Therapies and supports for autistic children: why does advice differ?
It’s common to get different or even conflicting advice about particular therapies and supports for autistic children, depending on where the advice is coming from. For example, you might get different advice from doctors, allied health professionals, researchers, other parents and so on.
Advice differs for several reasons:
- There might not be enough reliable evidence about a therapy or support to give you clear advice about it.
- Advice, reliable and otherwise, comes from all kinds of sources – for example, doctors, researchers, other parents, alternative practitioners and so on. These people might not agree with each other, or they might interpret the evidence differently, so their ideas about what you should do will differ.
- Professionals might not be familiar with some therapies and supports and prefer to keep using the ones they already know.
- Different people use different definitions of evidence. For example, some people rely on results from scientific studies for evidence that a therapy works. Other people feel that personal testimony or anecdotes are good evidence. This means that they have different standards for assessing and advising on what works.
- Someone might be trying to sell or promote a therapy or support. The advice you get about that therapy might be biased as a result.
Why do professionals disagree about what works for autistic children?
Sometimes health professionals, therapists, service providers or institutions disagree on the effectiveness of therapies and supports for autistic children.
This might be because they:
- have different definitions of ‘effective’ or ‘successful’, based on their own therapeutic or professional backgrounds – for example, speech pathologists and psychologists might look for improvements in different areas
- disagree on the theory behind a therapy, regardless of its track record
- use different research tools, methods or techniques to reach their conclusions
- use different terms to describe what therapies and supports do – the advice they give you might sound different but mean the same thing
- have different ideas about how therapies should be tested or evaluated.
It’s a good idea to ask professionals about the scientific evidence behind therapies or supports as well as why they’re recommending or not recommending particular therapies or supports. Therapies and supports that have been scientifically tested and found to work are most likely to be worth your time and money.
Why can’t we just say which therapies and supports work for autistic children?
At raisingchildren.net.au, we can usually say which therapies and supports are better supported by research. But in most cases, more research is needed to say whether an approach really ‘works’.
Also, a therapy or support that ‘works’ for one child might not be suitable for another child. For example, a child who doesn’t use speech and a child who can talk in sentences will benefit from different communication therapies or supports.
And ‘it works’ can mean different things, which makes it difficult to compare approaches. For example, one therapy might claim that ‘it works’, meaning that it ‘improves communication’. Another might make the same claim and mean that it ‘cures autism’.
How scientific studies can help you understand what works for autistic children
Scientific studies can answer questions about what therapies and supports are effective for autistic children.
These studies help you find out whether a therapy has been classified as:
- established – the research shows positive effects
- promising – some studies show positive effects but more research is needed, or there might be mixed results
- yet to be determined – there’s not enough research available
- ineffective or harmful – the research shows that the intervention has no effect, there are negative outcomes, or it might be harmful.
Our Parent Guide to Therapies summarises current research on therapies and supports for autistic children. It can help you understand the therapies and supports and make informed choices about them. The ‘research rating’ isn’t all you need to know. When you’re choosing a therapy, your decision will also be based on other factors – for example, costs, availability and what suits your family.
Why is it hard to prove therapies and supports work?
When people test therapies and supports, the testing has to meet a range of scientific standards. If these standards are met, you can feel confident that the testing has been done carefully, and that the evidence is reliable.
But there are obstacles to testing therapies, including the following:
- Good research costs time and money, and often proper testing has to wait until someone funds the research. Still, it can be useful to know that a therapy is still untested or researchers are undecided.
- Tests aren’t always designed to the highest standards. For example, the best testing usually involves designs based on randomised controlled trials, or several single-subject design trials, but this might be difficult. For example, it might be difficult to do a controlled trial because of the way a therapy is set up, or how participants feel about being in a control group.
- Comparing different tests can be difficult. For example, they might measure outcomes in different ways.
Obstacles aside, new tests are being carried out all the time, so it’s always worth asking professionals about what the evidence says.