Core Interventions for ASD are those developed specifically as treatment for behaviors and symptoms associated with ADS. Related and additional therapies include those therapies not exclusive to Autism, but may also be used to treat many other disorders.

Given the communication problems inherent in ASD, speechspeech-language therapy plays an integral part in the intervention program. Speech Therapy can be provided in the home, school or clinic setting. Speech Therapy is provided by a certified SpeechSpeechLanguage Pathologist or an SLP assistant under the supervision of a certified SLP.

Diane Sisk M.S. CCC-SLP, Mobile, AL working with Grace on speech.

Children with ASD can present with communication skills ranging from non-verbal to verbal communication. phrases or sentences) . music. nonCommunication problems most associated with ASD include: Perseveration (repetitive verbal and physical behaviors) Echolalia (immediate and/or delayed ³echoing´ of words.

Hyperlexia (precocious knowledge of letters/words or a highly developed abilitiy to recognize words but without full comprehension) Dactolalia (repetition of signs). and difficulty with ³wh´ questions ³wh´ Significant deficits in social skills and pragmatics . pronoun reversals. inappropriate responses to yes/no questions.

feeding/swallowing. fluency and vocal production. . articulation.The Speech Pathologist will provide a comprehensive diagnostic assessment including: receptive and expressive language. social skills and play skills. oral motor skills. pragmatics.

complexity. . adjectives. Articulation/phonology ± includes developing speech sound production. verb tenses. regular and irregular plurals. strength and coordination of oral motor movements. and people.Receptive Language ± the understanding of spoken or written language including naming objects. prepositions. Expressive Language ± the production of language including sentence structure. and length of utterance. rate. actions. OralOral-Motor Skills ± includes improving the range.

and safe swallowing. and play skills such as sharing. smells and consistencies. tastes. chewing patterns. and toleration of differences in temperature. Social skills/play skills ± includes appropriate social language.Feeding and Swallowing ± includes ability to close lips. turn-taking. manipulate food with tongue. and playing independently turnand with others. . ability to understand social cues/body language. ability to read facial expressions. textures.

dictionary. . and judgment.dictionary. symbol system. Cognition ± the mental processes of knowing.Pragmatics ± the use of language in social context. including awareness. (www. techniques. or combination of these to support or enhance communication Alternative or Augmentative Communication.the use of Communicationany device. www. perception.

The student is taught to initiate communication using these symbols and then skills are expanded to the use of sentences. . Many children who use PECS later develop some verbal skills and move on to the use of speech as the primary form of communication.´ ´ Sign Language ± use of ASL alone or paired with speech Picture Exchange Communication System (PECS) ± the use of picture symbols to communicate wants and needs.

Total Communication ± system that pairs simultaneous production of speech with manual signs. lights. Other communication devices ± designed to allow the user to create longer messages.´ ´ ´ Communication Boards ± developed with either picutures. augmentative devices or symbol systems. The child is encourage to use words and phrases that he/she is capable of and to use the signs and symbols to communicate what too difficult to produce verbally. These devices can also act as a universal remote which allows the user to operate electronic devices in the environments such as TV. picutures. . photos or real objects that the child points to or removes from the board to communicate. etc. .org Speech and Hearing Association of Alabama: Ohio Speech-Language Association: SpeechArkansas Speech Language Association:www.SPEECH THERAPY RESOURCES ´ ´ ´ ´ Ohio¶s Parent Guide to Autism Spectrum Disorders ± www.arksha.arksha.shaa.

SLP RESOURCES ´ ´ ³Writing and Developing Social Stories: Practical Interventions in Autism´ by Caroline Smith available at Little Pilgrims Labeling DVD Series .

PHYSICAL THERAPY ´ ´ Physical Therapists(PT) are specialists in sensorimotor development. PT¶s identify movement problems and determine what may be interfering with the ability to develop ageageappropriate gross motor skills. They are knowledgeable in the use of orthotic and prosthetic devices and assistive technology. . muscle and joint function. balance and coordination. posture. and gait and functional mobility.

