Application of behavioral interventions for autism exceed evidence of efficacy

Article Outline

• Copyright

This issue of The Journal includes the report of a study by Australian investigators Spreckley and Boyd, who performed a systematic review of studies of acute behavioral intervention (ABI) in preschool-aged children with autism spectrum disorder. They evaluated robustness of study methodologies using the physiotherapy evidence database (PEDro) scale and performed meta-analysis using selected studies in order to assess efficacy of interventions on intellectual and behavioral outcomes. Considering that only three randomized controlled trials (including a total of 76 children) have been published, that subjects were not always stratified by age at intervention or cognitive ability, and that control groups participated in uncontrolled interventions, it may not be surprising that ABIs had little demonstrable value added for long-term outcomes. The authors provide critically important information to the medical community and highlight gaping holes in our knowledge of the best ways to support preschool children with an autistic spectrum disorder and their families.

In an accompanying editorial, Msall agrees fully with the authors' conclusions and adds the context of US children affected and dollars that would be required to apply ABI. Most importantly, he stresses the opportunity and necessity for parents and developmental professionals to be allies in the challenge of each child's care and also in planning research. As Msall points out, it is critical to measure broad outcomes that include the caregiver's physical and mental health, the sibling's physical and mental health, and the impact on family life.