By Raising Children Network
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Young girl with ASD playing with Lego blocks

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Although there’s no reliable proof that any particular intervention will ‘cure’ ASD, we do know that interventions chosen to suit children’s particular needs and strengths will help them develop skills for everyday life.
 
If you’re the parent of a child with autism spectrum disorder (ASD), you’ll come across many different therapies or interventions for the condition. There’s no need to become an expert on them all. But if you can get a handle on the main intervention types, you’ll be better able to understand your child’s options.

What are interventions for autism spectrum disorder?

Intervention means doing something, taking action or using a treatment to try to improve a particular condition or problem.

When it comes to autism spectrum disorder (ASD), there are many kinds of interventions. Different interventions might involve children, parents or both. They might be one-off events or involve many sessions spread over years. 

What types of intervention are there?
There’s a huge range of treatments for ASD. They range from those based on behaviour and development to those based on medicine or alternative therapy. Some interventions even combine several others, and some are variations that are tailored for individual children.

Interventions are based on different theories about the causes of ASD. These theories guide the approach taken, so hearing the theory behind an intervention helps you understand what it’s trying to do. For example, a theory about chemical imbalance in the body leading to ASD might lead to a therapy involving taking prescribed drugs or making changes in diet to address the imbalance.

Below is a summary of the main types of intervention, with a look at what the research says. This is just one way to categorise interventions, and you’ll find that some interventions are based on (or include the use of) others.

Your choices of ASD interventions will depend a lot on what’s right for your child. Ideally, professionals will work with you to find an intervention that suits your child and family. Generally, the 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 (ABA), like those using Discrete Trial Training (DTT) as a teaching technique. 

Behavioural interventions

Behaviour-based approaches to autism spectrum disorder (ASD) focus on teaching children new behaviours and skills by using specialised, structured techniques. These techniques are the best teaching tools for developing skills and encouraging appropriate behaviour.

Behaviour-based approaches are probably the most scrutinised and best supported by evidence and research. Therefore, they’re the most commonly used type of intervention for children with autism. Interventions using an Applied Behaviour Analysis (ABA) approach are particularly common and well supported.

There’s still some discussion about different behaviour-based interventions and how the research on them should be interpreted. For example, it isn’t always clear whether the research is claiming that the intervention has led to ‘recovery’ or to an improvement in symptoms.

Examples of behaviour-based interventions include:

Medical interventions

Medical interventions tend to focus on treating characteristics of autism spectrum disorder (ASD), including the difficulties children experience in the areas of social interactions and relationships, communication and language, and repetitive behaviour and routines.

Every now and then, you’ll hear about a new ‘miracle cure’ for autism. So far there is no medicine proven as a cure for ASD. Rather, most medication is used to improve (but not necessarily remove) problems like:

  • behaviour associated with ADHD, like inattention or hyperactivity
  • symptoms of anxiety
  • obsessive compulsive behaviour
  • self-harming behaviour
  • sleep disorders.

Prescribed medications might reduce these behaviours enough so that behavioural or developmental interventions are more effective.

Examples of medical interventions include:

Things to consider about medications
It’s always best to talk through medication options and use with your health professional, because there are clear rules about how medical interventions should be managed.

Some medications have had positive effects on particular symptoms, like aggressive or hyperactive behaviour. But measuring the effects properly isn’t easy, and symptoms need to be monitored very carefully. You can discuss this with the prescribing doctor.

Also, more research is needed on the long-term side effects of medication, because many medications have never been tested on children. Instead, they’ve been trialled with adults, and it’s only assumed that they’ll work with children.

Some medications that have been shown to be ineffective and/or harmful for children with ASD include:

Developmental interventions

Developmental approaches to autism spectrum disorder (ASD) aim to help children with forming positive, meaningful relationships with other people. They focus on teaching children social and communication skills in everyday, structured settings. They also aim to help children develop skills for daily living.

Although there isn’t enough good-quality research on developmental interventions, studies on small parts of some of these interventions have shown positive results.

Developmental interventions are sometimes called ‘normalised’ interventions.

Examples of developmental interventions include:

Combined interventions

Some approaches combine elements of behavioural and developmental methods, and also use new information about autism and typical development.

Often a combined approach is the most effective, because it brings together characteristics of several good interventions. For example, any behavioural intervention will be much more effective if it’s also family-based.

Examples of combined interventions include:

Family-based interventions

Family-based interventions for autism spectrum disorder (ASD) emphasise the idea that family involvement in therapy is central to meeting children’s developmental needs. In particular, parents not only drive the decision-making about interventions, but they also take a key role in delivering them.

These interventions are designed to provide guidance, training, information and support to family members.

Research on how well family-based interventions work is limited but growing. Their success depends on having strong and collaborative parent-professional relationships. Their effectiveness also relies on addressing the needs of the whole family, so that everyone in the family benefits, not just children with ASD.

An example of a family-based intervention is the More Than Words® program.

Therapy-based interventions

Therapy-based approaches to autism spectrum disorder (ASD) directly provide a specific therapy that targets specific difficulties. Examples include:

  • developing a child’s communication and social skills using speech therapy
  • developing skills for daily life, including physical skills, using occupational therapy.

Therapy-based approaches are often used together with (or as part of) other intervention programs.

Examples of therapy-based interventions include:

Alternative interventions

Alternative interventions for autism spectrum disorder (ASD) include a broad range of treatments not often used in the mainstream medical system, because they’re not supported by scientific evidence.

There’s a lot of discussion and controversy about alternative treatments for ASD. This is because there isn’t much evidence to support their effectiveness. Also, considerable evidence shows no effect at all for some – for example, secretin. And there are potential risks associated with some of these treatments – for example, withholding the MMR vaccine.

Another common concern about these types of therapies – even those that do no direct harm – is that they use time, energy and sometimes money that families could otherwise spend on accessing well-established and well-supported therapies. 

Examples of alternative interventions include:

Psychodynamic interventions

Psychodynamic approaches to autism spectrum disorder (ASD) are based on the assumption that ASD comes from emotional damage to children. This theory isn’t supported by evidence, and there’s little evidence to demonstrate how effective these therapies are. 

Severely traumatised children can show behaviour that looks like ASD. But strong evidence now supports the theory that ASD is a developmental and brain-based disorder, rather than an emotional one.

Psychodynamic interventions are now seldom used for ASD.

Examples of psychodynamic therapies include holding therapy.

Other

These include a range of interventions that sit outside the categories listed above. So far there isn’t much quality research testing the outcomes for these programs.

An example of this type of intervention is music therapy.

Video Finding and starting early intervention for ASD

In this short video, parents talk about early interventions for autism spectrum disorder (ASD). They describe how it can be difficult and confusing to know where to start with interventions and therapies. They also share their experiences of some different interventions and tests.

There are many excellent resources and interventions available. But as these mums and dads note, it’s important to choose interventions that are right for your child and that are based on scientific evidence.

 
 
 
 
  • Last updated or reviewed 25-11-2016
  • Acknowledgements This article was developed in collaboration with Amanda Richdale, Olga Tennison Autism Research Centre, La Trobe University.