Physical Therapy may work closely with the occupational. sensory integration. They also assist preschoolers and schoolschool-aged children in becoming safe in their daily environments. jumping. such as using stairs and climbing. PT¶s are very important in helping ASD children acquire the skills necessary to play on playgrounds or participate in physical education or sports. and catching. . or speech therapists.PHYSICAL THERAPY CONTINUED ´ ´ ´ Physical Therapists help young children with ASD by assisting them in walking. running. pedaling. American Physical Therapy Association: www.RESOURCES Ohio¶s Parent Guide to Autism Spectrum Disorders ± Ohio Physical Therapy Association: .apta.ohiopt.

eating. or clothing care) *play or leisure activities . hygiene. feeding. shopping. socialization. Performance areas include: *activities of daily living (grooming. dressing). functional communication and functional mobility *work and productive activities and home management (meal preparation.OCCUPATIONAL THERAPY ´ ´ Occupational Therapy focuses on an individual¶s ability to perform daily life tasks or occupations that give life meaning.

tying shoes. . This focuses on controlling sensory input during specific activities. OT intervention is targeted towards those areas that are interfering with the child¶s ability to function. and eating. Targeted tasks may include: handwriting. Intervention with autistic children often includes a sensorysensory-integration approach.OT CONTINUED ´ ´ ´ ´ Following an evaluation. Sensory Integration will be discussed in more detail in the next section. improving handhand-eye coordination. buttoning. getting dressed.

.SCHOOL-BASED OT ´ ´ The focus of OT in the school is upon educationally relevant goals and associated with curriculum standards OT in the schools requires consultative approach in working with the entire educational team to ensure that accommodations and interventions will be implemented and effective.

Use of slant boards. specially lined paper. track objects across midline. and guided and colored transparencies. paper windows. extended time. shortened work load. use of keyboard. and perform the visual motor control needed to read text write. VisualVisual-Motor and Visual-Perceptual skills ± Visual        address the student¶s ability to control eye movements smoothly shift focus. use of note-taker or adapted software programs. .OT AREAS OF INTERVENTION FineFine-Motor control/written output ± ´ ´ ´ ´ ´ ´ fine-motor strengthening and coordination pencil-grips.

OT AREAS OF INTERVENTION CONTINUED ´ Postural Stability and Control ± Occupational Therapists may also help students in maintaining efficient seating postures (dynamic seating with therapy ball. camping pillow or a Move µn Sit Cushion. .

SENSORY INTEGRATION ´ ´ ´ Sensory Integration was first researched by A. Jean Ayres. Some bits of sensory information get ³tied up in traffic´ and certain parts of the brain do not get the sensory input they need to function. Sensory Integration is a process used by the brain to locate. . Ayres described sensory integration dysfunction as a ³traffic jam´ in the brain. sort and make sense out of incoming sensory information. PhD.

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Extreme sensitivity to noise, touch smell, or taste Need for bear hugs due to a hyposensitive proprioceptive system. These hypersenstive and hyposensitive reactions impact the child¶s ability to function independently in many areas of life (peer interaction, attention at school, and daily living activities.


Proprioception ± the sensation from joints, muscles, and tissues that lead to body awareness. These sensations occur when lifting, pushing and pulling heavy objects as well as engaging in activities that compress or pull apart the joints. This is the sense that allows a person to guide his arm or leg movements without having to observe the movement to make sure it is happening.


Vestibular ± the sense of movement, centered in the inner ear, obtained by spinning, swinging, and any type of body movement or change in head position. This system coordinates the movement of one¶s eyes, head, and body and tells the body where it is in space. The vestibular sense in central in maintaining muscle tone, coordinating two sides of the body and holding the head upright against gravity.

the sense obtained by providing a variety of input from textures. Music with an irregular beat and contrasting volumes tend to be energizing. Some auditory input has been shown to have a calming and organizational effect.´ ´ Tactile ± the sense of touch. Music containing 60 beats per minute can have such an auditory response. . It is closely connected to the vestibular system. The auditory input is obtained by listening to various types of music or natural sounds. temperature and pressure. Auditory ± the sense of what we hear.

