Patient information from BMJ

Autism spectrum disorder: information for parents - Support strategies

Last published:Nov 07, 2024

Autism affects how a person understands and interacts with the world. The medical name for autism is autism spectrum disorder.

Learning that your child is autistic can be overwhelming, it may also be a relief. Understanding autism and recognising your child’s support needs early can make a big difference for your child and your family.

This information helps explain what support strategies are available for autistic children. For more details about autism and how to recognise signs in your child, see our information titled: Autism spectrum disorder: Information for parents - What is autism spectrum disorder?

How do support strategies help autistic people?

Autism affects how a person's brain develops and works. This can affect how they communicate, interact with others, and understand the world around them. It’s not a ‘condition’ that can be ‘treated’ or ‘cured’, but a difference in the way the brain functions. Support strategies can’t change how your child’s brain works, and they don’t make your child ‘less autistic’. Instead, they support your child in expressing their feelings and developing their social and learning skills.

Support for autistic children focuses on helping them lead happy, healthy, and safe lives. It also helps them build communication skills and learn to become more independent as adults. These strategies seem to help most when started at a young age.

Every autistic child is different, and might need different levels of support. For example, a child who doesn't speak will need different support than a child who does. Your doctor will suggest support strategies that meet your child's specific needs. Their needs are likely to change as they get older.

Many people don’t fully understand autism. But as awareness grows, people can better support autistic individuals by accepting their differences, rather than expecting them to change.

What support strategies are available?

Most strategies focus on positive reinforcement to encourage progress. These may include parent-led educational or behavioural approaches to build your child's social and learning skills. They may also include therapies like speech, occupational, or physiotherapy to develop communication and daily life skills.

Parent-led educational or behavioural strategies

There are various programmes you can use to help your child learn through play and daily activities. Specialists train parents to use these methods and can provide ongoing support. This training can happen at home, in a clinic, at school, or in other community places.

Below are some of the most common programmes, but they may not all be available where you live. Some places might use different names for these programmes, and it is important to remember that they may or may not be suitable for your child and your family. Your doctor will suggest what strategies might be best for you and your child.

The following programmes are designed to develop communication, social and learning skills. They are intended for children between 1 and 5 years old.

• The Early Start Denver Model (ESDM): The ESDM is designed for children between 1 and 4 years old and involves using play and activities initiated by your child.

• More Than Words (Hanen programme): In this programme, you will attend parent-only group sessions and then you and your child will join three sessions together. It aims to improve your child’s communication skills by focusing on their strengths and interests.

• Applied behavioural analysis (ABA): ABA focuses on teaching positive behaviours and daily living skills through structured lessons and a reward system. It may be helpful if your child needs a more structured environment.

• Joint Attention, Symbolic Play, and Engagement Regulation (JASPER): JASPER helps your child practise joint attention, which means focusing on something together with another person. It also helps to develop your child’s level of play.

• Learning Experiences and Alternative Programme for Preschoolers and their Parents (LEAP): LEAP involves teaching autistic and non-autistic children together in a preschool setting. Children without autism learn how to support the social and communication skills of autistic children. The programme uses structured activities to guide this learning.

• Preschool Autism Communication Trial (PACT): This programme teaches you how to adapt your communication style to your child’s needs. It focuses on building shared attention through eye contact, sharing, and using language that matches your child's level of understanding.

The programmes below are intended for children between 5 and 18 years old.

• Children’s Friendship Training programme (CFT): This programme helps your child learn how to make and keep friends. It teaches them social skills, such as starting conversations and reading social cues.

• Peer-mediated interventions (PMI): This approach trains other children to help autistic children practise social skills and interactions. It often takes place in schools or community settings.

• Applied behavioural analysis (ABA): ABA usually begins when your child is young (see above) but can continue in older children.

• Treatment and Education of Autistic- and Communications-related Handicapped Children (TEACCH): TEACCH uses structured teaching methods and visual supports to help your child learn in school.

You can reach out to your child’s daycare centre or school to see if they can help with these programmes.

Personalised therapies

Alongside parent-led educational or behavioural strategies, your child might also benefit from other therapies led by specialists. Some of these are listed below.

• Speech-language therapy: This therapy helps children with communication difficulties. It can involve repeating sounds or words, or learning to understand what others mean and how they use words.

• Occupational therapy: This helps children learn and practise everyday skills, like getting dressed or writing, to make these tasks easier and more fun.

• Physiotherapy: This supports children with movement and coordination challenges, such as challenges with walking or using their hands.

Your doctor might suggest a combination of these to meet your child's support needs.

Total communication approach

A total communication approach can help children with speech or language difficulties. This approach uses a mix of methods like talking, gestures, sign language, or pictures to help children communicate and understand others better.

It’s especially useful for children who don’t speak, as it allows them to express themselves in different ways.

Strategies for distressed behaviours

Some autistic children may have behaviours that are hard to handle and can be stressful for you and your family. These might include actions like hitting, kicking, spitting, or pulling hair, but it can also be any behaviour that negatively affects your child or your family.

The main focus should be on understanding why your child is behaving this way, or what triggers the distressing behaviour. It could be due to communication difficulties, pain, or changes in routine, just to name a few.

A specialist will look at the behaviour, try to find the cause, and create a support plan. The support plan will include reducing triggers and teaching your child to express their feelings in a better way.

Positive behavioural support is an approach that rewards appropriate behaviours. It redirects from distressed behaviours without using punishment.

Medicines

If behavioural strategies don’t work, or you can’t figure out what’s causing the behaviour, then your child may be given medicines to help.

Most autistic children don’t need medicines. Medicines are a last resort and are mainly used when children are at risk of harming themselves or others. They aren’t usually given to younger children.

If your doctor recommends medicines, they should explain the potential benefits and side effects to you and your child.

If your child has another condition, like ADHD or depression for example, it will be treated separately. They might be given different medicines to help with these conditions.

Diets, supplements, and complementary ‘treatments’

Good nutrition is important for all children, but there are no special dietary needs with autism.

Several diets and supplements have been suggested as ‘treatments’ for autism. There is no good evidence that any of them have any effect on autism-related behaviours.

It’s important to be wary of approaches that claim to ‘cure’ autism. These may include any complementary ‘treatments’ for autism that you may hear or read about. Some of them may be harmful.

You should talk to a doctor if you are considering any complementary ‘treatments’.

Where to get more help

It's important to get the support you need so you can be in the best position to help your child.

There are many charities and support groups for autistic people and their families. Your doctor may be able to help you find one in your area, or you could search online. These groups often have useful resources and services and can connect you with others who care for an autistic child or relative.