Autism Spectrum Disorder (ASD)

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The disorder autism (ASD) was first reported by Kanner in 1944. He described a small number of children with a seemingly innate inability to communicate and interact with other people, but who were at the same time very sensitive to changes within their physical surroundings. If these children displayed any form of language development at all, this was characterized by echolalia (the compulsive repetition of words and parts of sentences) and problems in the use of pronouns and with being concrete. The children also displayed unusual types of stereotypical behaviour, unbefitting their situation. At first, all of this was thought to be a type of child psychosis, but soon after it was concluded that autism is a disorder in its own right. In order to make the diagnosis autism, problems in the following three areas should occur:

1. Social relationships – For instance, a lack of, or a strongly diminished display of verbal communication, few or no friendships with persons in the same age group and a lack of social-emotional abilities.

2. Communication and play – The problems express themselves in a delayed or sometimes even failing development of language skills. Furthermore, the child has trouble iniatiating and maintaining conversations; language is stereotypical and imaginative play is absent.

3. Limited interests and activities which reveal themselves in a strong preoccupation with just one subject or activity and the need to maintain certain rituals.

What exactly ASD is and what causes it still remains somewhat unclear. Research has now proven the importance of genes in the development of autism: autistic children often have family members with characteristics related to autism.


At present there is no treatment to cure ASD does not exist. However, certain types of treatments and coaching have proven to decrease some of the symptoms, helping children and adults with ASD to function better within society. Because ASD symptoms and their severity cover a large range, it is important that patients are treated with a combination of techniques from the various disciplines. Treatment should be aimed at the multiple aspects of the disorder.


For children with ASD, the best results are obtained when treatment is aimed at the various aspects of their behaviour. This kind of treatment is based on an analysis of their behaviour and examines the way in which the child’s surroundings influence it. This way of looking at behaviour is called ABA (Applied Behaviour Analysis). The treatment analyses the settings in which a certain type of behaviour occurs, the events which precede this behaviour and the way they influence it. In treating children with ASD, special attention is paid to: the use of language and communication, social interaction, the ability to play, cognitive and academic skills, locomotive skills, independence and problematic behaviour. These behaviours are studied over long periods of time and are, if necessary, adjusted. The best known treatment using the ABA method is DTT (Discrete Trial Training). Each complicated skill is divided into smaller parts, which are trained systematically and intensively during training sessions. If the task is executed in the right way, the child is rewarded for its good behaviour, but when the child fails at executing the task well, its behaviour is ignored and the tasks is explained once more. On average, this method results in an increase of the child’s IQ by 20 points. However, this method is very intensive (40 hours of training a week, for a period of at least two years or more), not all symptoms decrease, and as much as 50 % of children do not experience any significant improvement.


For children with ASD, communication skills are of considerable importance. These skills can best be trained in collaboration with a speech therapist. In case the child does not use any words yet, sign language and pictures may be employed. Children who do use words are taught to apply them to the different social situations they encounter in life.


Children with ASD should also be coached by their trainers and parents in other sets of skills, for example locomotive and academic skills.

Cognitive Behavioural Therapy

This form of therapy may be applied to children and adults who function well within society, in spite of ASD. The treatments helps to overcome fears, depressions and problems in controlling aggression.


Sometimes children with ASD are prescribed medication. This happens when they display certain symptoms, such as aggression, hyperactivity, attention disorders, compulsive behaviour and sleeping disorders, which could benefit from medication. This too may be the case when, alongside ASD, children or adults also suffer from anxiety disorders or depressions.


1. (in Dutch).

2. Volkmar, F. et al. (2014). Practice Parameter for the Assessment and Treatment of Children and Adolescents With Autism Spectrum Disorder. Journal of the American Academy of Child & Adolescent Psychiatry (53), 237-257.

3. Vismara, L. A. & Rogers, S. J. (2010). Behavioral treatments in autism spectrum disorder: what do we know? Annual Review of Clinical Psychology (6), 444-468.


The first version of this article was written by Olga Teutler. This article was translated into English by Anna Visser.


Autism, autistic, behaviour treatment, behavioural training

Flag of the Netherlands.svg Read this article in Dutch: Autisme Spectrum Stoornis (ASS)

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