Choosing early intervention for disability

Choosing therapies, supports and early interventions: starting with evidence

When you’re choosing therapies, supports and early interventions for children with disability or autism including developmental delay, it’s best to start by looking at the evidence.

That’s because therapies that are based on scientifically tested and reliable evidence are most likely to:

help your child
be safe for your child
be worth the money you spend on them.

But as a parent, how can you figure out whether therapies are scientifically tested and evidence based? You can question the:

claims about the therapies
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 therapies, supports and early interventions. It’s important to check whether there’s good evidence to say a therapy works before your child uses it.

Questioning claims about therapies, supports and early interventions

Sometimes it isn’t clear what people are saying a therapy, support or early intervention can do, or what the end result of the therapy is supposed to be. For example, people might claim a therapy will help your child to ‘behave better’ or ‘be more social’. They might even claim a therapy will ‘cure’ your child. But what do these claims actually mean?

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

How will you know whether the therapy has worked?
What does ‘better’, ‘improvement’ or ‘cure’ really mean? That is, what changes in your child should you 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 you want to see?

Questioning evidence behind therapies, supports and early interventions

When you understand what people are claiming about a therapy, support or early intervention, the next step is asking what evidence there is that the therapy 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 therapy 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 whether there’s good evidence for a therapy:

Has the therapy been tested?
Has it been tried with other children like your 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 therapy, used in the test? Did participants have an equal chance of being in the control group or therapy group?
Have other people tested this therapy and come up with the same results?

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

What theory or knowledge underlies the therapy? For example, is it based on neurobiology, behaviour psychology, cognitive psychology and so on?
Were the results published in a respected and reliable 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 you get copies of what has been published?

Professional advice: why it might differ on therapies, supports and early interventions

It’s a good idea to ask your child’s professionals about the scientific evidence behind therapies, supports and early interventions. When you combine professional expertise with your knowledge of your child, you’re more likely to get a positive outcome for your child.

But sometimes professionals have differing views on therapies. This can be because they:

have different definitions of ‘effective’ or ‘successful’, based on their professional backgrounds – for example, speech pathologists and psychologists might look for improvements in different areas
disagree on theories behind therapies, regardless of therapies’ track records
use different terms to describe what therapies do – the advice they give might sound different but mean the same thing
disagree on how therapies should be tested or evaluated – for example, which methods or techniques should be used.

It’s important to ask professionals why they’re recommending or not recommending particular therapies. If you’re not sure about the professional’s recommendation, it’s OK to get a second opinion.

Warning signs about therapies, supports and interventions

There are some warning signs that a therapy, support or intervention isn’t all it claims to be.

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

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

Is the cost excessive? Watch out for therapies 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.

Is the therapy, support or intervention promoted by paid advertisements in magazines, parenting publications, or on TV, websites or social media? Is it promoted as used by a celebrity, or does it claim to be popular with medical ‘experts’? This might mean the therapy relies on advertising rather than quality research.

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

Some therapies, supports or 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 therapies that might get better results.

Practical and personal questions about therapies, supports and early interventions

Here are some practical and personal questions that might help you decide whether a therapy, support or early intervention is a good option for your child and family:

Child fit: does the therapy meet the current needs of your child?
Cost: is the therapy affordable? If not, are there subsidies, rebates or funding that can help you afford it?
Time and involvement: some therapies 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: can you get the therapy in your area? If you can’t, is there a way you can use it – for example, through telehealth? Are there places available in the program?
Family fit: will the therapy help you meet your family’s goals and needs? Does the therapy fit with your family’s beliefs and values? Or can adjustments be made to accommodate these?