Autism Treatment for Adults: Revolutionary Approaches

Understanding Autism in Adults

Autism in adults is a topic that requires careful understanding and attention. With increasing recognition of the diversity of experiences in the autism spectrum, there is a growing emphasis on providing accurate information and effective support for adults with autism.

Autism Spectrum Disorder Overview

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that affects social interaction, communication, interests, and behavior. In 2013, the diagnostic criteria for autism and Asperger syndrome changed, and what was previously diagnosed as Asperger syndrome is now diagnosed as ASD.

It is important to note that more males than females are diagnosed with autism, although there is mounting evidence to suggest that girls and women are underdiagnosed.

Although autism cannot be cured, appropriate intervention and support can help people to develop skills and coping strategies. Social skills support can assist autistic people in understanding how to read the different expectations of social situations.

Autism Diagnosis in Adulthood

It is not unusual for autistic people to have reached adulthood without a diagnosis. Sometimes, people may choose to seek an autism diagnosis if they recognize symptoms that resonate with them.

A diagnosis of autism in adults can bring relief as it helps individuals understand their behaviors and emotions, and provides coping strategies for the challenges they face. Additionally, it can aid families in better understanding and supporting the diagnosed individual.

Despite the importance of diagnosis and support, research on services for adults on the autism spectrum is limited. The studies reviewed represent less than 1% of scholarly output on autism from 2013 through 2018. Only a small fraction of autism research focuses on adult issues, and only 2% of all autism research funding in the USA focuses on adult issues.

This emphasizes the significant need to improve physician training, research, and services to better serve the adult population with autism and contribute meaningfully to the understanding and treatment of autism in adults.

Autism Treatment Strategies

The treatment of autism in adults requires a multifaceted approach that focuses on enhancing the individual's ability to communicate, interact, and function effectively in their daily lives. Here, we explore some of the key strategies for autism treatment, namely psychoeducation, social stories, and social autopsies.

Psychoeducation for Autism

Psychoeducation plays a pivotal role in the treatment of adults with autism spectrum disorder (ASD). It involves providing individuals with enlightening information about ASD, including its effects on various aspects of life. Through psychoeducation, individuals with autism gain greater self-knowledge and self-awareness, enabling them to better understand their behaviors, feelings, and reactions. This increased understanding contributes significantly to their ability to manage daily challenges and thrive in different environments.

The psychoeducational approach involves a team of trained healthcare professionals, including developmental pediatricians, child psychiatrists, occupational and behavioral therapists, speech therapists, psychologists, specialist teachers, and social workers.

Utilizing Social Stories

Social stories are effective tools utilized in autism treatment. They involve the use of narratives or visual representations to teach individuals with autism about social behavior. This includes understanding social rules, decoding feelings and reactions, and inferring the mental state of others. By engaging with social stories, adults with ASD can develop a better understanding of social expectations, thereby improving their ability to interact socially.

Implementing Social Autopsies

Social autopsies provide a problem-solving strategy for adults with ASD, enabling them to analyze real-world social interactions effectively. This strategy involves identifying the cause and effect relationship between their behavior and the reactions of others. This process allows individuals with ASD to develop strategies to handle social situations more effectively, improving their social interactions and overall quality of life.

In conclusion, these autism treatment strategies underscore the importance of personalized, comprehensive approaches that account for the unique needs and experiences of individuals with ASD. Each of these strategies offers distinct benefits, contributing to the overall goal of enhancing the individual's ability to navigate their daily lives with confidence and ease.

Role of Medications in Autism Treatment

Medication undoubtedly plays a significant role in managing the symptoms of autism in adults. The primary purpose is not to cure the disorder but to help manage specific behaviors associated with Autism Spectrum Disorder (ASD).

Antipsychotics in Autism Management

Risperidone (Risperdal) and aripiprazole (Abilify) are the only two medications approved by the FDA to help reduce irritability in autistic children and teens. Antipsychotic medications, like these, are thought to work by affecting dopamine, a neurotransmitter associated with pleasure and reward.

Medication	FDA approved	Targeted Symptom
Risperidone (Risperdal)	Yes	Irritability
Aripiprazole (Abilify)	Yes	Irritability

These medications are typically prescribed on a trial basis to assess their effectiveness, and variations in dosages or combinations may be required to determine the most suitable treatment plan for individuals with autism [5].

Handling Anxiety in Autistic Adults

Around 50% of autistic adults and children live with anxiety, and managing anxiety in autistic individuals can be complex. The efficacy of anti-anxiety medications for autistic individuals is mixed, and one study recommends their use only after behavioral interventions have not helped.

A significant percentage of autistic children and adolescents are prescribed SSRIs (Selective Serotonin Reuptake Inhibitors) to help manage symptoms of anxiety and depression that often co-occur with autism. However, it's crucial to note that the FDA requires black box warnings on SSRI labels advising of an increased risk of suicidal ideation and behavior in teens and young adults.

Combining Medications with Behavioral Therapies

Incorporating medications with behavioral therapies can often lead to better effectiveness in managing autism symptoms. This integrated approach allows for a comprehensive treatment plan that addresses a range of symptoms and behaviors.

Families are advised to collaborate closely with healthcare providers to ensure the safe and beneficial use of any medication for individuals with autism, as all medications pose risks, some of which can be severe.

In summary, while medications play a crucial role in autism treatment for adults, it's important to remember that they are typically used to manage symptoms, not cure the disorder. The use of medications should be carefully monitored and regularly reviewed to ensure effectiveness and minimize potential risks.

