What sorts of therapy are useful for a child at that age?
Our daughter has difficulty in path planning (fine motor). She was delayed walking and as a result had low muscle tone. Her attention (eye contact, joint attention) was also poor, which made learning other skills difficult. Since very young she would hyper focus on objects like strings and would tantrum when you try to transition her to new task or object. The objects were usually not appropriate or typical and her interaction with them was not considered typical (repetitive behavior).
She now walks, has great eye contact and joint attention and is learning new words everyday (though still has some speech issues). She also plays more creatively and appropriately with toys... it's really opened up so much for her.
Mostly these are play based therapies. The difference is the way that tasks are broken down. For a lot of kids you have to master and work on REALLY basic steps for a long time before moving to even basic things (like stacking rings or requesting an object).
Any kid would benefit from these therapies, there is no magic to them. It's time and observation. We set goals for her then work with specialists to break down the operations and work with her to master fundamentals. Each new skill tends to unlock all sorts of other skills.
ABA is a trial based therapy that has a lot of good and bad information out there about it. It is basically what I just described but in a much more structured and documented manner. It's one of the more researched methods of treatment and has been proven to be highly effective. It's again tailored to the child, so there is no good way of describing other than to say that it emphasizes mastery of skills, errorless learning (no negative responses for wrong behavior) and intense hours (some kids do 40 hours of ABA a week alone).
As I mentioned, each kid really has their own set of issues, so it's tough to say what will work for each kid.
I read a few Behaviorist books when she was diagnosed. A lot of the therapies/techniques are really just good parenting advice.
A few articles on the topic might help for anyone unfamiliar that wants to learn more.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564498/ http://www.scientificamerican.com/article/gut-bacteria-may-p... http://news.nationalgeographic.com/news/2014/11/141114-autis...
I don't know a huge amount about the connection, but I know many autistic kids have GI issues (loose stools) and this has many families considering diet changes as a treatment, so to speak.
If you look through my history, you will see that I actually donate stool for stool transplants. My understanding of the connection (or what the hypothesis is) is that the flora of children doesn't adjust the same in autistic kids as it does in others. We naturally have a level of Clostridia bugs in our guts when we are born and they typically taper off at around 10 months or so. It's believed that in some kids, it doesn't taper off and continues to grow in their gut. As we know, Clostridia bacteria are great at producing toxins (botulism, c. diff toxin, GAS gangrene) and it's believed the Clostridia that are in the babies guts are producing neurotoxins that produce these autism symptoms. We've completed transplants on a few autistic kids with mixed results (younger kids seem to do better than older kids, the thinking is that the older you get, the more damage the neurotoxins have done).
As many have pointed out, autism is still such a new diagnosis, and it's truly a spectrum of symptoms, but also a spectrum of causes. Therefore a stool transplant might not work for every child.
The biomedical side of autism is often dismissed, and likely misunderstood, which I think explains the downvotes. Spending time with hundreds of children with autism, and you start to hear similar complaints and issues. Many of these kids are sick.
Diet can drastically alter these populations, and therefore when parents adjust diets (remove gluten, remove dairy etc etc) they are actually adjusting the gut flora.
The GFCF diet (and others) seems to get criticized because parental reporting doesn't seem to match scientific studies. But the anecdotal evidence is overwhelming. The Autism Research Institute has surveyed thousands of parents about diet and results, and some of the diets have a high success rate with helping some symptoms.
Our daughter had severe GERD at a young age, she would be screaming through the night in pain. Apparently GERD and gastro issues are somewhat typical of kids with ASD.
That being said I did a lot of reading on effective treatments. There's absolutely no shortage of parents seeing results with dietary changes and it's a fascinating area. Unfortunately I have not found any studies that conclusively make any link that we feel comfortable implementing.
Gluten intolerance and dairy intolerance run in my family. For the last 4 months we have cut out gluten. The reason is that it seems to anecdotally have a high link to symptoms and it's super easy to eliminate (comparatively).
Our Pediatrician (who is well versed on this sort of thing) expressed concerns that often the strict diets bring a fair amount of stress to both the parents and child. ASD kids often have feeding issues already... I know several who only eat 1 or 2 types of foods. She did not feel comfortable based on the research recommending any drastic change.
On a side note... there are a TON of well meaning and desperate parents out there. There are also TONs of unscrupulous companies who will make all sorts of claims. One of my biggest concerns is with all the poorly researched vitamin and medical interventions. I am not stupid enough to dismiss the entire field as without merit... but I have seen some pretty awful claims and therapies that have huge risk and almost no factual evidence. It's a scary landscape out there if you are uneducated and desperate.
You don't have to do a ton of searching to find some really scary interventions out there being done on very young children.
The day we implemented the diet, I took her to the cabinet and opened it up. It was empty but for a few things she still could have, and we eventually filled it with things she was allowed.
Flash forward to today, and her favorite foods are almost entirely vegetables and meats. She is very restricted - no dairy, gluten, soy, corn, sugar, any grains, and little processed food overall. She has been sick (cold) once in the past three years and attends elementary school.
The stress of a child not sleeping for years far outweighs the stress of meal planning and preparation, at least in my family (wife is at home).
I'm not a doctor (if that wasn't obvious already), but diet worked for us and she quickly realized that she would have to eat from choices we provided. There was no more than maybe a day of any negativity about it from her. Her diet now is incredibly healthy, and my wife is creative to make things that are safe alternatives to stuff that other kids are eating.
Some diets take more prep time than others, but I don't know that I've ever heard of stress to family or child as a stated objection to try it.
What has been you experience since the alteration? My daughter has trouble with feeding, but at this age it's less about what it is than it is about the process itself. She eats veggies and meats mostly anyway... so eliminating most things would be fairly straightforward for us.
My concerns are minimal... I just don't want to restrict without good cause.
Some people fear the diets because they are afraid of lacking nutrition. You do need to be aware of which diets may end up naturally being deficient in certain things, and you need to make an effort to include those things (like calcium or perhaps D in CF).
The biggest concern of mine when talking about diet is effort. Many people don't do it because 'it's too hard', and they don't want to spend that amount of time in the kitchen. Some allow a level of cheating ('one piece of pizza won't kill him/her'), which defeats the purpose of the diet entirely.
So the 'stress to the child/family' objection your doctor offered is the weakest of the usual objections, and if you really wanted to try diet your doctor likely wouldn't object.
In our case, daughter had diarrhea and loose stools for almost an entire year, every day. We started on SCD (Specific Carbohydrate Diet), which was originally designed for Crohn's or colitis patients I believe, and within a short time (weeks maybe?) she started being entirely regular.
We all (wife, daughter, me) did the early part of the diet together, so when we sat down she was eating what we were eating. First few days was basically broths, then it gradually introduces easy to digest foods (well cooked meats and certain vegetables). Her stomach has been fine ever since. We're not still on SCD, but we still eliminate several things as I mentioned before.
If you want more details on anything about my experience, my email is in my profile.
Even after 3 there is a tremendous value to these therapies... it's never too late.