Abstract
The author of this book outlines the basic tenets of the provision of practical information and advice to parents, involving parents directly in therapy and the decision making process, with a focus on changing behaviour through the use of naturally occurring reinforcers, implementing management techniques already in use within families, and improving the communication of parents as well as children. Other principles listed include a graded change approach to the modification of problems and the importance of providing a structured and predictable environment. The book advocates the prevention of problems by promoting liaison between families and social, health and education services, and ensuring treatment is family-focused rather than solely child-focused.
This book begins by comprehensively covering background information on the history of autism and Asperger syndrome, diagnostic criteria, the range of features and problems associated with these conditions, outcome, epidemiology, and aetiology. Some attention is also devoted to the debate surrounding whether the two conditions are actually different, and the confusion still surrounding diagnostic criteria. Illustrative case studies of each condition are also provided. These early chapters also provide information on identifying and assessing children with autism or Asperger syndrome, including useful information on early features and the importance of early diagnosis. The requirements of a comprehensive diagnostic assessment are also clearly outlined and conveniently supplemented by an appendix covering the assessment tools available. The assessment of cognitive ability, language skills, symptoms of autism, and psychosocial factors are all discussed. The importance of a thorough medical examination is emphasised, along with consideration of genetic disorders such as Fragile X syndrome and tuberous sclerosis, and metabolic disorders.
Five chapters are specifically devoted to treatment. These chapters comprehensively review the literature on all treatment approaches, including the claims of ‘miracle’ cures. A useful checklist for parents considering an alternative treatment is also provided, along with a list of seven key questions parents should ask regarding any therapy they are considering. The key areas of improving communication skills, dealing with problems of social understanding, stereotyped and ritualistic behaviours, and other problem behaviours are covered. These chapters contain reviews of research findings in each area, practical definitions and descriptions of techniques, and are supplemented by numerous case examples, which serve to demonstrate clearly the points made by the author. These case examples provide excellent demonstrations of common problems and difficulties that are faced by parents. They clearly show ways in which parents can successfully implement interventions in the home to deal with problems and to teach their children new skills. The broad range of examples and suggestions provides a wealth of innovative and imaginative solutions to a myriad of problems.
The final chapters cover issues around finding appropriate education for children with autism or Asperger syndrome and family issues. The chapter on education is an important one for parents, who are often faced with difficult decisions in this area. It discusses the possible advantages and disadvantages of different forms of education, and, consistent with the previous chapters, provides many illustrative case examples. The final chapter addresses the importance of parent–professional collaboration and working with parents as therapists. This chapter also discusses the effects that a child with autism or Asperger syndrome can have on families.
An important theme throughout the book is that of the prevention of problems. Rather than just providing assistance to families in times of crisis, the early provision of clear, practical advice on how to avoid or deal with potential problems before they emerge or become difficult to deal with is an especially important principle to bear in mind when working with the families of children with autism or Asperger syndrome.
This book was originally conceived as a re-edition of Treatment of Autistic Children co-authored by Patricia Howlin, Michael Rutter and colleagues (1987) [1]. However, the substantial progress made in the field of autism in the past 10 years, particularly in the areas of genetics and neurobiology, and the significant number of treatments reported to have a considerable impact on autism, necessitated a substantial revision of the earlier text. This has resulted in a book that comprehensively covers the literature to date in the area of autism and Asperger syndrome.
I highly recommend this book for both parents and any professional in contact with children with autism or Asperger syndrome. It is an impressive resource summarising the current literature on these conditions and highlighting the importance of home-based intervention that parents can implement. The emphasis on practical, family-focused advice provides an invaluable resource for both parents and clinicians alike.