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Many parents ask us about various treatments for their child, including approaches that are considered complementary or alternative. Examples of such treatments include dietary (such as casein gluten-free diets), biomedical (such as vitamin supplements or antiyeast therapy), and nonbiological treatments (such as auditory integration). When considering a treatment, it is important to discuss the options with your pediatrician. Dr. Gail Williams assists parents with these decisions as part of the STAR Biomedical Clinic. Some questions to consider are:
What are the costs of a particular treatment?
Consider the physical, emotional, and financial burdens imposed by particular therapies. Have the potential harmful short- and long-term effects of a treatment been explored? Can ongoing approaches be continued while a new one is implemented? This question is particularly important to consider if the new treatment is not successful. Parents should be reassured that is okay to not attempt treatments which may come at too high a price for your child and your family, especially when the effect of such treatment is questioned.
What is the evidence supporting the use of a particular treatment?
Reports from parents are important to consider, but pediatricians can educate families about the importance of scientific investigation and how to evaluate different types of information. Consider the communication, language, social, cognitive, and physical characteristics and age of the individuals with which a treatment has been successful in the past when evaluating whether or not a treatment is likely to be effective with your child.
How will outcomes be evaluated?
Gathering a baseline level of functioning of your child is very important before you begin a treatment so that future decisions about whether or not to continue a treatment can be made. Additionally, changing only one aspect of your child’s treatment plan at a time is crucial in being able to attribute success to the appropriate combination of approaches.
Additional Suggestions from Freeman, 1997:
- Approach new treatments with “hopeful skepticism”
- Beware of programs that claim to be appropriate for all individuals with autism or for any child with a disability
- Beware of programs that obstruct an individualized treatment approach
- Know that there are several treatment options for individuals with autism
- Know that all treatments should be based on individualized assessment
- Know that no new treatments should be provided until the treatment givers demonstrate assessment procedures that determine its appropriateness for the person with autism
- Know that new treatments have often not been scientifically validated
Questions to Ask and Things to Think About (Ruble & Stone, 1994)
Questions to ask:
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Things to think about: |
- Which behavior(s) does the treatment improve?
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Are these behaviors problematic for my child?
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- What positive effects (short-term and long-term) should I expect to see?
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How will I know whether the treatment is working?
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- How will the therapist assess the effectiveness of the treatment?
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How often will I be given progress reports? |
- How long do I have to stay involved before I can expect to see progress?
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Do I have the resources to stick with this treatment? |
- Are there any side effects?
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Can this treatment be physically or psychologically harmful to my child?
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Can I afford this treatment? Will participation in this treatment mean we will have to drop other treatments?
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- How much time does it take per week?
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Can I devote the required time? Is the treatment compatible with my child’s current program?
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- Is there scientific validation for this treatment?
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What do professionals think about the pros and cons of this treatment?
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- Who has used this treatment before, and what do they say about it?
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What kinds of experiences have other parents had with this treatment? |
- What training and qualification are needed to provided this treatment?
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Does the therapist have the appropriate training and/or credentials? |
- Does the therapist belong to a professional organization?
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Can the therapist be held accountable to a professional code of ethics? |
- What role do parents play in this treatment?
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Will I be taught the skills necessary to help my child at home and in the community?
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- How are challenging behaviors handled?
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Is there a plan for preventing the occurrence of problematic behaviors? |
Sources:
Freeman, B. J. (1997). Guidelines for evaluating intervention programs for children with autism. Journal of Autism and Developmental Disorders, 27, 641-651.
Nickel, R. E. (1996). Controversial therapies for young children with developmental disabilities. Infants and Young Children, 8, 29-40.
Ruble, L., & Stone, W. (2004). Autism spectrum disorders. In L. Osborn, T. DeWitt, L. First, & J. Zenel (Eds.), Pediatrics. (pp.1565-1570). St. Louis: Harcourt.uble, L., & Brown, S. (2003). Pervasive Developmental Disorders: Autism. In M. Wolraich (Ed.), Disorders of Development and Learning (pp.249-266). London: BC Decker.
e, L., & Stone, W. (2004). Autism spectrum disorders. In L. Osborn, T. DeWitt, L. First, & J. Zenel (Eds.), Pediatrics. (pp.1565-1570). St. Louis: Harcourt. |
