Autism Spectrum Disorder (ASD) presents with diverse developmental, communicative, and sensory

challenges, requiring therapy plans that are highly individualized rather than standardized. This concept paper

explores the determination of therapy plans for ASD by synthesizing evidence from systematic reviews in four

domains: behavioral interventions, speech and language therapy, occupational therapy, and sensory integration

functioning, and communication that start in childhood (Management of Autism Spectrum Disorder in

Children and Adolescents).

Research on the global prevalence of autism was reviewed, considering how socioeconomic, racial, and

geographic variables affect prevalence estimates. The estimation of the prevalence of autism spectrum disorder

is one in 100 children, worldwide (Zeidan et al., 2022). The World Health Organization (WHO) has taken this

matter seriously by producing WHO Comprehensive Mental Health Action Plan 2013–2030 and World Health

Assembly Resolution WHA73.10 for “global actions on epilepsy and other neurological disorders.” (WHO).

Based on statistics from the Malaysian Health Ministry, 589 children in Malaysia who are 18 years of age or

under were ASD in 2021, rising from 562 in 2020. ASD should be diagnosed clinically, through observation

and comprehensive (Murugesan, 2024).

conceptual framework that organizes how individualized therapy plans can be systematically designed across

four core domains: behavioral, speech and language, occupational, and sensory integration. The framework

synthesizes evidence from recent systematic reviews to highlight how assessment profiles, goal setting, and

intensity decisions interact in optimizing therapeutic outcomes for ASD patients.

Therapy planning for ASD requires systematic consideration of assessment, goal setting, and intervention

intensity. It involves comprehensive assessment, goal setting or domain-specific planning (behavioral, speech,

OT, sensory), and determination of intensity, duration & context. Systematic reviews have been conducted

with respect to each step:

functioning, and family/contextual factors. These child and family characteristics help determine which

interventions are most suitable and how effective they are likely to be (Sandbank et al., 2023).

(Chung et al., 2024) also agree that the patient’s profile includes the age, developmental level, strengths, and

deficits. Functional behavior assessments (FBA) and skill assessments are used to identify target behaviors,

skill deficits, and environmental factors influencing behavior.

(Jaicks, 2024) utilizes the Antecedent-Behavior-Consequence (ABC) model to determine the Severity of

symptoms/domains affected as follows:

 Sensory processing

 Relationship-building skills

 Body and object use

(Chung et al., 2024) stress behavioral precision. This variation indicates that comprehensive assessment in

ASD therapy should not rely on a single diagnostic orientation.

Upon completion of the assessment, therapy goals must be tailored to the individual’s developmental profile

and functional needs. Standardized tools and clinical observation guide the selection of intervention goals (e.g.,

attention, self-regulation, communication, adaptive behavior). Interventions are tailored to the child’s age,

developmental level, baseline skills, and target outcomes, which are obtained from the assessment. For

instance, language goals are set by assigning speech therapy, Augmentative and Alternative Communication

(AAC), or Picture Exchange Communication System (PECS), depending on verbal ability (Roberge & Crasta,

2022)

Sensory/self-regulation needs: sensory integration therapy or massage.

The program intensity and complexity can be matched according to the degree of functionality. Higher-

functioning patients can be assigned to structured skill-building and social/vocational goals. Meanwhile, the

lower-functioning patients are aimed for foundational developmental/behavioral support and focus on daily

living skills. Therapy should also fit family capacity: parent-mediated if involvement is possible; and therapist-

led or school-based if limited resources (Sandbank et al., 2023).

In summary, different types of goals or domains have different targets. Behavioral therapies such as Early

Intensive Behavioural Intervention (EIBI), ABA, PRT, and Early Start Denver Model (ESDM) involve broad

development, communication, and adaptive skills. Speech-language therapies expand vocabulary, improve

comprehension, or support alternative forms of communication.

The intensity of therapy in terms of duration, for example, hours/week, and adherence to a structured protocol

affect outcomes. Higher intensity can be beneficial, but may not be effective if the hours exceed what is

sustainable or appropriate (Roberge & Crasta, 2022).

Conversely, the amount of therapy (hours per week) is determined by the child’s needs and capacity. Early

intensive intervention could yield a greater impact (Chung et al., 2024). (Jaicks, 2024) suggest that some

children’s profiles allow for rapid initial gains, while others may need sustained intervention.

These differences highlight a central challenge: high-intensity therapies often yield stronger outcomes but risk

overburdening families, whereas moderate or flexible schedules promote sustainability but may require longer

durations to achieve measurable progress. Therefore, optimal intensity should be adaptively tailored to

2022).

Progress is tracked using criteria such as: speech development, communication/social skills, reduction of

repetitive speech, use of alternative communication, and emotional/behavioral regulation (Нryntsiv et al.,

2025). Progress is tracked continuously; therapy is adjusted if goals are not met or if new priorities emerge.

The plan should also ensure that the improvements are meaningful to the child and family, not just reductions

in problem behavior (Chung et al., 2024). Some profiles require special handling, such as Children with severe

comorbid medical conditions, active pharmacological treatment, or prior occupational therapy (Jaicks, 2024).

The overall discussion identifies the main gap in current ASD therapy literature, which is the lack of

integration among behavioral, sensory, and contextual domains, and the need for adaptable intensity

management. The conceptual framework proposed here addresses these limitations by outlining a systematic,

al., 2025)

Standardized speech &

language assessments

Speech therapy, AAC, PECS, social

communication interventions; match

therapy to communication baseline

Crasta, 2022)

assessments; observation

of regulation/attention

massage, adaptive seating, weighted

vests, sensory diets; to improve

regulation, attention, engagement

3. Management of Autism Spectrum Disorder in Children and Adolescents. Retrieved 11 August 2024 from