Autism is a developmental disability that most often appears during a child's first years of life. Autism impacts the normal development of the brain in the areas of social interaction and communication skills. Children and adults with autism often have difficulty with communication (verbal and non-verbal), interacting with others and play activities.

Over one half million people in the U.S. today have some form of autism. Its prevalence rate now places it as the third most common developmental disability - more common than Down's syndrome. Yet the majority of the public, including many professionals in the medical, educational, and public health fields, are still unaware of how autism appears in the population, how it affects people and how to work effectively with individuals with autism.

Autism is often referred to as a spectrum disorder, meaning that the symptoms and characteristics of autism can present themselves in a wide variety of combinations, from mild to severe. Although autism is defined by a certain set of behaviors, children and adults can exhibit any combination of the behaviors in any degree of severity.

Two children, both with a diagnosis of autism, can act very differently from one another. They may exhibit repeated body movements (hand flapping, rocking), unusual responses to people or attachments to objects and resist any changes in routines. In some cases, aggressive and/or self-injurious behavior may be present.

A generation ago, 90% of the people with autism were eventually placed in institutions. Today, as a result of appropriate and individualized services and programs, many children grow up to lead productive, happy lives, and even the more severely disabled can usually be taught skills to allow them to develop to their fullest potential.

Children with autism often appear relatively normal in their development until the age of 24-30 months, when parents may notice delays in language, play or social interaction.

The following areas are among those which may be affected by autism:

• Communication: language develops slowly or not at all; use of words without attaching the usual meaning to them; communicates with gestures instead of words; short attention spans.
• Social Interaction: spends time alone rather than with others; shows little interest in making friends; less responsible to social cues such as eye contact or smiles.
• Sensory Impairment: unusual reactions to physical sensations such as being overly sensitive to touch or under-responsive to pain; sight, hearing, touch, pain, smell, taste may be affected to a lesser or greater degree.
• Play: lack of spontaneous or imaginative play; does not imitate others actions; doesn't initiate pretend games.
• Behaviors: may be overactive or very passive; throw frequent tantrums for no apparent reason; may perseverate on a single item, idea or person; apparent lack of common sense; may show aggressive or violent behavior or injure self..

There are no medical tests for diagnosing autism. An accurate diagnosis must be based on observations of the child's communication, behavior and developmental levels. However, because many of the behaviors associated with autism are shared by other disorders, a doctor may complete various medical tests to rule out other possible causes.

Diagnosis is difficult for a practitioner with limited training or exposure to autism, since the characteristics of the disorder vary so much. Locating a medical specialist or a diagnostician who has experience with autism is most important. A child should be evaluated by a multidisciplinary team which may include a neurologist, psychologist, developmental pediatrician, speech/language therapist, learning consultant or other professionals knowledgeable about autism. Only with a careful evaluation can the earliest and best intervention be designed for each child.

Applied Behavior Analyses (ABA) refers to a systematic approach to the assessment and evaluation of behavior, and the application of interventions that alter behavior. An offshoot behavior modification, clinical ABA generally focuses on the development of adaptive, prosocial behavior and the reduction of maladaptive behavior.

For a more in-depth look at ABA, view our "About ABA" page.

In the sea of ABA providers, parents often wonder which providers are the best for their children. This is a very real and important concern. Unfortunately, there are numerous "providers" claiming to have expertise in the field of Autism treatment.

However, although a provider may have ABA training, it is important to ensure that they also have expertise with this client population and are able to develop individualized programs beginning with simple imitation and concluding with complex social understanding.

When evaluating ABA programs parents should ascertain whether the following program guidelines are in place:

Individualized Programming

• Does the provider work within the child's areas of strength?
• Are adaptations to the curriculum made when needed?
• Avoidance of "cook book" programming: Beware of Sd sheets copied from the Maurice or other similar books
• Does the agency incorporate the latest research findings into their treatment plans?

Emphasis on Generalization

• Does generalization work begin immediately?
• Is there an emphasis to generalize skills across people?
• Is there an emphasis to generalize the way instructions are given?
• Is there an emphasis to generalize skills across learning environments?
• Is there a push to transition to a naturally occurring reinforcement schedule?

Supervision

• Is regular supervision considered crucial to the program success?
• Are behavioral excesses and reductive strategies reviewed at each supervisory meeting?
• Is school progress reviewed and are there shadowing goals outlined?
• Are all drills reviewed and demonstrated at each supervisory meeting?
• Are the children's programs adapted to their individual needs?
• Are the necessary referrals provided when needed?

Intensity & Consistency

• Are the hours recommended consistent with research findings?
• Are steps taken to ensure consistency?
• Parent / Nanny / Extended Family Training
• Frequent Consultation with School Staff
• Frequent Consultation with other providers?

Acknowledgment of Biomedical Factors Impacting Treatment

• Are parents encouraged to explore medical treatments?
• Is information regarding dietary changes provided?
• Are pre-screened referrals provided when necessary?

Specialized Programs for Particular Learners

• Are Social Skills Training / Executive Function Training / Theory of Mind Work part of the program?
• Is adequate programming for non-verbal children available if needed?
• Are other programs brought in to aide the child's pattern of acquisition (PECS, Social Stories, etc.)?