This sense can also calm. or organize the nervous system.´ ´ ´ Visual ± the sense of sight can be used to calm or alert the nervous system. Taste ± The sense of taste is obtained by the use of sweet. . alert. salty. Olfactory ± the sense of smell can also calm. stimulate or send a child into sensory overload. crunchy. Visually busy or ³cluttered´ environments can interfere with some children¶s ability to concentrate and learn. soft or chewy foods.

carrying). trampoline jumping. wearing weighted vests. Components of a sensory diet may include brushing. swimming. chewing hard and or crunchy objects.THE SENSORY DIET ´ ´ ´ Following an evaluation of a child¶s sensory processing abilities and needs. heavy work (lifting. . the OT will work with parents. swinging. wearing earphones. tactile play. The sensory diet is a carefully designed program that provides the sensory input a child¶s nervous system needs to stay focused and organized. slp¶s and other professionals to develop a ³sensory diet´. teachers. wrist or ankle weights.

This procedure should only be used by professionals trained and under the supervision of a trained occupational therapist.WILBARGER PROTOCOL ´ ´ The Wilbarger Protocol is a system of tactile and proprioceptive input using a soft bristle brush to provide carefully controlled sensory input. . if done incorrectly. it can have harmful results. always followed by a deep pressure/joint compression system. While this protocol has been anecdotally reported as effective in regulating sensory processing for some.

aota.S.OCCUPATIONAL THERAPY RESOURCES ´ ´ ´ ´ ´ ´ ³The Out of Sync Child´ and ³The Out of Sync Child Has Fun´ by The American Occupational Therapy Association: www.braingym. Kranowitz ³Asperger Syndrome and Sensory Issues: Practical solutions for making sense of the world´ by Myles.actionbasedlearning.asp Brain Gym: www. Rinner and Robbins Action Based Learning: Junction of OT Function: http://junctionof-ot . Cook. Miller.

com Ohio¶s Parent Guide to Autism Spectrum Disorders: RESOURCES CONTINUED ´ ´ ´ ´ ´ ´ ´ The Kid Foundation: The Ohio Occupational Therapy Association: SI Focus magazine: www.otwww.SIFocus.otinnovations. www.htm Occupational Therapy Innovations: OT Exchange: Occupational Therapy and Autistic Children:

Vision Therapy is a process of retraining the visualvisualperceptual system so it functions with optimal efficiency. Visual Perception is the means by which a person becomes aware of his body¶s relationship to external space.VISION THERAPY ´ ´ ´ Some children with ASD experience visual-perceptual visualproblems. or the relationship in space between one object and another (Kranowitz. . 1998).

. who claim that vision therapy is not supported by scientific data. Therapy activities are carried out in the office and frequently reinforced with home activities. There is some conflict between proponents of vision therapy and many ophthalmologists.´ ´ ´ ´ The process of Vision Therapy follows a sequence of steps aimed at improving the visual system. Vision Therapist contend that while ophthalmologists are experts in eye disease and surgeries. they are underunder-informed in the area of vision therapies and the benefits they can provide. Ohio¶s Parents Guide to Autism Spectrum Disorders: www.VISION THERAPY RESOURCES ´ ´ Optometrists Network: .ocali.

sequencing and processing.INTERACTIVE METRONOME ´ ´ Interactive Metronome is an assessment and treatment tool used in therapy to improve the neurological process of motor planning. behavioral therapists and music therapists who are trained in Interactive Metronome . It can be used by OT¶s. PT¶s. educators. SLP¶s.

. goalgoaloriented process that challenges the patient to synchronize a range of hand and foot exercises to a precise computer-generated reference tone heard computerthrough head phones.´ ´ Interactive Metronome provides a structural. The client attempts to match the rhythmic beat with repetitive motor actions. A patented audio-visual audioguidance system provides immediate feedback measured in milliseconds and a score is provided.

com .interactivemetronome.INTERACTIVE METRONOME GOALS ´ ´ ´ ´ ´ ´ Increase focus attention for longer periods of time Increase physical endurance and stamina Filter our internal and external distractions Improve ability to monitor mental and physical actions as they are occurring Progressive improvement of coordinated performance www.

