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Mental Health Services for ASDs

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Sigmund Freud

Sigmund Freud (Source: Flickr)

Students with Autism Spectrum Disorders (“ASDs”), including Asperger’s Syndrome and Pervasive Developmental Disorder, Not Otherwise Specified (“PDD-NOS”), are often challenged by anxiety, which is an emotional health need. Many school districts contract with county mental health agencies or other providers for forms of individual psychotherapy services that may not be appropriate for some students with ASDs. Further, they may have no other service to offer to address ASD-related anxiety issues.

To add to the confusion, many county mental health agencies have recently re-identified themselves as county behavioral health agencies, yet they do not provide Applied Behavioral Analysis (“ABA”) or any other type of peer-reviewed behavioral intervention. ABA is supported by research to be effective in not only contending with undesired behaviors among persons with ASDs but also in providing explicit instruction to teach the skills these individuals lack.

Explicit instruction in social skills such as greetings, farewells, maintaining a topic of conversation chosen by another person, initiating conversations, and other aspects of human interaction have to taught to many children with ASDs as explicit, scripted procedures. Those procedures can then be generalized into real life by reinforcing them when they occur in natural settings and pointing out to the individual, in vivo, when he/she has engaged in the steps of the procedure so that he/she learns to recognize social contexts in which each script is to be applied.  Eventually, it becomes a learned, rehearsed strategy to deal with specific types of situations.

The degree to which persons with ASDs can master various scripted procedures, or even need this level of support, varies from individual to individual. The same for the degree to which someone with an ASD can generalize knowledge from one context to another, such as from the instructional setting to real life.  It’s called a spectrum disorder for a reason. The range of severity between mild and severe is quite broad and anyone can fall anywhere along it.

Traditional “talk therapy” that promotes developing one’s insight and insight into other people’s perspectives to sort out one’s issues is not necessarily appropriate for some individuals with ASDs. Because there are so many differences among people with ASDs, it’s not fair to say that no one with an ASD can benefit from traditional talk therapy. But, it is safe to say that there are a significant number of students with ASDs who truly cannot benefit from traditional talk therapy but still have emotional health needs that require mental health services as part of their special education programs.

The matter comes down to, “What form of mental health services are appropriate for students in special education who have ASDs and require mental health services in order to benefit from their IEPs?” Well, as with anything in special education, you can’t take a cookie-cutter approach and say one specific type of program will fix everything for everybody. For one thing, no such statement will ever be true; learners with disabilities, even within a population impacted by the same condition, are too diverse for one-size-fits-all programming. Federal law requires individualized programming for this very reason.

That said, there are certain approaches that are generally known to be more effective with students who have ASDs than others. These may work with many students with ASDs, but whether or not they will be effective with an individual student really depends on that student.  The following are possible methods by which effective mental health services can be delivered to some persons challenged by anxiety associated with ASDs.

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