Currently there is no definitive, single treatment for ASDs.  However, there are a variety of ways to help minimize the symptoms and maximize learning.  Persons with an ASD have the best chance of using all of their individual capabilities and skills if they receive appropriate behavioral and other therapies, education, and medication.  In some cases, these treatments can help people with autism function at near-normal levels. 

Some possible treatments for autism are explained below.  If you have a question about treatment, you should talk to a health care provider who specializes in caring for people with autism. 

Behavioral therapy and other therapeutic options

In general, behavior management therapy works to reinforce wanted behaviors and reduce unwanted behaviors.  At the same time, these methods also suggest what caregivers should do before or between episodes of problem behaviors, and what to do during or after these episodes.  Behavioral therapy is often based on Applied Behavior Analysis (ABA).  Different applications of ABA commonly used for people with autism include:  Positive Behavioral Interventions and Support (PBS), Pivotal Response Training (PRT), Incidental Teaching, Milieu Therapy, Verbal Behavior, and Discrete Trail Teaching (DTT), among others. 

Keep in mind that other therapies, beyond ABA, may also be effective for persons with autism.  Talk to your health care provider about the best options for your child.

A variety of health care providers can also help individuals with ASDs and their families to work through different situations.

• Speech-language therapists can help people autism improve their general ability to communicate and interact with others effectively, as well as develop their speech and language skills.  These therapists may teach non-verbal ways of communicating and may improve social skills that involve communicating with others.  They may also help people to better use words and sentences, and to improve rate and rhythm of speech and conversation. 
• Occupational therapists can help people with autism find ways to adjust tasks and conditions that match their needs and abilities.  Such help may include finding a specially designed computer mouse and keyboard to ease communication, or identifying skills that build on a person’s interests and individual capabilities.  Occupational therapists may also do many of the same types of activities as physical therapists do.
• Physical therapists design activities and exercises to build motor control and to improve posture and balance.  For examp[le, they can help a child who avoids body contact to participate in activities and games with other children.

Special services are often available to pre-school and school-aged children, as well as to teens, through the local public school system.  In many cases, services provided by specialists in the school setting are free.  More intense and individualized help is available through private clinics, but the family usually has to pay for private services, although some health insurance plans may help cover the cost.

Educational and/or school-based options

Children with ASDs are guaranteed free, appropriate public education under federal laws. Public Law 108-77: Individuals with Disabilities Education Improvement Act ¹⁷(2004) and Public Law 105-17: The Individuals with Disabilities Education Act—IDEA¹⁸ (1997) make it possible for children with disabilities to get free educational services and educational devices to help them to learn as much as they can.  Each child is entitled to these services from age three through high school, or until age 21, whichever comes first. 

The laws state that children must be taught in the least restrictive environment, appropriate for that individual child.  This statement does not mean that each child must be placed in a regular classroom.  Instead, the laws mean that the teaching environment should be designed to meet a child’s learning needs, while minimizing restrictions on the child’s access to typical learning experiences and interactions.  Educating persons with ASDs often includes a combination of one-to-one, small group, and regular classroom instruction. 

To qualify for access to special education services, the child must meet specific criteria as outlined by federal and state guidelines.  You can contact a local school principal or special education coordinator to learn how to have your child assessed to see if he or she qualifies for services under these laws.

If your child qualifies for special services, a team of people, including you and your family, caregivers, teachers, school psychologists, and other child development specialists, will work together to design an Individualized Educational Plan
(IEP)¹⁹ for your child.  An IEP includes specific academic, communication, motor, learning, functional, and socialization goals for a child based on his or her educational needs.  The team also decides how best to carry out the IEP, such as determining any devices or special assistance the child needs, and identifying the developmental specialists who will work with the child.

The special services team should evaluate and re-evaluate your child on a regular basis to see how your child is doing and whether any changes are needed in his or her plan.

A number of parents’ organizations, both national and local, provide information on therapeutic and educational services and how to get these services for a child.  Visit http://www.nlm.nih.gov/medlineplus/autism.html for a listing of these organizations, or check the local phone book.

Medication options

Currently, there is no medication that can cure ASDs or all of the associated symptoms.  Further, the Food and Drug Administration (FDA) has not approved any drugs specifically for the treatment of autism or its causes.  But, in many cases, medication can treat some of the symptoms associated with ASDs. 

Please note that the NICHD does not endorse or support the use of any of these medications for treating symptoms of ASDs, or for other conditions for which the medications are not FDA approved. 

Medication can improve the behavior of a person with autism.  Health care providers often use medications to deal with a specific behavior, such as reducing self-injurious behavior.  With the symptom minimized, the person with autism can focus on other things, including learning and communication.  Some of these medications have serious risks involved with their use; others may make symptoms worse at first or may take several weeks to become effective. 
Not every medication helps every person with symptoms of autism.  Health care providers usually prescribe medications on a trial basis, to see if it helps.  Your child’s health care provider may have to try different dosages or different combinations of medications to find the most effective plan.  Families, caregivers, and health care providers need to work together to make sure that medications are working and that the overall medication plan is safe.  

Medications used to treat the symptoms of autism²⁰ may include (but are not limited to):

• Selective serotonin re-uptake inhibitors (SSRIs) are a group of antidepressants that treat problems resulting from an imbalance in one of the body’s chemical systems, such as obsessive-compulsive behaviors and anxiety, which are sometimes present in autism. These medications may:  reduce the frequency and intensity of repetitive behaviors; decrease irritability, tantrums, and aggressive behavior; and improve eye contact.
• Tricyclics are another type of antidepressant used to treat depression and obsessive-compulsive behaviors. Although these drugs tend to cause more side effects than the SSRIs, sometimes they are more effective for certain people. 
• Psychoactive or anti-psychotic medications affect the brain of the person taking them.  Use of this group of drugs is the most widely studied treatment for autism. In some people with ASDs, these drugs may decrease hyperactivity, reduce stereotyped behaviors, and minimize withdrawal and aggression. 
• Stimulants may be useful in increasing focus and decreasing hyperactivity in people with autism, particularly in higher-functioning individuals. Because of the risk of side effects, health care providers should monitor those using these drugs carefully and often.
• Anti-anxiety drugs can help relieve anxiousness and panic disorders associated with autism.

What is secretin and is it an effective treatment for autism?

Secretin is a hormone produced by the small intestine that helps in digestion.  Currently, the FDA approves a single dose of secretin only for use in diagnosing digestive problems. 

In the 1990s, news reports described a few persons with autism whose behavior improved after getting secretin during a diagnostic test. 

However, a series²¹ of clinical trials funded by the NICHD and conducted through the Network on the Neurobiology and Genetics of Autism:  Collaborative Programs of Excellence in Autism (CPEAs) found no difference in improvement between those taking secretin and those taking placebo.  In fact, of the five case-controlled clinical trials published on secretin, not one showed secretin as any better than placebo, no matter what the dosage or frequency.  For this reason, secretin is not recommended as a treatment for ASDs.