Fast ForWord -Fast ForWord software helps with: ´ ´ ´ ´ ´ ´ EARLY PHONICS DIFFICULTY. DYSLEXIA. . LEARNING DIFFICULTIES.COMPUTER BASED INTERVENTIONS I. READING COMPREHENSION. The Fast ForWord program has been around for over a decade and has helped over one million students. AND AUDITORY PROCESSING DISORDERS II. AUTISM.

com .COMPUTER BASED INTERVENTIONS ´ www.gemlearning.

www.earobics. As students engage with the software. the program automatically adjusts based on each student¶s Individual strengths and weaknesses. plus .COMPUTER BASED INTERVENTIONS ´ ´ Earobics is a powerful and transformative multisensory reading intervention for raising academic achievement. Earobics software provides individualized. explicit instruction in all areas of reading.

aitinstitute. 10Sessions are provided under the supervision of AIT therapists or other AIT trained professionals. www.AUDITORY INTEGRATION THERAPY ´ ´ ´ ´ ´ Auditory Integration Therapy is a sound therapy designed to retrain a disorganized auditory system and improves hearing distortions and sound . Developed by Dr. Guy Berard Participants listen through headphones to modulated music therapy from an ³AIT´ device for 20 sessions of 30 minutes each for a total of 10 hours over 10-12 days.

and supplements to address behaviors.BIOMEDICAL INTERVENTIONS ´ ´ Biomedical Interventions for ASD include the use of medication. and sensory needs. . diets. The following is an over-view of the more well-known overwellbiomedical interventions. There are many such interventions available. cognition.

anxiety. aggression. and self-injury. and other doctors may prescribe medications to target the following symptoms: hyperactivity.MEDICATIONS ´ ´ ´ ´ ´ A variety of medications have been prescribed for individuals with ASD. .oscai. no one medication is effective for every individual with ASD Neurologists. Of course. sleep problems. obsessive www. medications are prescribed on a trial basis with close monitoring of positive and negative effects. selfAs a rule.autism-society. Psychiatrists.

parents should not embark on any intervention without the guidance of the child¶s doctors. As always. Consultation with a gastroenterologist or nutritionist is also a important step toward implementing any dietary or supplementary program. these intolerances and allergies may contribute to behavioral issues.NUTRITIONAL AND DIETARY INTERVENTIONS ´ ´ ´ Individuals with autism may exhibit low tolerance or allergies to certain foods or chemicals. . While not the specific cause of ASD.

THE GLUTEN-FREE /CASEIN-FREE DIET ´ Proponents of this diet believe that some individuals are unable to completely digest the protein in cereals (Gluten) or in dairy products (Casein). known as peptides. From this premise. it follows that long-term exposure to longthese peptides can have damaging effects on the developing brain and can also affect behavior. resembles opiates and are thought to have an opiateopiate-like effect on the brain and nervous system. . The molecular structure of the partially undigested proteins. just as a narcotic would.

Gluten is most commonly found in wheat. rye and barley and some oats. Casein is found in dairy products. . One obstacle is that the children who would benefit from this diet often crave foods with Gluten and Casein and are sometimes reported to experience withdrawal symptoms.´ ´ ´ ´ Beginning such a diet can be difficult because Gluten and Casein are found in many. many prepared and ready to eat foods.

com www.´ ´ ´ ´ ´ ´ It may take up to six months for gluten and one month for casein to clear out of the system.ocali. Advocates of the diet recommend trying it for at least a year to give the best chance for improvement. Calcium supplements may be necessary on this diet Autism Network for Dietary Intervention: CFCF Diet Support Group: .gfcfdiet.

three petroleum-based preservatives and certain petroleumsalicylates. with the exception of salicylates are made from petroleum and digesting them uses up the PST enzyme. These additives. salicylates. Salicylates and phenols also depress the levels of PST enzyme.FEINGOLD DIET ´ ´ ´ ´ This diet is a food elimination program developed by Ben F. Feingold to treat hyperactivity. flavors. aspartame. This diet is free of artificial colors. . which is the main enzyme for detoxification of the body.

´ ´ ´ ´ Removing these artificial foods from the diet allows the people with marginal PST enzyme will have it available to detoxify the body including the .feingold. Proponents suspect individuals with ASD have a marginal amount of the PST enzyme. Feingold Association: www.ocali.

. the diet may help individuals with ASD who experience gastrointestinal problems. and sucrose-free regimen. promote and fuel the growth of bacteria and yeast in the intestines. The theory is that carbohydrates. causing an imbalance of bacteria and yeast.SPECIFIC CARBOHYDRATE DIET ´ ´ ´ This diet is a strict grain-free. being forms of sugar. grainsucroseIt was initially developed for individuals with celiac disease and other intestinal disorders. however.

www.Gastrointestinal abnormalities in children with autistic disorder.533135.K.ocali. Journal of Pediatrics. 135.´ ´ ´ Toxins and acids are then formed by the bacteria and yeast which injure the small intestine . Horvath.(1999).533-535.

