Pros and Cons of Rural Living
As one study has shared (Preece, D. 2021), living with autism in remote or rural settings have their own set of benefits and challenges. ...
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Living on the Spectrum
Defining the Challenge of Life on the Spectrum
Living with autism means living with a variety of potential challenges, including troubles with social communication and interactions, difficulties understanding or recognizing emotions in others, low impulse control and sense of self-preservation, and a limited repetitive set of behaviors and interests. These symptoms can occur in a variety of ways, and at varying intensities, but there are ways to recognize, diagnose, and adapt to life on the spectrum.
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Autism Defined
The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) was published by the American Psychiatric...
Intended for All Audiences
This website is for anyone looking for more information about interacting with children on the spectrum, with particular focus on middle...
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How a Physician can Help
There are many FDA approved medications to treat symptoms and "specific behaviors, such as to reduce self-injury or aggression" (nichd.nih.gov) relating to autism. Depending on the symptoms that are being exhibited a healthcare provider may suggest and prescribe any combination of the following:
SSRI's and antidepressants
Tricyclics
Psychoactive or anti-psychotics
Stimulants
Anti-anxiety medications
Anticonvulsants
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How Counselors Can Help
Due to the broad scope of ASD, the treatment for children on the spectrum is equally varied. “When developing treatment plans, counselors are encouraged to create goals that decrease the quantity and severity of maladaptive behaviors and increase skill development." (Feather, K. 2023). It is important for the counselor to take the whole family into consideration, both their suggestions and their emotional needs, as they are the ones who are living with the daily challenges of autism. While working directly with autistic children, it is best to keep the sessions well-structured and focused, using visual materials to aid communication. Counselors should not be rigid in their treatment and adapt to the individual client (Hilviu, D. 2023).
More recent interdisciplinary therapy approaches have had more positive results than singular, one dimensional style of therapy in the past. Applied Behavior Analysis (ABA) can now be adopted alongside Cognitive Behavior Therapy (CBT) to help work with autistic children to improve speech and attention. "Additionally, social models of disability emphasize the role played by societal attitudes and barriers in disabling individuals with special needs, thus centering intervention efforts on the interplay between the individual and the society. According to this perspective, individuals with autism should not be seen as passive recipients of treatments designed to 'normalize' their behavior, but as participants in their community whose unique needs, goals and contributions to the society require societal accommodations, rather than an exclusive focus on modifying the behavior of the individual. Both autism research and treatment are increasingly receptive of this conceptualization." (Vivanti, G. 2021). In other words, preferences, motivations, and choices of individuals with autism are taken into consideration instead of therapists pathologizing it as something that needs to be "fixed".
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Home Strategies
Adjustments made at home to help an autistic child thrive.
There are many things a family can do around the home to help a child with autism feel more comfortable.
For structure and routine, visual cues can be provided to show what is behind closed doors, rooms can be kept tidy and organized, and each room can have a single consistent activity or usage. To aid in communication, visual instructions and color coding has proven useful. If therapy is done in the home, using a dedicated space that is set up with minimal distractions can be helpful.
One can also consider the materials used around the house, including sound proofing between rooms and around outside walls, as well as utilizing furniture that is extra sturdy, and unbreakable (plastic or paper) dishware. Natural lighting, avoiding fluorescent bulbs, and climate control can all help with hyper-sensitivity. Providing large spaces to let out excess energy, as well as small quiet spaces for the child to retreat to should they get overwhelmed can help a child feel more at ease (Nagib, W. 2017).
For security, doors and window with out of reach locks, camera systems, and sensor-operated water taps and oven controls can all help keep everyone safe and avoid damage to the home. Open floor plans that allow the autistic child to be observed from a distance without having someone right in their space can be very calming.
Quality family leisure activities that everyone can enjoy have also been found to improve overall family communication, and thus provide better family functioning and satisfaction (Walton, K. 2019).
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School Strategies
Individual lessons that can be tailored to an autistic child's needs are ideal, although not always possible, particularly in public school settings. There are private schools that provide this kind of education, but they are expensive without aid. Teachers and counselors in public schools must work to educate themselves and be willing to look after the needs of the children in their care. For example, techniques such as allowing an autistic child to explore their own interests can help keep their attention and can be built upon to explore other lessons with them.
