Behavior-focused therapies help children with autism, study shows

The review, conducted by the Agency for Healthcare Research and Quality (AHRQ)-funded Vanderbilt Evidence-based Practice Center (EPC), updates a prior systematic review of interventions for children (up to age 12) with a focus on recent studies of behavioral interventions.

Study authors said the quality of research studies has improved dramatically since AHRQ's 2011 review of studies on ASD, when authors reported that there were significant gaps in research available to document the benefits of treatments.

The updated review examined published evidence regarding the effectiveness of early intensive behavioral and developmental interventions -- interventions with a primarily behavioral approach based on applied behavioral analysis (ABA) principles and a comprehensive focus targeting multiple areas of functioning.

"We are finding more solid evidence, based on higher quality studies, that these early intensive behavioral interventions can be effective for young children on the autism spectrum, especially related to their cognitive and language skills," said lead author Amy Weitlauf, Ph.D., assistant professor of Pediatrics and a Vanderbilt Kennedy Center investigator. "But the individual response to these treatments often varies from child to child."

"We are also finding evidence that some of these targeted interventions, especially related to cognitive treatments for anxiety disorders, are also very effective for many, many children. Again, responses vary substantially and there are some children for whom these treatments have not yet been studied. So there is lots of promising evidence that these interventions are helpful, but we definitely need more research on which kids the treatments are more helpful for over time," Weitlauf said.

In previous decades ASD was often thought to be almost untreatable, said senior author Zachary Warren, Ph.D., director of the Vanderbilt Kennedy Center's Treatment and Research Institute for Autism Spectrum Disorders (TRIAD).

But researchers, clinicians and parents have increasingly documented impressive improvements in early cognitive, language and educational outcomes for some children with ASD receiving intervention.

Research results were not as strong in terms of improving broad developmental outcomes of children with ASD when interventions focused on training parents to use behaviorally based approaches with their children, but the interventions did show positive effects on parenting behaviors, on interactions between parents and children and on communications skills for some children.

"Given the potential for interventions to powerfully improve children's quality of life, in combination with the significant costs and resources often associated with treatment, it is not surprising that many groups -- parents, providers, policymakers, insurance providers -- are searching for an enhanced understanding of which interventions work the best for children with ASD," said Warren, associate professor of Pediatrics, Psychiatry and Special Education.