Research on autism interventions helps parents make better choices

More children than ever are being diagnosed with autism, which means more parents than ever face a dizzying array of often expensive treatment options. Giving parents and professionals authoritative information is the purpose of a new review spearheaded by the Frank Porter Graham Child Development Institute at the University of North Carolina at Chapel Hill.

Without a thorough review of autism interventions, Allison Smith of Pawtucket, R.I., might never have asked to try video-modeling to help her twin sons, age 4, develop the key motor skill of blowing a feather, a steppingstone to speech.

“Knowledge is power,” said Smith, who found video-modeling on a list of proven interventions from the National Professional Development Center (NPDC) on Autism Spectrum Disorders, a multi-university center to promote the use of evidence-based practices. UNC is one of three NPDC operating sites. “Knowing what works has given us the upper hand in acquiring appropriate therapy and tools.”

Autism incurs an average lifetime price tag of $3.2 million per person, according to a 2007 research study in the Archives of Pediatric and Adolescent Medicine. But the Autism Society estimates that early diagnosis and effective interventions can reduce that lifetime cost by two-thirds.

“Parents often pay for interventions that have no evidence behind them,” said FPG director Samuel L. Odom, who co-headed the new review. “This report will allow them to make the best choices.”

In this five-year update for the NPDC, UNC scientists screened 29,000 articles about autism spectrum disorders to find the ones proven to work best. Compared to the 24 proven interventions in the 2008 report, the new report lists 27.

Applying even more stringent criteria this time, the FPG team dropped “structured work systems” and added five practices: “exercise,” “structured play groups,” “scripting,” “modeling” and “cognitive behavior intervention.” After considering more studies, scientists also renamed and broadened one category, “technology-aided instruction.”

“Expanding the list offers more tools to educators and service providers. This improves outcomes for children with ASD,” said Kristine Ganley, a training and technical assistance provider at George Mason University.

NPDC’s report on evidence-based practices provides important guidance for professionals and families. Before NPDC’s list, parents and professionals often searched for practices online, with unreliable results.

“Some interventions may seem cutting-edge, but we don’t yet know if they have any drawbacks or trade-offs,” said FPG investigator Connie Wong, the new report’s lead author and co-head of the review of research. “Our report only includes what’s tried and true.”

Published January 17, 2014.