Choosing evidence-based interventions
You wouldn’t give your child a medicine if you didn’t believe it worked – if it hadn’t been tested as effective and safe to use. So, before you assume that an ASD intervention is effective and safe, it’s best to seek out some reliable information about it.
Interventions that are based on scientifically validated and reliable evidence are the ones most likely to:
- be worth the time, money and energy you have to invest
- be safe for your child.
Here are some tips for choosing wisely and thinking critically about individual interventions.
Generally, evidence suggests that early interventions that use a behavioural or educational focus have the best outcomes for the majority of children with ASD. These interventions include those based on the principles of Applied Behaviour Analysis
(such as those using Discrete Trial Training
as a teaching technique).
Question the claims
Sometimes it’s hard to know whether an intervention for ASD really works. Often this is because it’s not clear what claims are being made about the intervention, or what the outcomes of the intervention are supposed to be.
For example, you might want your child to ‘behave better’, ‘act normal’ or ‘be more social’. Perhaps a therapist is telling you that a treatment will ‘cure’ your child.
To find out whether these claims are valid, you might ask:
- How will we know whether the intervention has worked?
- What does ‘better’, ‘improvement’ or ‘cure’ really mean? That is, what changes in our child should we expect to see?
- How will the changes be measured?
- Could the changes be measured by anyone (objectively)?
- Is there a risk of bias, or ‘seeing what I want to see’?
Question the evidence
As a parent learning about a therapy, you might be finding it difficult to look at things critically. It’s easy to feel overloaded with information, or convinced immediately that the treatment works – after all, you just want to help your child. You’ll also get conflicting advice (even from professionals) about what will work. And to make things even harder, many interventions have not been properly tested.
Under these circumstances, it’s worth asking what evidence there is that the therapy does what it says. The information you find on an intervention won’t always be clear and conclusive, but it’s always best to make an informed choice.
The following questions can help you consider the testing and science behind the therapy.
Some questions to ask about testing
- Has the therapy been tested?
- Was the test reliable or fair? That is, was a scientific approach used?
- Did the test use unbiased research methods that could not be influenced by the person running the tests?
- During the test, could other factors (such as parent or therapist expectations) have influenced the results? What about the placebo effect?
- Was a control group (or 'comparison group') used in the test?
Some questions to ask about the science
- Have other people tested this therapy and come up with the same results? This also helps to ensure that the results one researcher got weren’t because of other factors, and were in fact because of the therapy.
- Were the results published in a scientific journal? Or by an organisation or association with a good reputation?
- Were the results published more than once, or as part of a bigger study (such as systematic review)?
- Can I get copies of what’s published?
These questions about evidence and the science behind it are based on what we know about how interventions are tested.
Choosing a good fit for your child and your family
There are also some practical and personal questions you’ll need to consider alongside the evidence before committing yourself to an intervention. Consider the following questions to help you decide if an intervention is a viable option for your family.
Cost: is the intervention affordable? If not, are there subsidised options or funding that can help?
Time and involvement: some interventions are time consuming and require a high level of parent involvement. Can your family commit to this? What arrangements would you need to put into place to make it work?
Availability: is this intervention available in your area? Is there a way you can use it if not? Are there places available in the program?
Child fit: does the intervention meet the current needs of your child?
Family fit: does the intervention meet the goals and needs of your family? Does the intervention fit with your family’s beliefs and values? Or can adjustments be made to accommodate these?
It might also help to read more about choosing disability service providers in our Children with a Disability section.
Intervention warning signs
- Beware of any claims that an intervention will cure or fix your child, or make your child ‘normal’.
- Beware of the jargon. Lots of scientific-sounding language doesn’t necessarily mean that the approach is scientific.
- Is the cost over the top? Beware of interventions that might be trying to sell you something or whose costs seem out of proportion to what they are offering. Talk to people you trust to find out more.
- Some interventions might seem harmless. If they are not appropriate for your child, however, they can waste time and energy that would be better spent on interventions that are likely to result in better outcomes.
- Beware if you see lots of testimonials or anecdotes about the intervention’s effectiveness. Testimonials don’t replace quality research. Families might give testimonials for many reasons, and there might be many reasons why an intervention seems to have worked. The family might have been doing something else that helped, the improvement may simply have been consistent with the child’s expected development, or it may be the placebo effect.
Finding and starting early intervention
In this short video, parents talk about finding and starting early intervention for their children with autism spectrum disorder (ASD). They share their experiences with different interventions and tests.
As they note, there are many excellent resources and interventions available, but it’s important to choose interventions based on scientific evidence that work for your child.