Autism (including Asperger syndrome) is a lifelong disability and the concept of a cure is controversial for some people on the autism spectrum and their families. However, there are many approaches and forms of support which can help people with autism to manage their condition and fulfil their potential.
It can be difficult to make decisions about which approach is right for each person. Many different interventions have been developed and yet there is a great deal we still do not know about the effectiveness of each one, as very few have been independently or scientifically evaluated.
Too often, bold claims are made about therapies and interventions for people with autism without any supporting evidence. This is irresponsible and inappropriate, and we try to keep people aware of current concerns in our news section. It is therefore vital that parents of children with autism and individuals on the autism spectrum 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 individual is supported as an individual and any interventions are adapted to their specific needs.
There are a range of communication-based, behavioural and educational approaches used to support people with autism to fulfil their potential. These include approaches such as PECS (Picture Exchange Communication System), TEACCH (Treatment of Autistic and Communication Handicapped Children), ABA (Applied Behavioural Analysis), sensory integration and speech and language therapy. The National Autistic Society (NAS) believes that such interventions need to be adapted to the needs of the individual 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 NAS believes there is little scientific evidence demonstrating the efficacy of biomedical interventions in supporting people to directly ‘manage’ their autism, rather than to treat other conditions. As with many drug treatments, some biomedical interventions have associated side-effects and risks. People with autism may be more susceptible to those side-effects. The NAS believes 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 Clinical Excellence (NICE). A guideline on the diagnosis and management of autism in adults, which looks directly at therapies and interventions, was published in June 2012. In 2013, NICE published a guideline on the management and support of children and young people on the autism spectrum.
Both guidelines were developed by a team of health and social care professionals, people with autism and their families/carers and technical experts. The guidelines specify a number of psychosocial interventions that should be considered for use with children, young people and adults with autism. 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:
- 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)
Some of the interventions above are used by people with autism to manage additional problems that they may experience. However, the child guideline is clear that secretin, hyperbaric oxygen and chelation should never be used in any context – our position is that this applies across all ages.
NICE guidelines are reviewed every three years taking into account any new evidence.
The NAS firmly believes 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.
The NAS has helped to establish Research Autism, a trust that raises funds and commissions research into interventions for people with autism. Research Autism also establishes methods of evaluation for existing approaches and disseminates findings
The NAS can provide information and answer queries on a range of therapies and interventions.