A simple change would be to allow them to remain in one classroom for all of their lessons, rather than swapping every period. If changing rooms is required, then allowing them to move between rooms before or after the other students have been let out would protect them from excessive noise and jostling. Allowing usage of open spaces, such as the gymnasium, for sensory play when other students aren't there would be beneficial, as would establishing a quiet place for the autistic child to retreat to if they get overwhelmed, such as a counselor's office or the nurse's station (Teaching Autism, 2021).
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References and Resources
REFERENCES
Aman, M. G., McDougle, C. J. et al. Medication and parent training in children with pervasive developmental disorders and serious behavioral problems, 2009, Journal of the American Academy of Child & Adolescent Psychiatry 48(12), 1143-1154
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.
Baou, C., Bell, G. et al. Effectiveness of primary care psychological therapy services for treating depression and anxiety in autistic adults in England: a retrospective, matched, observational cohort study of national health-care records, www.thelancet.com/psychiatry Vol 10, 2023, Lancet Psychiatry 2023; 10: 944–54
Broderick, P.C. & Blewitt, P. (2019). The Life Span: Human Development for Helping Professionals (5th ed). Hoboken, NJ: Pearson Education Inc.
Feather, K., Dahl, H. et al. "I Don't Think There's a Cookie-Cutter Way of Working With People With Autism": Mothers of Children With Autism and Their Experiences With Counseling Services, Department of Counselor Education, School Psychology, and Human Services, University of Nevada, Las Vegas, Department of Educational Psychology, Northern Arizona University, Journal of Mental Health Counseling, Volume 45/Number 4/October 2023/Pages 319-339/https://doi.org/ 10.17744/mehc.45.4.03
Hilviu, D., Frau, F. et al. Can Narrative Skills Improve in Autism Spectrum Disorder? A Preliminary Study with Verbally Fluent Adolescents Receiving the Cognitive Pragmatic Treatment, Journal of Psycholinguistic Research (2023) 52:1605–1632 https://doi.org/10.1007/s10936-023-09945-4
McDougall, F., Willgoss, T. et al. Development of a patient-centered conceptual model of the impact of living with autism spectrum disorder, Autism 2018, Vol. 22(8) 953–969 sagepub.com/journals-permissions DOI: 10.1177/1362361317718987 journals.sagepub.com/home/aut
Nagib, W. and Williams, A. Toward an autism-friendly home environment, School of Geography & Earth Science, General Science Building, McMaster University, Hamilton, Canada. Housing Studies, 2017 VOL. 32, NO. 2, 140–167 http://dx.doi.org/10.1080/02673037.2016.1181719
Preece, D. and Lištiaková, I. L. “There Isn’t Really Anything around Here . . . ”: Autism, Education and the Experience of Families Living in Rural Coastal England. MDPI, education sciences, Basel, Switzerland. Educ. Sci. 2021,11(8), 397; https://doi.org/10.3390/educsci11080397
Shannon, C., Olsen, L. et al. “There’s nothing here”: Perspectives from rural parents promoting safe active recreation for children living with autism spectrum disorders, University of British Columbia, BC, Canada, Canadian Institute for Inclusion and Citizenship, BC, Canada, Research in Developmental Disabilities 115 (2021) 103998
Van Rooij, D. Ph.D., Anagnostou, E. et al. Cortical and Subcortical Brain Morphometry Differences Between Patients With Autism Spectrum Disorder and Healthy Individuals Across the Lifespan: Results From the ENIGMA ASD Working Group, Am J Psychiatry 2018; 175:359–369; doi: 10.1176/appi.ajp.2017.1701010
Vivanti, G., and Messinger, D. Theories of Autism and Autism Treatment from the DSM III Through the Present and Beyond: Impact on Research and Practice, Journal of Autism and Developmental Disorders (2021) 51:4309–4320 https://doi.org/10.1007/s10803-021-04887-z
Walton, K. Leisure time and family functioning in families living with autism spectrum disorder, Autism 2019, Vol. 23(6) 1384–1397, sagepub.com/journals-permissions DOI: 10.1177/1362361318812434 journals.sagepub.com/home/aut
RESOURCES
cdc.gov/ncbddd/autism/hcp-dsm.html
gov.mb.ca/healthychild/mcad/middlechildhood, Manitoba, Child and Youth Programs
nichd.nih.gov/health/topics/autism/conditioninfo/treatments/medication-treatment
Teaching Autism and Special Education, podcast, 2019-2021
youtube.com/AmericanPsychiatricAssociation
wix.com (website management)
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