Autism and Mental Health
“Autism spectrum disorder (ASD) is a developmental condition that affects a person’s ability to socialize and communicate with others. The term “spectrum” refers to the degree in which the symptoms, behaviors and severity vary within and between individuals. Some people are mildly impaired by their symptoms, while others are severely disabled.” (nami.org)
1 in 36 children are diagnosed as being on the autism spectrum. Although autism is a developmental condition and not a mental illness, those with autism can also struggle with mental health. In fact, there is a high rate of additional diagnoses such as depression, anxiety, or OCD in those with autism (Young minds, 2023). Therefore, a variety of therapies are helpful with learning to live with autism, such as speech therapy or occupational therapy. However, including mental health therapy as a form of treatment could prove to be very beneficial.
Because autism is a developmental condition, abnormal behaviors are often prevalent. This may stem from the child being unable to communicate thoughts and feelings. It could also be because they do not know how to manage those thoughts and feelings. This causes those children to either act out, scream, and become physical, or for them to become quiet, distant, and seclude themselves. Parents and therapists can work together to implement behavior modification strategies.
Each situation is unique to the child, so teamwork and patience are key to find what works. Maybe there is a way for a nonverbal child with autism to try to communicate feelings through signs or using objects. Parents and caregivers may learn what works to calm the child, and therefore to use that method regularly. For a child who becomes physical, it may be important to teach safe ways to manage those difficult emotions.
For young children, Play Therapy and Floor Time Therapy are interactive forms of therapy that can help with mental health (Brennan 2023). For example, if a child with autism is playing with a toy, a therapist might join in with the play to connect about feelings the child may be experiencing. Maybe through pretend play, a therapist can help the child recognize different emotions and demonstrate how to manage them. Eventually, a goal might be for the child to play with another child. Music and Art therapy are also forms of therapy that may help a child with autism to communicate and regulate feelings.
Applied Behavioral Analysis, ABA, is another form of therapy, specifically behavioral, aimed to help reinforce positive behaviors through a reward system. “Treatment goals are based on the individual. They might include communication, social skills, personal care, and schoolwork. Studies show children who receive early, intensive ABA can make big, lasting gains,” (Brennan 2023). There are different types of ABA used in various situations such as Discreet Trial Training (DTT) and Pivotal Response Treatment (PRT). “ABA is one of the most researched behavioral therapies for autism. It teaches children positive behavior while discouraging the negative. A child, for example, may be directed to hand his therapist a pencil. If he does, he will receive a reward, such as praise or a small toy. If he doesn't, he will receive a prompt, such as the therapist moving his hand to the pencil.” (nami.org)
Relationship Developmental Intervention (RDI) is another form of therapy that has proven to be beneficial. This technique teaches children with autism how to form bonds with family members. It focuses on psychological, social, and flexible thinking as well as how to handle day to day transitions. This includes the ability to form an emotional bond and share experiences with others. According to the Autism Speaks website, there are six objectives of RDI.
Emotional Referencing: the ability to learn from the emotional and subjective experiences of others.
Social Coordination: the ability to observe and control behavior to successfully participate in social relationships.
Declarative Language: the ability to use language and non-verbal communication to express curiosity, invite others to interact, share perceptions and feelings and coordinate your actions with others.
Flexible Thinking: the ability to adapt and alter plans as circumstances change.
Relational Information Processing: the ability to put things into context and solve problems that lack clear cut solutions and have no “right and wrong” solutions.
Foresight and Hindsight: the ability to think about past experiences and anticipate future possibilities based on past experiences.
Cognitive Behavioral Therapy (CBT) is a form of talk therapy frequently used in psychotherapy sessions. It can be used with a verbal child on the autism spectrum to help identify negative cognitions, to minimize the feelings associated with them, and to rebuild self-esteem. Client-centered therapy would also be helpful to identify feelings, learn to manage emotions, and even to vent about issues with bullying, depression, anxiety, or relationships.
It may also be useful to have a psychotherapist working with the whole family. If the therapist is familiar with autism, they may be able to help by discussing challenges arising at home. The parents may learn more about autism and some techniques to better assist their child.
It's important to separate autism and mental health symptoms. Although they may look similar, it would be helpful to know if the visible signs are due to the autism or due to a mental health issue and treat accordingly. For example, if a child with autism is overstimulated and reacts by screaming and stomping, it shouldn’t be confused with having a mental health problem that needs to be evaluated and treated. On the flipside, if a child appears to throw a tantrum because he has feelings he can’t manage, it should be recognized as a mental health issue that can be mitigated instead of accepting it under the umbrella of autism and letting it go.
As the world becomes more and more familiar with autism, more has been discovered to assist with those on the spectrum. Although psychotherapy may not cure autism, it can help those living with it to learn, adapt, and function as well as possible.
Kyndal Sims
Birch Psychology
https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Autism
https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Autism/Treatmen
https://www.webmd.com/brain/autism/therapies-to-help-with-autism
https://www.youngminds.org.uk/young-person/mental-health-conditions/autism-and-mental-health/