The Role of Therapy in Autism: Understanding Possibilities and Limitations

Autism spectrum disorder (ASD) is a complex neurological condition that affects communication, social skills, behavior, and sensory processing. An ASD diagnosis is lifelong, but the right interventions can help children and adults manage challenges and reach their full potential. This has led many parents to wonder: Can therapy help my child “recover” from autism?

The Role of Therapy in Autism Understanding Possibilities and Limitations
The Role of Therapy in Autism Understanding Possibilities and Limitations

The short answer is that autism itself does not go away. However, with consistent, high-quality applied behavior analysis (ABA) therapy starting early in life, some children can make remarkable progress in communication, behavior, and life skills. While they remain autistic, their improved abilities may make their diagnosis less obvious to others.

What Does an Autism Diagnosis Mean?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the standard reference guide for mental health disorders, autism spectrum disorder is a developmental condition characterized by:

  • Persistent difficulties with social communication and social interaction
  • Restricted, repetitive patterns of behavior, interests, or activities
  • Symptoms present in early childhood that limit or impair everyday functioning

These symptoms start early, persist through adulthood, and lead to clinically significant impairment in important areas of life.

Autism exists along a spectrum. Some autistic individuals need very substantial support for daily living, while others are able to live more independently. However, all autistic people have differences in communication, social skills, sensory processing, and behavior that require acceptance and accommodations.

An accurate ASD diagnosis does not go away over time. Claims of children “recovering” from autism generally fall into a few categories:

  • Misdiagnosis – the child did not actually have ASD initially but was struggling with a separate issue that improved with treatment
  • Mild ASD – the child had high-functioning autism and gained skills to mask social difficulties
  • Effective early intervention – consistent ABA and other therapies allowed the child to gain life and communication skills

The Promise and Controversy of ABA Therapy

Applied behavior analysis is a scientifically-based approach to teaching communication, social, academic, motor, and life skills and reducing problem behaviors. It does this by breaking down skills into small, measurable steps and providing positive reinforcement as milestones are met.

ABA is the most researched autism treatment, with decades’ worth of studies showing its effectiveness for building skills in young autistic children. Research has linked ABA to:

  • Improved IQ and language skills
  • More positive social behaviors and interactions
  • Decreased disruptive behaviors like tantrums or self-injury

However, ABA has also faced criticism, especially from autistic adults who found the therapy restrictive or traumatizing. Much of this stems from early versions of ABA that focused intently on eliminating autistic behaviors like hand flapping or rocking.

Modern ABA therapy has evolved to take a strengths-based approach that identifies each child’s unique abilities and challenges. The primary focus is on functional life skills that allow for greater independence. ABA also incorporates the child’s special interests to motivate learning.

Still, there are legitimate concerns that ABA can seem regimented or “robotic”, as autistic children are intensively trained to maintain eye contact, sit still, and refrain from stimming. Ethical ABA providers balance teaching essential skills with accepting the child for who they are.

Does ABA Therapy Lead to Recovery from Autism?

ABA therapy starting as early as age 2 has the best chance of influencing a child’s development and abilities. When delivered consistently by experienced providers, ABA can help toddlers and preschoolers make remarkable progress with:

  • Communication – from nonverbal to using speech functionally
  • Social skills – from isolated to interactive with peers
  • Cognitive abilities – from intellectual disability to average IQ
  • Behavior – from severe tantrums to self-control

This means that after a year or more of high-quality ABA therapy, some children can transition into a mainstream classroom and need less support in everyday activities. Their autism may seem less obvious.

However, these children still have ASD. ABA allows them to gain skills and coping mechanisms but does not eliminate underlying differences in sensory processing, social reasoning, and communication. As academic and social demands increase, learning and behavioral challenges often reemerge.

Ongoing support remains necessary. While ABA therapy led to substantial improvements, autism itself does not “go away”.

Limitations of ABA Recovery Claims

Autism advocates caution that ABA “recovery stories” have significant limitations:

  • Bias – ABA providers naturally promote and celebrate their best outcomes. This may skew perceptions.
  • Mild ASD – Children with high cognitive abilities and milder symptoms have the most dramatic response to early ABA therapy. This does not reflect outcomes for children with more support needs.
  • Loss of identity – Some ABA seeks to train autistic children to “pass” as neurotypical, at the cost of accepting and accommodating neurological differences.
  • Compliance over quality of life – ABA can value compliance with demands over a child’s happiness, self-esteem, or authentic self-expression.
  • Limited data – Most studies on ABA “recovery” lack long-term follow-up. Success in preschool does not always predict later social and mental health challenges.

