1.  The impediments to effective social, communicative and cognitive functioning that exist in childhood continue into adolescence and adulthood.  Manifestations of impairments associated with the autism spectrum depend on the timing, quality and duration of interventions as well as the individuals’ level of intellectual and adaptive functioning. There can be improvement as well as adaptive learning. Therefore, there is ongoing need for:

• Social skills training and refinement of skills;
• Speech and language development.

2.  Psychological and psychosocial supports are essential during various transition periods. Biological and societal factors include the transition into puberty and coping with associated adolescent issues; transition from school to adult programming; the transition from family to community based living; coping with aging parents; and loss of significant others. Therefore:

• Ongoing support for individuals via psychological and psychotherapeutic interventions is indicated. The type of support required depends on the ability to communicate and the degree of psychological mindedness and relatedness;
• Family supports are essential during these periods.

3. Individuals with autism have significant deficits in the development of social skills.  Some find the stimulation of social interactions aversive. There may be difficulty relating to others’ feelings and understanding social rules and norms. Sexual interest may be present but there may be problems expressing these feelings and interests in a socially appropriate manner. Therefore:

• The use of techniques such as formal social skills curricula and social stories to understand emotions and recognize the topography of other people’s emotional states in relation to specific situations can be helpful;
• Evaluation of sexual knowledge is indicated.  Educational and counseling when appropriate should be provided.

4. When individuals with autism transition into adolescence and adulthood they continue to require habilitation to prepare them for community-based day and vocational programs, and ultimately, the possibility for competitive employment with or without supports. Therefore:

• Placement into day programs or vocational opportunities must be based on the individual’s strengths;
• Programming will need to be individualized as much as possible;
• Structured settings with fixed routines are preferable.

5. Many individuals with autism have difficulty with fine motor skills, visual spatial difficulties, have unusual sensory interests, and at times defend against both external and internal stimuli including pain. Hypersensitivity to any type of stimuli can lead to either agitation or even withdrawal as a defense against aversive stimuli. Therefore:

• It is essential to develop fine motor and sensory strategies to compensate for weaknesses in these areas;
• Finding environments where optimal functioning is possible;
• Understanding the function of defensive behavior is essential.

6. People with autism will often have sensory sensitivities that interfere with their functioning; there are interventions that can help them, which include desensitization procedures.

7. Many individuals with autism manifest rigidity in routines, OCD like symptoms, and stereotypic movements that can interfere with functioning as well as the ability to socialize and relate to others in an appropriate manner. Therefore it is essential to:

• Provide Cognitive Behavioral Therapy as needed;
• Shape alternative adaptive skills associated with stereotypic movements;
• Negotiate/Shape new routines that can be tolerated over time;
• Prepare the individual for significant changes in daily routine.

8. People with autism and other related developmental disabilities have a 70% probability of developing psychiatric disorder(s) and/or behavioral problems. These individuals can exhibit a wide range of symptoms associated with specific psychiatric disorders. Symptoms should not be treated in isolation and treatment strategies must be individualized, taking into account the autistic individual’s strengths, weaknesses and ability to tolerate various methods of treatment. Therefore:

• Psychiatric and psychological evaluations are helpful;
• Judicious use of psychotropic medications is indicated;
• Cognitive-behavioral therapy and psychotherapy must be paired with psychiatric interventions;
• Family programs based on coping and modifying behavior are often needed;
• External supports including respite and crisis intervention programs are available in emergencies.