There are now a great number of approaches available for people with autism and parents and professionals may find it difficult to decide which approach is best-suited to their individual circumstances.

It is important to remember that although different approaches have been known to work for some people with an autism spectrum disorder, they have not been evaluated on a long-term basis. Before using any particular approach it is best to find out as much information as you can about it. Any approach should be positive, build on people's strengths, and help to discover their potential, increase motivation and provide opportunity.

You'll find here a useful guidance paper written by Richard Mills, Director of Research for the NAS and a supplementary paper by Claire Le Feuvre, a parent of a child with autism.

Here are some questions to consider before choosing an approach.

About you and your family

  • What does your child need most support with?
  • Do you want to have people visiting your home, or do you want to visit the therapist?
  • Do you want the intervention to be delivered by a therapist, or do you want to be able to learn how to deliver it yourself?
  • Do you have other children or relatives who may be affected by the approach that you decide on? For example for some approaches therapists may need to visit the house regularly, or relatives may be expected to learn how to carry out the approach themselves.

 

About the approach

  • What does the approach claim to do?
  • How does it work?
  • How was it developed?
  • How long has the approach been in existence?
  • How many people have been treated and what was the outcome?
  • How long is the course of treatment?
  • How much time does each session take, including any preparation and travel time?
  • Does the approach focus on one particular skill or does it offer more general treatment?
  • Are treatment goals individual (ie, based on the needs of each individual)?
  • Exactly what involvement is required from the person with autism, their family, and professionals working with them?
  • Is there a brochure or other written information?
  • Is the approach available near to you?
  • Do you feel comfortable with stated aims? 
  •  Will the programme identify and develop any particular strength? 
  •  Will the programme support the development of personal autonomy – how? 
  •  Is the main emphasis of the programme on elimination of problem behaviours or the development of new skills and interests? 
  •  What is the underlying rationale or philosophy behind the programme? 
  •  How much parental time is involved daily? 
  •  How much professional time is involved daily 
  •  Is the program able to integrate other approaches? If so what examples of this can they provide? 
  •  Does the programme use techniques that are
    o Painful or hazardous?
    o Distressing for the child?
    o Socially unacceptable (e.g. based on punitive sanctions or on restricting liberty?)
    o Illegal (e.g. some forms of physical interventions including restraint, confinement, seclusion - or use of illegal substances) 
  •  Is there co-ordination between programme and other professionals (e.g. psychologists, teachers, therapists, doctors, therapists?)

 


 

Effectiveness of the approach

  • What research evidence is there for the approach’s effectiveness?
  • Is there supporting evidence for the approach’s effectiveness from other parents and professionals or people on the autism spectrum?
  • Or from: research publications in peer-reviewed journals, Independent research or evaluation, or independent professional opinion?

  • Can you talk to other parents who have tried the approach?
  • Can I talk to others who have undergone this programme?
  • Are there any known side-effects?
  • Are there many cases where the approach has not worked and what were the circumstances?
  • Are there many cases where the approach made things worse and what were the circumstances?
  • Is there a complaints procedure?

 

Credentials of staff

  • What is the background of the programme director and staff?
  • What are the qualifications of the programme director and staff?
  • What is the experience of the programme director and staff with individuals with autism? Can this be verified?
  • Have the programme director and staff worked with people who have similar needs to my child before?
  • Will you have a written agreement about the terms and conditions of the therapy?
  • Does the programme publish all data –including unsuccessful cases?
  • How are unsuccessful cases dealt with?
  • Have there been any complaints about the programme or legal disputes?
  • Is the programme carried out under licence or by agreement from elsewhere?

  • What is the attitude of the programme to independent scrutiny or evaluation; and has this been done?

Costs

  • How much in total does the approach cost? This total cost might include enrolment and registration fees, course fees, renewals, administration fees, the cost of course materials, your travel costs and any other additional costs.
  • Is any funding available?
  • Do you have to pay for the therapy in advance? Will your money be refunded if you stop the therapy before the course has finished?
  • Can costs be refunded if the approach is not effective?
  • Is there any follow up?

  • How is follow up organised – will I have to pay?

 

Facilities, equipment and modifications

  • When and where will the treatment take place?
  • If it takes place at your home, do you have enough space?
  • Will special adaptations or modifications to the person's home be needed?
  • Will special equipment be needed?
  • Will we have to suspend other treatments?
  • Will we have to suspend or modify other family activities?
  • Will I have to stop other treatments or activities if I do this programme?

 

Gathering information

Talk to other families or adults with an ASD who have experience of the intervention. You could join our online community (community.autism.org.uk) or find a local parents’ group (www.autism.org.uk/directory)

Read the research. The charity Research Autism (www.researchautism.net) publishes impartial and independent information about all the different therapies used with people with autism. This includes details of what the intervention is, how much it costs, what it claims to do and details of any research or supporting evidence for each intervention.

Find out what is available locally. Are there private therapists near you? What is provided by your local NHS body, social services department or school?


And remember

  • Be sceptical about any approach that claims to 'cure' autism. Parents whose child has just received a diagnosis may be particularly susceptible to trying anything. Autism is a lifelong condition and although certain approaches may help control and manage characteristics behaviours and/or enhance particular skills that make life for the individual much easier and more enjoyable, they will continue to require some level of support and assistance throughout their life. We try to keep people aware of current concerns in our news section.
  • Do not rush judgement about any particular approach if you have only been using it for a short period of time. Changes in behaviour at the beginning may be temporary and settle back into a usual pattern so it is best to test effectiveness in the long-term to decide whether the individual benefits from any particular approach.
  • Be wary if you are advised that the individual cannot improve unless one particular approach is used. Every person is different and what works for one person with an ASD may not necessarily work for another. You may also find that the individual may improve to a certain extent without the implementation of any professional approaches. Interventions are mainly used as additional tools to help aid development more quickly and easily.
  • Be wary of any method which suggests it is the only/best approach to use and cannot be used alongside other approaches. Many approaches are compatible and can be used alongside others to give the most comprehensive support to an individual with autism.

 

The charity Research Autism has an independent and impartial web-based directory of all the interventions used with people with autism. The directory includes details of what the intervention is, how much it costs, what it claims to do and details of any research or supporting evidence for each intervention.

Please note - The National Autistic Society cannot make recommendations as to the effectiveness of any individual treatment.

 


 

Quick link to this page: www.autism.org.uk/26567