An imbalance in this bacteria causes the yeast to grow uncontrolled.ANTI-YEAST DIET ´ ´ ´ ´ This diet was developed to address the overproduction of or allergies to a certain form of yeast: Candida albicans. it is usually harmless because it is controlled by beneficial bacteria. While it is impossible to keep out of the body. . releasing acidic toxins into the bloodstream. These toxins slow the brain down. albicans.

vinegar. pickles. Some believe that individuals with ASD are likely to have an allergy to or overproduce this .ocali. and aged www.´ ´ ´ ´ The anti-yeast diet consists of removing fermented antifoods from the diet. Nutrition Institute: www. soy sauce. chocolate. barley malt. nonnon-alcoholic beer. These foods may include: alcohol.

eye contact. . and immune system function. brain. Vitamin B12 ± a deficiency is characterized by the inability to absorb food. a fatty layer which insulates nerves in the sheth. It is essential for metabolism of fats and carbohydrates and the synthesis of proteins. Vitamin B12 is also involved in the production of the myelin sheth. behaviors.SUPPLEMENTS ´ ´ B6 and Magnesium ± reported to help improve language. brain electrical activity.

Tri-methylTMG. melatonin has been shown to improve sleep patterns. . SAMe is a nutritional supplement sometimes used to treat mood disorders.Tri-methyl-glycine breaks down into DMG and SAMe in the body. Children with ASD often have sleep problems. Melatonin ± a hormone made by a part of the brain called the pineal gland. It may help our bodies know when it is time to sleep and wake.´ ´ ´ ´ DMG ± Dimethylglycine is a food substance found in brown rice and liver. TMG.

Vitamin C ± is a anti-oxidant that helps the brain utilize antioxygen. . Megson (2004) began vitamin A therapy with her patients and observed positive results in improved speech and language and eyeeye-contact.´ ´ ´ Vitamin A ± high doses have been used to treat the measles virus. Administering vitamin A should be under a doctors supervision. as too much can be toxic. Using cod liver oil.

and a nutrient nonessential to the brain¶s health. confusion and depression can develop. It can also help support the immune system.kirkmanlabs. and cod liver www. probiotics. Folic Acid ± a non-toxic B vitamin.ocali. It has been reported as helpful in treating autism.´ ´ ´ ´ ´ ´ Without vitamin C. aid in detoxification. Autism Research Institute: www. Other supplements include essential fatty acids. and fight viruses and bacteria. zinc.autism. probiotics. It is most effective when taken with vitamins B12 and .com Kirkman Labs: www. . Rimland).org Defeat Autism Now!: www.DEFEAT AUTISM NOW! PROTOCOL (DAN) ´ ´ ´ ´ ´ ´ ´ This protocol is a guide for clinical assessment of individuals with ASD developed by participants in the DAN Conferences organized by the Autism Research Institute (founded by www.defeatautismnow. Autism One: www.ocali. Bernard Rimland). The basic premise of the DAN! Protocol is that heavy metal toxicity in the form of thimerosal in Center for the Study of Autism: Generation Rescue: www. or some other source is the cause of the symptoms of autism.generationrescue. amalgams.

He claimed that a combined measles. and his findings were published by a prominent British medical journal the Lancet. Reality Check ± The February 7th edition of the San Francisco Chronicle reported the following: ³ in the case of autism.´ ´ Chelation therapy is the process involving the use of chelating agents to remove heavy metals from the body. . a sketchy study by British physician Andrew Wakefield in 1998 set the vaccine blame game in motion. mumps and rubella inoculation given to infants was linked to the disease.

The damage will be hard to undo.´ ´ But follow-up research by other teams failed to match followhis results. The Lancet disavowal this past week capped the collapse. violations of research ethics and a "callous disregard" for the 12 children involved in the research. a range of conditions that disrupts communication skills and social interaction.´ . his study fell apart amid charges of dishonesty. In recent years. Autism." he said. has grown in reported numbers as parents and doctors learned to recognize its symptoms. Nearly 1 in 100 American children is diagnosed with autism or a related condition. How does he feel about the wholesale discrediting of his work? The findings are "unfounded and unjust.

