Study Warns Against Too Much Autism Intervention

When it comes to autism intervention, new research suggests that more is not always better.

Children diagnosed with autism are often recommended to receive 20 to 40 hours per week of intensive interventions, which may include behavioral or developmental approaches.

However, a new analysis looking at data from 144 previous studies involving more than 9,000 children concludes that current advice may be misguided.

“We concluded that there was no rigorous evidence to support the idea that increasing the amount of intervention results in better intervention outcomes,” said Micheal Sandbank, an assistant professor in the Department of Health Sciences at the University of North Carolina School of Medicine, who led the study. study recently published in the journal JAMA Pediatrics. “Instead, we recommend that practitioners consider what level of intervention would be appropriate for the child’s development and for the family’s support.”

The researchers said current guidelines on how much intervention children receive stem from a 1987 study, which found that children with autism who participated in 40 hours a week of behavioral intervention experienced greater cognitive improvement than those who received just 10 hours. However, Sandbank noted that subsequent research on this topic has been of questionable quality and has yielded variable results.

The new review assessed how much intervention children participated in each day and the number of days it was provided. The researchers also controlled for the age of the children, all of whom were 8 years old or younger. They then looked at whether the amount of intervention correlated with a developmental benefit for the children, depending on the type of intervention they received.

Overall, the study found nothing to suggest that more intervention would produce greater benefit for children with autism.

“There is probably a minimum amount of intervention needed to get any benefit, and an optimal amount that depends on the child,” Sandbank said. “Unfortunately, at this point, we don’t have clear evidence about what that amount should be.”

For now, doctors should “exercise caution” in recommending intensive interventions, the researchers conclude in the study.

“Although we did not find evidence that increasing the amount of intervention was associated with greater benefits, this should not be interpreted as evidence that autistic children should be left without support,” the authors wrote. Instead, they said clinicians should work with families to “calibrate individualized supports for autistic children to an intensity that evidences individual benefit without impacting activities and routines in the home, educational, and community environments that are important for their progress.”

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