Choosing early intervention for disability

Choosing early interventions: start with the evidence

When you’re choosing early interventions for children with disability, autism spectrum disorder (ASD), developmental delay and other additional needs, it’s best to start by looking at the evidence.

That’s because early interventions that are based on scientifically tested and reliable evidence are the ones most likely to:

help your child
be safe for your child
be worth your time, money and energy.

But as a parent, how can you figure out whether an intervention is scientifically tested and evidence based? You can:

questions the claims about the intervention
question the evidence behind these claims.

You wouldn’t give your child a medicine if you thought it wouldn’t work – that is, if it hadn’t been tested as effective and safe to use. It’s the same with early interventions. It’s important to check there’s good evidence to say they work before your child uses them.

Questioning the claims about early interventions

Often it isn’t clear what people are saying an early intervention can do for your child, or what the end result of the intervention is supposed to be. For example, an intervention might claim it will help your child to ‘behave better’, or ‘be more social’, or even claim to ‘cure’ your child. But what does this actually mean?

To get clearer information about the claims being made for the intervention, you can ask questions like these:

How will I know whether the intervention has worked?
What does ‘better’, ‘improvement’ or ‘cure’ really mean? That is, what changes in my child should I expect to see?
How will the changes be measured?
Could the changes be measured by anyone (objectively)?
Is there a risk of bias– that is, of seeing what I want to see?

Questioning the evidence behind early interventions

When you feel you understand what people are claiming about an intervention, the next step is asking what evidence there is that the intervention does what it says – and how good that evidence is.

You won’t always be able to find clear and conclusive evidence – for example, the research might say the intervention helps only some children or some problems. But it’s still best to get as much information as you can.

Here are some questions that can help you find out about whether there’s good evidence for the intervention:

Has the intervention been tested?
Has it been tried with other children like my child?
Was the test reliable or fair?
Did the test use research methods that couldn’t be influenced by the person running the tests?
During the test, could other factors like parent or therapist expectations have influenced the results? What about the placebo effect?
Was a control group, which didn’t get the treatment, used in the test? Did participants have an equal chance of being in the control group or therapy group?
Have other people tested this intervention and come up with the same results?

You might also like to find out more about the science behind the intervention:

What theory or knowledge underlies the intervention? For example, is it based on neurobiology, behaviour psychology, cognitive psychology and so on?
Were the results published in a scientific journal? Or by an organisation or association with a good reputation, like a university or hospital?
Were the results published more than once, or as part of a bigger study, like a systematic review?
Can I get copies of what has been published?

These questions about evidence and the science behind it are based on what we know about how interventions are tested.

Deciding on early intervention: what’s the right fit for your child and family?

There are some practical and personal questions you’ll also need to consider before committing your child and family to an intervention. The following questions might help you decide whether an intervention is a real option for your family.

Cost: is the intervention affordable? If not, are there subsidies, rebates or funding that can help you afford it?
Time and involvement: some interventions take a lot of time and need you to do a lot as a parent. Can your family commit to this? What would you need to do to make it work?
Availability: is this intervention available in your area? If it isn’t, is there a way you can use it – for example online? Are there places available in the program?
Child fit: does the intervention meet the current needs of your child?
Family fit: will the intervention help you meet your family’s goals and needs? Does the intervention fit with your family’s beliefs and values? Or can adjustments be made to accommodate these?

Warning signs about early interventions

There are some warning signs that an intervention isn’t all it claims to be.

For example, beware of claims that an intervention will cure or fix your child, or make your child ‘normal’.

Beware of jargon too. Lots of scientific-sounding language doesn’t necessarily mean that the approach is scientific.

Is the cost excessive? Watch out for interventions that might be trying to sell you something or whose costs seem out of proportion to what’s being offered. Talk to people you trust to find out more.

Some interventions might seem harmless. But if they’re not right for your child, they can waste time and energy that you could be spending on interventions that might get better results.

Lots of personal testimonials or stories about how good an intervention is can also be a warning sign, especially if they’re the only evidence supporting the intervention. Testimonials don’t replace quality research. There might be many reasons why an intervention seems to have worked for families who give testimonials – for example, a family might have been doing something else that helped.