While ABA can be life-changing for many children, providers must balance skill-building with compassion and respect for neurodiversity. Truly supportive ABA seeks to expand possibilities for autistic individuals, not erase their identity.

Using ABA to Support Children on the Spectrum

ABA therapy is most successful when providers partner closely with families to understand their child’s challenges and capabilities. Together, they develop an individualized plan targeting functional, meaningful goals that reflect the child’s needs and interests.

Here are tips for using ABA effectively for an autistic child:

  • Start ABA therapy as early as possible, ideally by age 3.
  • Find experienced providers with advanced training and a strengths-based philosophy.
  • Set goals collaboratively that focus on communication, social interaction, self-care, play, and pre-academic skills.
  • Embed ABA into everyday activities like getting dressed, eating, and family time.
  • Advocate for your child’s needs – speak up if activities or demands seem stressful versus skill-building.
  • Be patient. Building new abilities through ABA is a gradual process based on consistency and encouragement.
  • Use your child’s special interests to motivate them during ABA sessions.
  • Monitor progress and adjust ABA goals as your child develops. Therapy should evolve with the child.
  • Consider complementary therapies like speech and occupational therapy to enhance ABA gains.
  • Stay vigilant for signs of anxiety, depression, or loss of self-esteem and advocate for adjustments to therapy.

In-Home ABA Therapy in Maryland

Jade ABA Therapy provides caring, highly customized ABA services to help each child reach their potential. Our experienced clinicians design an individualized program focused on the functional, social, and cognitive skills your child needs to thrive at home, school, and in the community.

We partner closely with families to fully understand your child’s needs and incorporate their passions into therapy. Our ABA sessions take place in the comfort of your home and everyday routines.

Jade ABA Therapy offers top-quality, compassionate ABA services throughout Maryland. Get started today by calling (410) 616-0901 or emailing info@jadeaba.org. Discover how ABA can help your child gain skills for greater connection, confidence, and independence while respecting their unique strengths.

The Takeaway

While autism itself does not “go away”, the right interventions at the right time can help children reach their full potential. Consistent ABA therapy starting as early as possible gives many toddlers and preschoolers the communication, cognitive, and social skills needed to thrive in school and life.

However, autism remains a lifelong diagnosis. Even children who make great strides through early ABA will continue to benefit from accommodations and support. ABA providers should focus on expanding possibilities over “recovery”, pairing skill building with compassion.

References

Treffert, D. A. (2015). Outgrowing autism: A closer look at children who read early or speak late. Scientific American. https://blogs.scientificamerican.com/observations/outgrowing-autism-a-closer-look-at-children-who-read-early-or-speak-late/

Wiggins, L. D., Rice, C. E., Barger, B., Soke, G. N., Lee, L., & Levy, S. (2019). DSM-5 criteria for autism spectrum disorder maximizes diagnostic sensitivity and specificity in preschool children. Social psychiatry and psychiatric epidemiology, 54(6), 693–701. https://doi.org/10.1007/s00127-019-01674-1

Eigsti I. M. (2015). Language comprehension and brain function in individuals with an optimal outcome from autism. NeuroImage. Clinical, 7, 549–559. https://doi.org/10.1016/j.nicl.2015.02.013

Hus, Y., & Segal, O. (2021). Challenges surrounding the diagnosis of autism in children. Neuropsychiatric disease and treatment, 17, 3509–3529. https://doi.org/10.2147/NDT.S282569

Jaffal, M. (2022). Barriers general education teachers face regarding the inclusion of students with autism. Frontiers in psychology, 13, 873248. https://doi.org/10.3389/fpsyg.2022.873248

Begum, F., John, S. E., & Francis, F. (2022). Dirfloor time in engaging autism: a systematic review. Iranian journal of nursing and midwifery research, 27(1), 21–32. https://doi.org/10.4103/ijnmr.IJNMR_272_21

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