Applied Behavioral Analysis (ABA) Therapy

One of the most widely recognized and effective autism treatment for adults is Applied Behavioral Analysis (ABA) therapy. This therapy focuses on the function of behaviors and how different environments can impact those behaviors. It aims to develop new positive skills while reducing non-beneficial skills in individuals on the autism spectrum, making it a flexible and adaptable treatment method.

ABA for Adults: A Closer Look

ABA therapy can be used with adults who have a diagnosis of autism, focusing on goals such as life skills, physical health, and social interactions. While the core principles of ABA remain the same for adults, the specific goals differ from those set for children. For instance, a child might have a goal to develop social skills for school, while an adult might aim to develop skills for independent living or gainful employment.

Benefits of ABA Therapy

ABA therapy has been successful for individuals on the autism spectrum as it aims to build new positive skills and reduce skills that are not beneficial. This method has been widely used since the 1960s and can be adapted for different ages, levels of ability, settings, and behaviors, making it suitable for patients throughout their lifetime. It's this adaptability and focus on individual skills that make ABA a valuable tool in the toolbox for autism treatment.

Adapting ABA for Different Ages

The flexibility of ABA therapy extends to its adaptability across ages. Therapists who provide ABA services must be flexible in implementing treatment plans as what works for one child on the autism spectrum may be unproductive for another child with the same diagnosis. ABA therapy does not recommend a single treatment plan for every individual, emphasizing the need for individualized approaches.

For instance, children who undergo ABA therapy as part of an early intervention treatment plan may have play incorporated into the sessions to keep them engaged and focused. Toys used in ABA therapy may include sensory toys, puzzles, and board games tailored to improve cognitive, communication, and social skills in children on the autism spectrum.

In contrast, adults might focus more on life skills, such as cooking, cleaning, or job-related tasks. Regardless of age, ABA therapy is designed to meet individuals where they are and help them develop the skills they need to improve their quality of life and overall functioning.

Mental Healthcare for Autistic Adults

Navigating mental healthcare can be a complex process for anyone, but it presents unique challenges for autistic adults. The importance of proper treatment and support cannot be overstated, as it plays a significant role in the overall well-being of autistic individuals.

Navigating Mental Healthcare Challenges

Autistic adults often face significant barriers in accessing the mental healthcare they need. These challenges include complex steps to access care, long waitlists, and high costs. Despite the high utilization of mental healthcare, autistic adults still experience high rates of unmet mental healthcare needs.

Furthermore, autistic adults tend to use mental healthcare services more frequently than non-autistic adults. They also tend to use the emergency department for mental health-related conditions more than non-autistic adults. This could indicate a lack of adequate preventative and regular care, leading to emergency situations [8].

Despite the higher usage, the mental healthcare services sought by autistic adults are often for the management of conditions such as attention deficit hyperactivity disorder (ADHD), anxiety, depression, and obsessive-compulsive disorder (OCD), rather than for core features of autism itself. Counseling and psychiatry are among the most commonly used services by autistic adults [8].

Importance of Autism-Trained Providers

One of the significant barriers to adequate mental healthcare for autistic adults is the limited availability of autism-trained providers. When autistic adults seek care from a mental health provider not trained in working with autism, it can hinder their access to equitable, patient-centered healthcare.

Most autistic adults use mental healthcare and use it more often than non-autistic adults. However, their experiences are often characterized by a lack of providers knowledgeable about autism, treatments that may not accommodate individual needs, and difficulty navigating the complex healthcare system. These barriers contribute to prevalent unmet needs for mental healthcare [8].

Therefore, it's essential to increase the availability of autism-trained providers to improve mental healthcare for autistic adults. This will require investment in training and education for healthcare providers, as well as systemic changes to make mental healthcare services more accessible and autism-friendly. By doing so, we can ensure that all autistic adults receive the care they need to live healthy, fulfilling lives.

High-Functioning Autism and Its Challenges

High-functioning autism (HFA), formerly known as Asperger's syndrome, refers to individuals on the autism spectrum who have low support needs but may still find some day-to-day activities challenging due to traits such as sensory overload, difficulty with social cues, and emotional control. Despite their label of being "high-functioning," these individuals often encounter invisible challenges related to sensory issues, emotional regulation, social skills, executive functioning, verbal communication, and mood disorders [9].

Social Interaction Difficulties

One of the most common challenges faced by individuals with HFA is difficulty with social interactions. This can stem from challenges in recognizing social cues and body language, which can lead to perceived social awkwardness. These difficulties can present obstacles to making friends, finding and keeping a job, and dating.

Many individuals with HFA may want to engage socially but struggle to understand the unspoken "rules" of social interaction. This can result in feelings of isolation and frustration, as well as potential misunderstandings with peers and colleagues.

Mental Health Conditions and High-Functioning Autism

Another significant challenge associated with HFA is the prevalence of associated mental health conditions. Individuals with HFA are more likely to be diagnosed with a mood disorder than the general population, with anxiety and depression being particularly common. The connection between autism and mental health conditions is not clear, but it is possible that factors such as genetics, environment, and social rejection contribute to these associations.

Executive Functioning in High-Functioning Autism

Many people with HFA struggle with executive functioning, which refers to the skills used to organize and plan their lives. This can manifest as challenges in tasks like following schedules, completing long-term projects, and adapting to minor schedule changes.

Some people with HFA may struggle with time management, procrastination, or difficulty starting or completing tasks. These challenges with executive functioning can have significant impacts on an individual's ability to succeed in school, work, or other areas of life.

These challenges highlight the need for comprehensive autism treatment for adults that addresses not only the core symptoms of autism but also the associated challenges that can impact quality of life. Understanding these challenges can inform treatment strategies and help individuals with HFA to lead fulfilling, productive lives.