOHYDRATE DIET
This diet is a strict grain-free, and sucrose-free regimen.
It was initially developed for individuals with celiac
disease and other intestinal disorders, however, the diet
may help individuals with ASD who experience
The theory is that carbohydrates, being forms of sugar,
promote and fuel the growth of bacteria and yeast in the
intestines, causing an imbalance of bacteria and yeast.
Toxins and acids are then formed by the bacteria and
yeast which injure the small intestine lining.
Horvath,K.(1999).Gastrointestinal abnormalities in
children with autistic disorder. Journal of Pediatrics,
This diet was developed to address the overproduction
of or allergies to a certain form of yeast: Candida
While it is impossible to keep out of the body, it is
usually harmless because it is controlled by beneficial
An imbalance in this bacteria causes the yeast to grow
uncontrolled, releasing acidic toxins into the
These toxins slow the brain down.
The anti-yeast diet consists of removing fermented
foods from the diet. These foods may include: alcohol,
non-alcoholic beer, vinegar, barley malt, chocolate,
pickles, soy sauce, and aged cheese.
Some believe that individuals with ASD are likely to
have an allergy to or overproduce this yeast.
Nutrition Institute: www.nutritioninstitute.com
B6 and Magnesium – reported to help improve
language, eye contact, brain electrical activity,
behaviors, and immune system function.
Vitamin B12 – a deficiency is characterized by the
inability to absorb food. It is essential for metabolism of
fats and carbohydrates and the synthesis of proteins.
Vitamin B12 is also involved in the production of the
myelin sheth, a fatty layer which insulates nerves in the
DMG – Dimethylglycine is a food substance found in
brown rice and liver.
TMG- Tri-methyl-glycine breaks down into DMG and
SAMe in the body. SAMe is a nutritional supplement
sometimes used to treat mood disorders.
Melatonin – a hormone made by a part of the brain
called the pineal gland. It may help our bodies know
when it is time to sleep and wake.
Children with ASD often have sleep problems;
melatonin has been shown to improve sleep patterns.
Vitamin A – high doses have been used to treat the
measles virus. Using cod liver oil, Megson (2004) began
vitamin A therapy with her patients and observed
positive results in improved speech and language and
Administering vitamin A should be under a doctors
supervision, as too much can be toxic.
Vitamin C – is a anti-oxidant that helps the brain utilize
Without vitamin C, confusion and depression can
develop. It can also help support the immune system,
aid in detoxification, and fight viruses and bacteria.
Folic Acid – a non-toxic B vitamin, and a nutrient
essential to the brain’s health. It has been reported as
helpful in treating autism. It is most effective when
taken with vitamins B12 and C.
Other supplements include essential fatty acids, zinc,
probiotics, and cod liver oil.
Autism Research Institute: www.autism.com
Kirkman Labs: www.kirkmanlabs.com
DEFEAT AUTISM NOW! PROTOCOL (DAN)
This protocol is a guide for clinical assessment of
individuals with ASD developed by participants in the
DAN Conferences organized by the Autism Research
Institute (founded by Dr. Bernard Rimland).
The basic premise of the DAN! Protocol is that heavy
metal toxicity in the form of thimerosal in vaccines,
amalgams, or some other source is the cause of the
symptoms of autism.
Autism One: www.autismone.org
Center for the Study of Autism: www.autism.org
Defeat Autism Now!: www.defeatautismnow.com
Generation Rescue: www.generationrescue.org
Chelation therapy is the process involving the use of
chelating agents to remove heavy metals from the body.
Reality Check – The February 7th edition of the San
Francisco Chronicle reported the following: “ in the
case of autism, a sketchy study by British physician
Andrew Wakefield in 1998 set the vaccine blame game
in motion. He claimed that a combined measles, mumps
and rubella inoculation given to infants was linked to
the disease, and his findings were published by a
prominent British medical journal the Lancet.
But follow-up research by other teams failed to match
his results. In recent years, his study fell apart amid
charges of dishonesty, violations of research ethics
and a "callous disregard" for the 12 children involved
in the research. The Lancet disavowal this past week
capped the collapse. How does he feel about the
wholesale discrediting of his work? The findings are
"unfounded and unjust," he said.
