Managing Autism in Children

No other psychiatric diagnosis has more profound negative implications than autism. On the surface, autism impacts social, emotional, behavioral, and academic functioning. However, autism is pervasive in ways less immediately observable, and, as a result, children with autism require developmental and educational interventions that are different in both form and intensity from those required by children with other special needs.

Finding the appropriate intervention is difficult. A parent must first have an in-depth understanding of the diagnosis because, to be of benefit, interventions need to be geared to the individual child.¹ Assessing general intellectual and developmental functioning and the presence of comorbid disorders is a first step in identifying appropriate interventions. This is best accomplished by a multidisciplinary approach, and guidance and coordination by the psychiatrist is crucial.

Psychiatrists must also address the parents' functioning and adjustment to the diagnosis: prolonged reactions of shock, denial, helplessness, guilt, anger, grief, and resentment interfere with the parents' ability to negotiate the many obstacles they will face in securing effective services for their child, not just initially, but over the course of their child's life. Parents will find that the most sought-after and proven programs (such as those that primarily use the principals of applied behavioral analysis [ABA]) are limited in availability because of fund- ing issues, waiting lists, or geography. Adding to the stress is that time is of great importance; there is substantial evidence that early and appropriate intervention is strongly related to better outcome.

For psychiatrists to advocate for these children, it is necessary to become familiar with why these chil-dren need specific and intensive ser- vices, how these interventions are applied, and what the outcomes are of these treatments.

How are children with autism different?

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