What Works to Treat Autism?
Studies Detail Evidence Behind Medication, Behavioral Therapies for Autism Spectrum Disorders
Early Intensive Behavioral Interventions continued...
“There are some kids who get response to some treatments over a short period of time, but it’s kind of hard to figure out which of the kids respond best to which specific treatments and whether those treatments have a large impact over time,” he says.
It’s a critical question, too, considering what it costs to provide these therapies.
“There are high costs associated with these treatments, hundreds of thousands of dollars a year,” Hollander says.
Reviewers cited a lack of high-quality studies and a lack of confirmatory research, or studies that independently duplicate previous findings, as a reason to further question these approaches. They noted that one finding that was “powerfully replicated” across studies was that many kids who get these therapies “will not demonstrate dramatic gains ... .”
Among seven studies of parent-training programs, researchers said small sizes, failure to randomly assign participants to different treatments, wide variation in the symptoms of children enrolled in the studies, and a lack of objectively assessed outcomes limited the conclusions that could be drawn.
The final review looked at evidence behind the use of controversial therapy of the gut protein secretin.
Out of 4,120 studies considered, only eight met criteria for inclusion in the review.
When secretin was compared to a placebo, no studies have shown improvements in measures of language, cognition, or autistic symptoms.
“That’s one of the interventions that have the most powerful evidence,” Warren says, “and the evidence really powerfully suggests that this is something that should not be pursued.”
Hope on the Horizon
Hollander and Warren say although current therapies appear to offer little in the way of help, a new generation of medications in development aim to ease symptoms by targeting the underlying causes of the disease, not just the symptoms.
“We’re on the verge of an era of being able to think about being able to develop new, targeted treatments based on an understanding about what we know about autism and how autism is related to our brain,” Warren says. “In animal models, they’ve been able to demonstrate recovery of certain symptoms and certain behaviors.”
And many experts feel that with better designed studies, at-home behavioral training, where a therapist educates parents about ways to find opportunities to practice communication skills, will ultimate show great benefits.
“Parent training approaches, where parents learn to find teachable moments with their child, that’s a very powerful thing,” says Byrna Siegel, PhD, director of clinical services at the University of California at San Francisco’s Autism Clinic.
“I tell people that there’s a lot of stuff you can do to help your kid, but it involves a lot of hard work,” she says.