Behavioral Interventions for Children with Autism Spectrum Disorders

Decades of research indicate that autism spectrum disorder (ASD) is a lifelong disorder that ranges in severity across individuals. Though the central diagnostic components of the disorder center on social communication and restrictive and repetitive behaviors, ASD may influence many other features of an individual's life. This article includes an overview of the disorder and diagnostic process. We provide an in-depth look at various domains that may intersect with ASD including social and language development, play and leisure, wellness, and adolescence and adulthood. Characteristics of contemporary services are highlighted including an emphasis on personalization, integration of the individual's strengths, and connection to family and cultural values.

Autism is a pervasive disorder characterized by a complex symptomatology, based principally on social dysfunction. The disorder has a highly complex, largely genetic etiology, involving an impressive variety of genes, the precise contributions of which still remain to be determined. For this reason, a reductionist approach to the study of autism has been proposed, employing monogenic animal models of social dysfunction, either by targeting a candidate gene, or by mimicking a single-gene disorder characterized by autistic symptoms. In the present review, we discuss this monogenic approach by comparing examples of each strategy: the mu opioid receptor knock-out (KO) mouse line, which targets the opioid system (known to be involved in the control of social behaviors); and the Fmr1-KO mouse, a model for Fragile X syndrome (a neurodevelopmental syndrome that includes autistic symptoms). The autistic-relevant behavioral phenotypes of the mu-opioid and Fmr1-KO mouse lines are described here, summarizing previous work by our research group and others, but also providing novel experimental evidence. Relevant factors influencing the validity of the two models, such as sex differences and age at testing, are also addressed, permitting an extensive evaluation of the advantages and limits of monogenic mouse models for autism.

Autism and autism spectrum disorders (ASDs) are heterogeneous, severe neurodevelopmental pathologies. The main core symptoms are: dysfunctions in social interactions and communication skills, restricted interests, repetitive and stereotypic verbal and non-verbal behaviors. Several biochemical processes are associated with ASDs: oxidative stress; endoplasmic reticulum stress; decreased methylation capacity; limited production of glutathione; mitochondrial dysfunction; intestinal dysbiosis; increased toxic metal burden; immune dysregulation. Current available treatments for ASDs can be divided into behavioral, nutritional and medical approaches, although no defined standard approach exists. Current drugs fail to benefit the ASD core symptoms and can have marked adverse effects, are mainly palliative and only sometimes efficacy in attenuating specific autistic behaviors.

Helminthic therapy shows potential for application as anti-inflammatory agent. Several human diseases can be treated by helminths (i.e. inflammatory bowel disease, asthma, multiple sclerosis and autoimmune diabetes). Trichuris suis ova (TSO) show strong immunomodulatory properties. Authors hypothesize that TSO could be useful in addressing ASD immune dysregulations. TSO could be a novel therapeutic option for ASD management.

In rodents, insufficient adenosine produces behavioral and physiological symptoms consistent with several comorbidities of autism. In rodents and humans, stimuli postulated to increase adenosine can ameliorate these comorbidities. Because adenosine is a broad homeostatic regulator of cell function and nervous system activity, increasing adenosine's influence might be a new therapeutic target for autism with multiple beneficial effects.

This article is part of the Special Issue entitled ‘Neurodevelopmental Disorders’.

There is a pressing need for intervention research that reflects real world practice to support evidence-based decision making for families, professionals and administrators who support children with ASD. Some of the challenges confronting intervention research are explored, with solutions offered based on single case design methodology. Challenges with single case designs are also outlined and contemporary solutions that are applicable in real world contexts are illustrated in a study by the authors. Research utilizing these strategies may assist with facilitating practitioners to engage in practice-based research to bridge the research to practice gap in intervention with young children with ASD.