RECREATIONAL THERAPIES ´ Recreational Therapy is a general term used to describe the practice of using leisure activities as therapeutic interventions. and may include. but are not limited to the following: . Such therapies provide opportunities for supporting and enhancing communication and social and motor activities.

Swimming provides movement that can help enhance motor planning. endurance. and increase function.AQUATIC THERAPY ´ Aquatic Therapy is the use of water and specifically designed activities to help restore. Water pressure can be soothing and calming for children with ASD . maintain. Aquatic/swimming therapy focuses on therapeutic play activities that improve range of motion and increase balance. and body awareness.

AQUATIC THERAPY RESOURCES ´ ´ ´ Aquatic Resources Network: Ohio¶s Parent Guide to Autism Spectrum Disorder: Aquatic Therapy and Rehabilitation Institute: .

mental. organization. and emotional well-being. planning and artistic expression. . visual motor. wellArt Therapy can increase fine-motor. finevisual perception skills.ART THERAPY ´ ´ Art therapy is an established profession that uses the creative process of art to improve and enhance the physical. Art Therapy Credentials Board: Ohio¶s Parent Guide to Autism Spectrum Disorders: www.ocali.ART THERAPY RESOURCES ´ ´ ´ American Art Therapy .: www.

Music is a form of non-verbal communication in that nonemotions and feelings can be expressed through melodies and lyrics. Music therapy can also have a positive effect on selfselfesteem and reduce anxiety while developing appropriate expression of emotions. motor. and social skills.MUSIC THERAPY ´ ´ ´ Music Therapy is the prescribed use of music and musical interventions to work towards specific therapeutics goals and objectives. emotional. academic. . Goal areas include communication.

Musical games like passing a ball back and forth to music or playing with sticks and cymbals with another person may foster interaction. . teacher. or other professionals.´ ´ ´ Music is a natural reinforcer«immediate in time and provides motivation for practicing non-musical skills. nonParallel music activities are designed to support the objectives of the child as observed by the therapist or as indicated by the parent. A music therapist might observe the child¶s need to socially interact with others.

Preferred music may be used contingently for a wide variety of cooperative social behaviors like staying in a chair or remaining with a group of children in a circle.´ Eye contact may be encouraged with imitating clapping games near the eyes. .

musictherapy.MUSIC THERAPY RESOURCES ´ ´ ´ American Music Therapy Association.ocali.html Ohios¶ Ohios¶ Parent Guide to Autism Spectrum Disorders: www.: Center for the Study of Autism: www.autism. .org/music.

uses horses as a source of treatment to improve balance. and self-esteem. independence. thus providing a good foundation on which to build relationships with others. behavioral. and mobility. While learning from the horse. or therapeutic horseback riding. Horseback riding enables one to participate in a enjoyable activity while increasing attention span. . and communication functions of individuals of all ages. posture. It can also improve the cognitive.THERAPEUTIC HORSEBACK RIDING ´ ´ ´ ´ Hippotherapy. riders often bond with the horse as well as the other riders.

org Ohio¶s Parent Guide to Autism Spectrum Disorders: www.americanequestrian.: www.narha.htm North American Riding Association.THERAPEUTIC HORSEBACK RIDING RESOURCES ´ ´ ´ American Hippotherapy Association: www. .com/hippotherapy.

. These tricks are simple at first and then more complex tricks as they proceed and then exploring the benefits of each one.HOCUS FOCUS ´ ´ Hocus Focus is a student centered experiential based education approach that utilizes the art of magic in the context of empowering relationships with the goal of student growth and development. It is a systematic approach by which students learn to focus and accomplish specific goals and objectives by learning magic tricks.

http://hocusfocuseducation. The activities combine education and imagination to help children improve skills in planning. Lessons are designed to address the eight areas of neuroneuro-developmental function (Levine. memory skills and more. fine motor skills. sequencing. organizing tasks and movements. gross motor function/ .´ ´ ´ Hocus Focus is presented in nine teaching models. 2002) using magic tricks to impact educational development.

therapists. teachers. Careful consideration of the individual needs of the child along with input from doctors.SUMMARY ´ As a parent or clinician. and parents should be reviewed before initiating any new intervention. the sheer amount of supportive therapies for the ASD child is quite overwhelming. .

RESOURCES ´ The Ohio¶s Parent Guide to Autism Spectrum Disorders: .ocali.