CHAPTER 6: CONCLUSIONS AND RECOMMENDATIONS
3.2 INTERVENTION STRATEGIES FOR MANAGING LEARNERS WITH AUTISM
3.2.1 Individual therapy
Learners with autism are all unique, with unique individual needs. It is therefore important to get the learner individual therapy according to their individual needs.
3.2.1.1 Medical treatment
There is currently no medical test to diagnose autism as a diagnosis is based on observable characteristics and the behaviour that each person presents (Sicile-Kira, 2003; Hellemans, 2007b). A medical diagnosis could help provide fundamental support needed by the parent and educator and will assist in the process of understanding the behaviour. (Jordan and Jones,1999;Hellemans,2007b). There are, however, no medications that effectively treat autism as a whole,because autism is a syndrome and has more than just one identifiable symptom, but is rather a collection of symptoms that vary from child to child (Siegel, 1996;Hellemans, 2007a; Grinker, 2007). Medication is thus used to treat a specific symptom, or group of related symptoms (Hellemans, 2007a),and should mainly help for ADHD,ADD,stereotyped motor movements, self-injurious behaviours, aggressiveness, social withdrawal, excessive anxiety, and poor sleep (Siegel, 1996; Hellemans,2007a). Psychiatrists in South Africa mainly use the following medications for learners with autism: Epilim or Lamictin for epilepsy,Tegretol for epilepsy and behaviour problems,Ritalin (or a generic),or Dixarit for hyperactivity,Imipramine for hyperactivity,to reduce anxiety and as a mild anti-depressant, and Risperdal to reduce anti-social behaviours, repetitive stereotypical behaviourand for attention difficulties (Sheppard,2007).
In Belgium,psychiatrists mainly use Ritalin,Ritalin LA and Concerta for hyper- and hypoactive behaviours, Strattera as an anti-depressant, and Risperdal, Haldol and Dipiperon for aggression,panic attacks and anxiety,stereotypical behaviours and Tics (Hellemans,2007a).
3.2.1.2 Dietary Interventions
The feeding habits and food preferences of individuals with autism were at one time considered part of the diagnostic indicators. Gastrointestinal problems occur in 46 - 84% of children with autism, and are associated with loose stools or frequent diarrhoea (Filipek,2005). This is the reason dietary and biomedical interventions are effective in helping individuals whose metabolic systems do not function properly.
Thereasons for this often have to do with the fact that the individual' ssystem is not
processing essential nutrients properly due to food allergy or intolerance. Even worse, sometimes it's because of high levels of mercury and other toxic metals or a 'leaky gut', where the wall of the intestine does not keep the contents separate from the bloodstream. Health practitioners are becoming more aware of these interventions and how to treat patients with AD from a dietary and biomedical perspective (Sicile- Kira, 2003), as these are linked to difficulties with processing of information, sensory hypersensitivities, communication, mood and behaviour (Williams, 1996).
The Gluten or casein free diet is another intervention and should be done under the care of a knowledgeable and experienced health professional. This diet is for individuals who have allergies or a toxic response to~luten and/ or casein. This response is due to peptides derived from an incomplete breakdown of certain types of foods, which affect neurotransmissions within the central nervous system. The individual may show signs of diarrhoea, constipation, hyperactivity, red face or ears, breaking wind frequently or pale skin. The individuals are advised not to eat foods containing gluten, found in wheat, oats, rye and barley, or casein which is found in dairy products (Sicile-Kira, 2003:101). Several studies (Whitely, Rodgeres, Savery and Shattock, 1999; Woodward and Hogenboom, 2000) have proven that this diet can reduce autistic behaviour.
3.2.1.3 Support therapies
Different therapies have been tried on children with autism. For example,in the early 1960's , d-lysergic acid diethylamide (LSD-25) and mentholated derivative (UML) were given to children with autism (Bender,Goldschmidt and Siva, 1962a; 1962b). In the late 1960's ,the use of electric convulsive therapy was introduced as another form of intervention. This included very low level of electrical stimulation as a negative reinforcer (Lichstein and Schreibman, 1976;Lischstein, 1977).
Therapies either target a particular need of the individual, or are part of a wider programme. There are many different assessments that are important to help determine the child's ability in terms of his/her age: speech and language, occupational therapy, physiotherapy, etc. These willhelp determine what the learner
is able or unable to do,and it will givethe parent and educator guidelines on what to concentrate on when helping or teaching the learner.
Speech therapy helps with language delay,which is one of the triads of impairment of ASD. Speech therapists evaluate the learner's level oflanguage functioning and then help the learner develop language with which to communicate (Sicile-Kira, 2003).
Occupational therapists help equip the learner with the skills needed in everyday life, such as self-care, work and leisure. These all depend on the child's age, ability and need.
Some therapists are specifically trained in sensory integration. (Sicile.;.Kira,2003).
. .. . . ' . . . . .
Sensory integration isfor individuais'with sensory disorders. These children have senses that send incorrect messages to the brain. One of the difficult behaviours of individuals with autism is the attempt to avoid certain types of sensations, or to seek preferred stimuli (Wing, 1980, Sicile-Kira, 2003). Sensory integration facilitates the development of the nervous system's ability to process sensory input appropriately, and to use ones senses in an integrated way. This should help the person with autism to process information more fully and quickly (Emmons and Anderson, 2005;
Williams,1996).
Auditory Integration Training (AIT) is a method that assists individualswith autism in reducing auditory hypersensitivity, improving the clarity of hearing and communication skills (Emmons and Anderson, 2005; Auditory Integration Training and the Counselling Centre,2007). AIT helps to rehabilitate disorders of the auditory system of individuals who are hypersensitive towards certain sound frequencies.
Distortions in hearing or auditory processing often add to behavioural or learning disorders. When the AIT method is used,the learner will listen to music sent through a specialized electronic device which randomizes and filters the frequencies and sends these modified sounds into the trainee's ears through a set of headphones. These frequencies mobilize and exercise the inner ear and brain (Auditory Integration Training and the Counselling Centre,2007).