Autism (including Asperger syndrome) is a lifelong disability and the concept of a cure is controversial for many autistic people and their families. However, there are a range of approaches that can support autistic people to reach their full potential.
Many different approaches exist, making it difficult to decide which is best to use. There is a lot we don’t know about their effectiveness, as few have been independently or scientifically evaluated.
Bold claims are often made about interventions and therapies for autistic people without any evidence to back them up. This is irresponsible and inappropriate, and we try to keep people aware of current concerns in our news section. It is therefore vital that autistic people and parents/carers can access reliable information and advice both after diagnosis and on an ongoing basis.
Autism is complex and what helps one person may not help others, so it is vital that each person is supported as an individual and that any interventions are adapted to their specific needs.
A range of communication-based, behavioural and educational approaches exist such as:
- PECS (Picture Exchange Communication System)
- SPELL (Structure, Positive, Empathy, Low arousal, Links)
- TEACCH (Treatment of Autistic and Communication Handicapped Children)
- Social Stories
- speech and language therapy.
The National Autistic Society believes that interventions need to be adapted to the needs of the person and monitored for impact.
Biomedical interventions include restrictive diets, supplements, hormone interventions and drugs. Some people advocate the use of biomedical interventions to ‘treat autism’, whilst others believe they are useful in treating co-existing conditions. The National Autistic Society believes there is little scientific evidence demonstrating the effectiveness of biomedical interventions in supporting people to ‘manage their autism’, rather than to treat other conditions. As with many drug treatments, some biomedical interventions have associated side-effects and risks. Autistic people may be more susceptible to those side-effects. We believe that biomedical interventions should only be used under medical supervision by someone who understands autism and that the positive and negative impacts should be regularly and carefully reviewed.
The most comprehensive analysis of therapies and interventions has been conducted by the National Institute for Health and Care Excellence (NICE). Autism spectrum disorder in adults: diagnosis and management looks directly at therapies and interventions and was published in June 2012. In 2013, NICE published guidance for children and young people, Autism spectrum disorder in under 19s: support and management.
Both guidelines were developed by a team of health and social care professionals, autistic people and their families/carers, and technical experts. The guidelines specify a number of psychosocial interventions that should be considered for use with autistic children, young people and adults. For children and young people, these include play-based strategies with parents, carers and teachers. For adults, these include employment support programmes, structured leisure activities and social skills training.
They also rule out a number of biomedical interventions for ‘management of the core symptoms of autism’, including:
- chelation
- exclusive or restrictive diets including gluten-free, casein-free or ketogenic diets
- hormone therapies or testosterone regulation
- hyperbaric oxygen
- vitamins, minerals and dietary supplements
- drugs which are usually given for problems with memory and thinking
- anticonvulsants, antidepressants or antipsychotics (unless other conditions are present, eg epilepsy and depression)
- secretin.
Some of these interventions are used by autistic people to manage co-existing conditions. However, the NICE child guideline is clear that secretin, hyperbaric oxygen and chelation should never be used in any context. The National Autistic Society position is that these interventions should never be used by autistic people, no matter what age they are.
NICE guidelines are reviewed every three years taking into account any new evidence.
We firmly believe that rigorous scientific evaluation is necessary to estimate the likely benefits of any approach and its application. Knowledge about autism is increasing all the time and therapy and interventions is a constantly evolving area.
