Parents of children with an autism spectrum disorder (ASD) are faced with the overwhelming challenge of determining which treatments or therapies, amongst the myriad of interventions available, should be pursued for their child. In most cases, children with ASDs require a variety of interventions and the cost of many of these can be quite high and can involve a significant commitment of time and resources. So how does a parent choose which of those treatments truly work and are worth pursuing? The demand for evidence-based practice guidelines for ASDs has long been recognized.
To address this need, the National Autism Center launched a project in 2005 with the support and guidance of an expert panel composed of nationally recognized scholars, researchers, and other leaders representing diverse fields of study. The culmination of this rigorous multi-year project was the National Standards Report (Phase 1 of the National Standards Project), published in 2009. It was the most comprehensive analysis available at the time about interventions for children and adolescents with ASD. Since 2009, the National Autism Center has shared these results with hundreds of thousands of individuals.
The National Autism Center launched the second phase of the National Standards Project (NSP2) in 2011 in order to provide up-to-date information on the effectiveness of a broad range of interventions for ASD. There has been a great deal of new research published since 2007, the end of the period evaluated by Phase 1 of the National Standards Project. The findings and conclusions of this project are now available. To summarize, various interventions were placed in three categories: “Established, Emerging, and Unestablished” and are outlined below.
“Established” is considered to mean that there is sufficient evidence available to confidently determine that an intervention produces favorable outcomes for individuals with ASDs. That is, these interventions are established as effective. The following interventions have been identified as falling into the “Established” level of evidence for individuals under 22:
- Behavioral Interventions
- Cognitive Behavioral Intervention Package
- Comprehensive Behavioral Treatment for Young Children
- Language Training (Production)
- Modeling
- Natural Teaching Strategies
- Parent Training
- Peer Training Package
- Pivotal Response Training
- Schedules
- Scripting
- Self-Management
- Social Skills Package
- Story-based Intervention
“Emerging” is deemed to mean that although one or more studies suggest that an intervention produces favorable outcomes for individuals with ASDs, additional high quality studies must consistently show this outcome before firm conclusions about intervention effectiveness can be drawn. In addition, “Emerging” interventions “should be considered promising and warrant serious consideration.” The following interventions have been identified as falling into the Emerging level of evidence for individuals under age 22:
- Augmentative and Alternative Communication Devices
- Developmental Relationship-based Treatment
- Exercise
- Exposure Package
- Functional Communication Training
- Imitation-based Intervention
- Initiation Training
- Language Training (Production & Understanding)
- Massage Therapy
- Multi-component Package
- Music Therapy
- Picture Exchange Communication System
- Reductive Package
- Sign Instruction
- Social Communication Intervention
- Structured Teaching
- Technology-based Intervention
- Theory of Mind Training
Finally, “Unestablished” is regarded to mean that there is little or no evidence to allow firm conclusions to be drawn about intervention effectiveness with individuals with ASD and additional research may show the intervention to be effective, ineffective, or harmful. Therefore, these interventions should be considered “only after additional research has been conducted and this research reveals favorable outcomes for individuals with ASD.” The following interventions have been identified as falling into the Unestablished level of evidence for individuals under age 22:
- Animal-assisted Therapy
- Auditory Integration Training
- Concept Mapping
- DIR/Floor Time
- Facilitated Communication
- Gluten-free/Casein-free diet
- Movement-based Intervention
- SENSE Theatre Intervention
- Sensory Intervention Package
- Shock Therapy
- Social Behavioral Learning Strategy
- Social Cognition Intervention
- Social Thinking Intervention
For adults (age 22 and older), interventions have been categorized as follows:
Established:
- Behavioral Interventions (The Behavioral Intervention category consists of applied behavior analytic interventions to increase adaptive behaviors and decrease challenging behaviors.)
Emerging:
- Vocational Training Package
Unestablished:
- Cognitive Behavioral Intervention Package
- Modeling
- Music Therapy
- Sensory Integration Package
In order to access the complete report, go to the National Autism Center’s website: www.nationalautismcenter.org and click on “National Standards Project, Phase 2.”