The damage will be hard to undo. Autism, a range of
conditions that disrupts communication skills and
social interaction, has grown in reported numbers as
parents and doctors learned to recognize its
symptoms. Nearly 1 in 100 American children is
diagnosed with autism or a related condition.”
Recreational Therapy is a general term used to describe
the practice of using leisure activities as therapeutic
interventions. Such therapies provide opportunities for
supporting and enhancing communication and social
and motor activities, and may include, but are not
limited to the following:
Aquatic Therapy is the use of water and specifically
designed activities to help restore, maintain, and
increase function. Aquatic/swimming therapy focuses
on therapeutic play activities that improve range of
motion and increase balance, endurance, and body
awareness. Swimming provides movement that can
help enhance motor planning. Water pressure can be
soothing and calming for children with ASD
Art therapy is an established profession that uses the
creative process of art to improve and enhance the
physical, mental, and emotional well-being.
Art Therapy can increase fine-motor, visual motor,
visual perception skills, organization, planning and
ART THERAPY RESOURCES
American Art Therapy Association, Inc.:
Art Therapy Credentials Board: www.atcb.org
Ohio’s Parent Guide to Autism Spectrum Disorders:
Music Therapy is the prescribed use of music and
musical interventions to work towards specific
therapeutics goals and objectives. Goal areas include
communication, academic, motor, emotional, and social
Music therapy can also have a positive effect on self-
esteem and reduce anxiety while developing
appropriate expression of emotions.
Music is a form of non-verbal communication in that
emotions and feelings can be expressed through
melodies and lyrics.
Music is a natural reinforcer…immediate in time and
provides motivation for practicing non-musical skills.
Parallel music activities are designed to support the
objectives of the child as observed by the therapist or
as indicated by the parent, teacher, or other
A music therapist might observe the child’s need to
socially interact with others. Musical games like
passing a ball back and forth to music or playing with
sticks and cymbals with another person may foster
Eye contact may be encouraged with imitating clapping
games near the eyes. Preferred music may be used
contingently for a wide variety of cooperative social
behaviors like staying in a chair or remaining with a
group of children in a circle.
MUSIC THERAPY RESOURCES
American Music Therapy Association, Inc.:
Center for the Study of Autism:
Ohios’ Parent Guide to Autism Spectrum Disorders:
THERAPEUTIC HORSEBACK RIDING
Hippotherapy, or therapeutic horseback riding, uses
horses as a source of treatment to improve balance,
posture, and mobility.
It can also improve the cognitive, behavioral, and
communication functions of individuals of all ages.
Horseback riding enables one to participate in a
enjoyable activity while increasing attention span,
independence, and self-esteem.
While learning from the horse, riders often bond with
the horse as well as the other riders, thus providing a
good foundation on which to build relationships with
THERAPEUTIC HORSEBACK RIDING
American Hippotherapy Association:
North American Riding Association, Inc.:
Ohio’s Parent Guide to Autism Spectrum Disorders:
Hocus Focus is a student centered experiential based
education approach that utilizes the art of magic in the
context of empowering relationships with the goal of
student growth and development.
It is a systematic approach by which students learn to
focus and accomplish specific goals and objectives by
learning magic tricks. These tricks are simple at first
and then more complex tricks as they proceed and then
exploring the benefits of each one.
Hocus Focus is presented in nine teaching models.
Lessons are designed to address the eight areas of
neuro-developmental function (Levine, 2002) using
magic tricks to impact educational development.
The activities combine education and imagination to
help children improve skills in planning, sequencing,
organizing tasks and movements, fine motor skills,
gross motor function/coordination, memory skills and
As a parent or clinician, the sheer amount of supportive
therapies for the ASD child is quite overwhelming.
Careful consideration of the individual needs of the
child along with input from doctors, therapists,
teachers, and parents should be reviewed before
initiating any new intervention.
The Ohio’s Parent Guide to Autism Spectrum Disorders:
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