Information on Empirically Supported Treatment Options for A.S.D

The authors (consisting of an expert panel) of the National Standards Report (2009) assessed various treatment approaches for A.S.D. and classified the level of empirically supported for treatment methods:

Established Treatments

Sufficient evidence is available to confidently determine that the treatment produces Charlieeficial treatment effects for individuals on the Autism Spectrum – that is, these treatments are well-established as effective.

§  Antecedent Package – interventions that aim to manage and/or modify situational events that typically precede the target behaviour.

§  Behavioural Package – interventions that are designed to increase functional behaviours and decrease dysfunctional behaviours using basic principals of behaviourism.

§  Applied Behaviour Analysis (A.B.A.) – this intervention focuses on the principles that explain how learning takes place. Positive reinforcement is one such principle. When a behaviour is followed by a reward, the behaviour more likely to be repeated.

§  Joint Attention Intervention – interventions that increase and reinforce responses to nonverbal social bids, like following eye gaze, showing, pointing, etc.

§  Modelling -  interventions that involve an adult or child demonstrating the desired behaviour and the individual with A.S.D. is reinforced for imitating the behaviour.

§  Naturalistic Teaching Strategies – interventions that involve engaging in child-directed interactions to teach functional skills in the natural environment.

§  Peer Training Package – interventions that involve teaching children without disabilities strategies for facilitating play and interactions with children on the Autism spectrum.

§  Pivotal Response Treatment – this treatment focuses on targeting pivotal behavioural areas, such as motivation to engage in social communication, self-management, etc.

§  Schedules – interventions such as Visual Schedules, that involve the presentation of  a task list.

§  Self-management – interventions that promote independence and self-care.

§  Story-based Intervention – interventions, such as Social Stories, which involve written descriptions of situation under which specific behaviours are expected to occur.

Emerging Treatments

Although one or more studies suggest that the treatment produces Charlieeficial effects for individuals with A.S.D., additional high quality studies must consistently show this outcome before firm conclusions can be drawn about treatment effectiveness.

§  Augmentative and Alternative Communication Device (A.A.C.), which involves using technology to facilitate communication.

§  Picture Exchange Communication System (P.E.C.S.), which involves the application of a specific augmentative and alternative communication system based on behavioural principles to teach functional communication.

§  Sign Instruction – interventions that involve the direct teaching of sign language to an individual with A.S.D. as a means of communication.

§  Cognitive Behavioural Therapy (C.B.T.), which involves individuals with A.S.D. to change negative or unrealistic thought patterns and behaviours in order to improve affect.

§  Social Skills Package – interventions that seek to build social interaction skills in people with A.S.D. by targeting basic social responses, such as eye contact.

§  Social Communication Intervention – interventions that involve targeting pragmatic skills.

§  Developmental Relationship-based Treatment – interventions that emphasize the importance of building social relationships.

§  Exercise – that is, using physical exertion to reduce problematic behaviours and increase appropriate behaviours.

§  Exposure Therapy – interventions that require an individual with A.S.D. to increasingly face anxiety-provoking stimuli while preventing strategies, such as avoidance, used in the past in similar conditions.

§  Imitation-based Interaction – interventions that involve the adult imitating the actions of the child with A.S.D.

§  Initiation Training – interventions that involve directly teaching individuals with A.S.D. to initiate interactions with peers.

§  Language Training (Production and/or Understanding), which are interventions that have as their primary goal increased speech production and/or the understanding of communicative acts.

§  Scripting – interventions that involve the development of a specific verbal or written script about a specific skill or situation that can serve as a model for children with A.S.D.

§  Reductive Package – interventions that reduce problematic behaviours in the absence of increasing alternative appropriate behaviours.

§  Massage/Touch Therapy – interventions that involve the provision of deep tissue stimulation.

§  Music Therapy – interventions that involve teaching individuals with A.S.D. through music – goals might be learning to count, name colours or take turns.

§  Peer-mediated Instructional Arrangement – interventions that involve targeting academic skills by involving same-aged peers in the learning process.

§  Theory of Mind Training – interventions involve teaching individuals with A.S.D. to recognise and identify mental states, like thoughts and feelings, in oneself and in others – and to be able to take the perspective of others in order to predict their actions.

§  Structured Teaching – interventions such as TEACCH, that involve the organisation of the physical setting, provision to predictable schedules, and individualised teaching methods.

§  Technology-based Treatment – interventions that involve the presentation of instructional material using technology as the medium.

Unestablished Treatments

There is little or no evidence of treatment effectiveness for individuals with A.S.D. Additional research may show the treatment to be effective, ineffective, or harmful.

§  Sensory Integration – interventions that are aimed at addressing hyper-or-hypo-sensitivity to stimuli.

§  Gluten-and-Casein Free Diet – that is, introducing a special diet that eliminates gluten and casein.

§  Facilitated Communication – interventions that involve having a facilitator to support the hand or arm of an individual with limited communication skills in order to help the person express themselves through pictures or by using a typing device.

§  Auditory Integration Training – an intervention that involves the presentation of sounds through headphones in an attempt to retrain the individual’s auditory system.

§  Academic Interventions – interventions that involve the use of traditional teaching methods, such as picture-to-text matching, to improve academic performance.

Ineffective/Harmful

Sufficient evidence is available to determine that the treatment is ineffective or harmful for individuals on the autism spectrum.

§  At the time of publication, no treatments sufficiently evidenced harmful treatment effects specific to the A.S.D. population; however, certain alternative treatments (e.g., special diets, chelation, secretin, and deep pressure) are highly controversial and potentially dangerous.