General management and advice to patient and family

• The child’s educational placement is a crucial element in ensuring the child’s potential is maximised.
• The optimal provision should be decided on an individual basis following a full assessment, and taking into account the severity of the child’s difficulties, their overall level of intelligence and their language abilities.
• Children may be best placed in a specialist school for children with autism or in a unit for children with autism or communication difficulties within a mainstream or special school. Higher functioning children may benefit from education in mainstream school, although they usually need additional help and support.
• Affected children generally need explicit teaching about social conventions and guidance and feedback on appropriate ways of interacting with others. Break times and lunchtimes can be particularly difficult for children in mainstream schools, who are vulnerable to bullying.
• At home, parents should complement the behavioural and teaching strategies of teachers, speech therapists and other professionals. However, the behaviour of children with autism can vary substantially across different environments and parents might need advice and help to deal with particularly problematic behaviours at home, for example sleep problems, feeding difficulties with rigid adherence to certain foods, difficulty with change in routines. There is evidence that parents can manage these behaviours successfully using parent training approaches (ref 248).

References

248 Diggle T, McConachie HR, Randle VRL. Parent-mediated early intervention for young children with autism spectrum disorder (Cochrane Review). In: The Cochrane Library, Issue 2, 2003. Oxford: Update Software. Two studies were analysed. There is some evidence that parent training might provide benefits to both children and parents. However, large-scale randomized controlled trials are needed, to involve both short- and long-term outcome information, to evaluate for which children parent-mediated early intervention might be most beneficial, and to include economic evaluations.

Last edited: 20/1/2004

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