Treating the core features of autism: Are we there yet?

Abstract

A wide variety of nonestablished treatments have been proposed as "cures" for the core features of autism and are used frequently despite having largely escaped scientific scrutiny. In contrast, a growing body of empirical evidence supports the use of a few forms of theory-based and empirically validated treatment for some aspects of the core features of autism. These include behavioral/psychoeducational interventions and specific forms of medication treatment, which can produce significant improvements in communication, social interaction, and problem behaviors that both maintain over time and generalize across settings. While there is no doubt that treatment and educational services for persons with autism have improved over the past 6 decades, it also appears that significant issues remain with respect to (1) the routine application of validated treatments for the majority of cases with autism, (2) the resistance to even validated forms of treatment for a substantial minority of cases with autism, and (3) the extent to which validated treatments effectively treat the specific core features of autism that are most disabling for persons with autism and their families.

Psychiatric Hospitalization Among Children with Autism Spectrum Disorders

“…The results suggest some potential points for intervention to reduce psychiatric hospitalization among children with ASD. For example, especially for younger children, behavioral interventions may reduce the aggressive and self-injurious behaviors that lead to hospitalization (Bodfish, 2004;Volkmar et al 1999). Pharmacological treatments also have been developed to address these behaviors (Hollander et al 2003), but there are many concerns about long-term consequences, especially in young children (Volkmar 2001).…”

Physician collaboration involving students with Autism Spectrum Disorders

“…The reported behavioral and developmental benefits of Secretin led to an aggressive search for the physiological mechanisms of this purported effect and evidence of its efficacy. However, numerous well-designed studies, published in peer-reviewed journals, involving over 700 children failed to confirm any beneficial treatment effects (Bodfish, 2004;Levy & Hyman, 2005).…”

“…We encourage the interested reader to examine several reviews of both conventional/psychopharmacological (Bodfish, 2004;Scahill, 2004;Tuchman, 2004) and CAM treatments for ASDs (Levy & Hyman, 2005). A brief review of conventional and CAM treatments follows.…”

“…Psychopharmaceutical research in this population has been limited by several factors, including the inconsistent signs and symptoms present in young children with ASDs, the absence of reliable instruments to measure the effects of medications, the lack of double-blind studies, and the short-term duration of most medication trials (Bodfish, 2004). Most of the published drug studies have focused on the efficacy of medications to treat specific symptoms, such as hyperactivity, and it is clear that clinical practice is proceeding ahead of published research (Owley, 2002).…”

Fad, Pseudoscientific, and Controversial Interventions

“…These types of treatments attempt to adjust the neurological and physiological processes that result in ASD symptomology (Bodfi sh, 2004 ;Levy & Hyman, 2005 ). Clearly, there are traditional pharmacological approaches to addressing the parallel behavioral (i.e., aggression, anxiety) and medical (i.e., seizures) symptoms associated with the ASD spectrum that have been thoroughly vetted through systematic investigation (Bodfi sh, 2004 ).…”