Autism Therapies

What should I know about autism therapies?

Autism therapies are interventions that help your child make the most of their strengths while addressing any challenges they face. Some therapies take place in a provider’s office, while others take place at home, school or other public places. There’s a huge variety in what these therapies look like, but in general, they help your child develop the skills they need to socialize, learn and be as independent as possible.

Pediatricians and other healthcare providers understand that autism is a difference in how your child’s brain works (neurodivergence). It’s not a disease that can “cured.” So, therapies don’t aim to “fix” autism or force your child to fit into a certain mold. Instead, therapies help autistic kids develop the skills they need to grow and thrive in a world that doesn’t always make life easy for neurodivergent people.

When you’re looking for therapies to support your child, keep this in mind: not all autism therapies or treatments are created equal. You can’t always trust that what you find online or hear about from a well-meaning friend is legit (or even safe). There are lots of myths and misinformation out there about autism — including its causes and ways to treat it.

Your pediatrician and other members of your child’s care team will recommend evidence-based therapies for autism. Like their name suggests, these therapies have evidence — or data from credible, well-designed research studies — that show they’re safe and effective.

What types of therapy are best for autism?

There are many therapies available to support your child. No single therapy is best for all kids. Your child’s providers will recommend one or more therapies that:

• Are tailored to your child’s age and unique needs.
• Take into account any co-occurring conditions.
• Work with your family’s preferences, schedule and budget.

You may need to try several different therapies to find what’s most helpful for your child.

Here are some therapies your child’s providers may suggest:

• Behavioral therapy.
• Speech-language therapy.
• Occupational and physical therapy.
• Social skills training.
• Parent training.

Behavioral therapy

Behavioral therapy for autism encourages your child to do certain positive behaviors, like asking for something they need. It also helps reduce challenging behaviors, including those that may lead to self-harm.

Providers called board certified behavior analysts (BCBAs) design interventions according to the principles of applied behavior analysis (ABA). ABA is a learning theory that says behaviors are a result of their circumstances, especially the things that happen after the behaviors (consequences). Rewarding positive behaviors and not rewarding others can help kids learn behaviors that will serve them well in life.

ABA has a controversial history, namely because its earliest forms used punishments to reduce unwanted behaviors. This no longer happens.

Today, behavioral therapy interventions:

• Use rewards (positive reinforcement). Rewards in response to meeting certain goals encourage your child to learn skills and behaviors that support their schooling, socializing and daily life.
• Use play. Play-based activities help your child learn social skills and build peer relationships. For example, providers might model types of play or encourage your child to try something other than their familiar play routines.
• Identify the reasons for challenging behaviors. Understanding why your child engages in a behavior allows providers to develop a plan tailored to your child’s needs. For example, your child may get upset because they don’t know how to communicate a request.
• Take place in a variety of settings. These vary by program. For example, some therapies occur in a structured environment, like a provider’s office. Others happen in your home, your child’s school or other community settings where your child would naturally be.
• Can be short- or long-term. Your child may do behavioral therapy for just a few months, a year or longer. It depends on their needs, which change over time. Some programs cover a broad range of skills while others help your child accomplish a specific, short-term goal.

Examples of behavioral therapy interventions

There are lots of terms floating around online that relate to behavioral therapy for autism. It can be hard to tell them apart or know if they’re credible. Your pediatrician can tell you more about anything you find and help you identify the programs that have solid evidence backing them up. To get you started, here’s a list of some well-known and evidence-based interventions: 

• Early Intensive Behavioral Intervention (EIBI): EIBI begins at age 4 or younger and typically continues for a few years. It addresses challenges in the areas of communication, socializing and restrictive or repetitive behaviors. It takes place in a structured setting.
• Early Start Denver Model(ESDM): ESDM is designed for toddlers and takes place at your home or other everyday places (what providers call “natural settings”). It uses play to help your child build social, cognitive and language skills.
• Joint Attention, Symbolic Play, Engagement and Regulation (JASPER): JASPER uses play to teach social communication skills to kids 12 months to 8 years old. It takes place in natural settings like your home or your child’s classroom.
• Pivotal response treatment(PRT): PRT helps your child build fundamental social skills by motivating them to want to interact. Specific skills include starting a conversation, responding to others and taking turns.
• Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH®): TEACCH helps your child build a range of skills in a structured environment tailored to their abilities and sensory preferences.

Speech-language therapy

Speech-language therapy supports your child’s communication skills. It’s one of the most used therapies for autism. Here are just a few examples of what speech therapists can help your child do:

• Learn short phrases to make requests.
• Put their feelings into words.
• Adjust the speed or rhythm of their spoken words.
• Use augmentative and alternative communication (AAC). AAC includes things like speech-generating devices, sign language and cards with pictures or symbols on them.

Occupational and physical therapy

Occupational therapy (OT) helps your child gain the skills they need to do daily tasks (occupations). For example, OT can improve your child’s ability to do activities of daily living (ADLs), like brushing their teeth or getting dressed. Physical therapy helps your child with things like gross motor skills, balance, gait stability and toe walking.

These therapists might guide your child through exercises to improve their physical strength, coordination and motor skills (the movements they need when learning, playing or enjoying hobbies).

Social skills training

Social skills training, also called group social skills intervention (GSSI), is a targeted approach to helping your child navigate social life. This makes it different from other therapies that build social skills as part of a broader plan addressing lots of different things. Social skills training occurs in groups and is often designed for adolescents and young adults.

Social skills training uses direction instruction, modeling, visuals, role play and more to help your child feel more confident and comfortable in social situations. For example, providers might help your child:

• Learn strategies for building peer relationships.
• Understand nonverbal cues like eye contact and facial expressions.
• Engage in back-and-forth conversations.
• Manage bullying.

Parent training

This type of intervention helps you learn strategies for supporting your child. For example, providers might teach you:

• How to follow your child’s lead.
• How to get your child’s attention.
• Ways to offer choices to your child.
• Ways to encourage peer-to-peer interactions.

Depending on the specific program, you may train in a group setting with other parents. The work you do in your parent training sessions will complement the therapies your child receives.

How can autism therapies help my child?

Autism therapies can help your child:

• Make the most of their skills and talents.
• Communicate in ways that meet their wants and needs.
• Build social skills.
• Experience fewer behavioral challenges.
• Gain daily living skills that support their independence.
• Make life transitions — for example, from childhood to adolescence or adolescence to adulthood.

When are therapies most helpful?

Therapies for autism have the greatest long-term impact when they start before age 3. That’s because, during your child’s first few years of life, their brain is still developing and more open to change. Still, therapies at any age can be valuable and may help your child.

What should I look for when choosing an autism therapy program for my child?

Your pediatrician can guide you and make recommendations. In general, here are some key features to look for:

• Providers do an assessment of your child’s needs.
• Providers set clear goals for your child to meet, and they can explain how they’ll measure your child’s progress.
• There’s enough staff to give your child individualized attention.
• Providers have proper training and share their credentials and background with you.
• Your child’s interests and preferences play a role in how therapy unfolds (for example, in deciding the types of positive reinforcement).
• Providers welcome your involvement, including asking your preferences and teaching you things to do at home to support your child.

Autism therapies should lift your child up and honor them as an individual. If something doesn’t feel right to you or you’re not comfortable with any aspect of a therapy program, trust your gut and go elsewhere.