View source for Medicine:Autism therapies

{{short description|Therapy aimed at autistic people}}
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{{Infobox medical intervention
| image        = Opening a window to the autistic brain.jpg
| caption      = An autistic three-year-old points to fish in an aquarium, as part of an experiment (2004) on the effect of intensive shared-attention training on language development.<ref>{{cite journal | vauthors = Powell K | title = Opening a window to the autistic brain | journal = PLOS Biology | volume = 2 | issue = 8 | pages = E267 | date = August 2004 | pmid = 15314667 | pmc = 509312 | doi = 10.1371/journal.pbio.0020267 | doi-access = free }}</ref>
| alt          = A young child points, in front of a woman who smiles and points in the same direction.
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'''Autism therapies''' include a wide variety of therapies that help people with [[Medicine:Autism|autism]], or their families. Such methods of therapy seek to aid autistic people in dealing with difficulties and increase their functional independence.

Many therapies marketed towards autistic people and/or their parents claim outcomes that have not been supported by Level of Research (LOE) Level 1 (highest level assigned based on the methodological quality of their design, validity, and applicability to patient care). Level 1 research includes evidence from a systematic review or meta-analysis of all relevant RCTs (randomized controlled trial) or evidence-based clinical practice guidelines based on systematic reviews of RCTs or three or more RCTs of good quality that have similar results.<ref>{{Cite web |title=Levels of Evidence |url=https://libguides.winona.edu/ebptoolkit/Levels-Evidence |access-date=May 10, 2022 |website=Winona State University: Darrell W. Krueger Library}}</ref>

Autism is a neurodevelopmental condition characterized by differences in reciprocal social interaction and communication as well as restricted, repetitive interests, behaviors, or activities.<ref>{{Cite book |last=American Psychiatric Association |title=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision |publisher=American Psychiatric Association |year=2022 |isbn=978-0-89042-575-6 |location=Washington, DC |doi=10.1176/appi.books.9780890425787 |s2cid=249488050}}</ref>{{Rp|page=60}}<ref>{{Cite web |date=2023 |title=6A02 Autism spectrum disorder. |url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/437815624 |access-date=2023-07-29 |website=[[Medicine:ICD-11|ICD-11 for Mortality and Morbidity Statistics]] |publisher=[[Organization:World Health Organization|World Health Organization]]}}</ref> As of 2023, no therapy exists to eliminate autism within someone, let alone to a high degree of viability. Treatment is typically catered to the person's needs. Treatments fall into two major categories: educational interventions and medical management. Training and support are also given to families of those diagnosed with autism spectrum disorders (ASDs).<ref name="CCD" />

Studies of interventions have some methodological problems that prevent definitive conclusions about [[Chemistry:Efficacy|efficacy]].<ref name="Ospina" /> Although many [[Social:Psychosocial|psychosocial]] interventions have some positive evidence, suggesting that some form of treatment is preferable to no treatment, the [[Systematic review|systematic review]]s have reported that the quality of these studies has generally been poor, their clinical results are mostly tentative, and there is little evidence for the relative effectiveness of treatment options.<ref name="Seida" /> Intensive, sustained special education programs and behavior therapy early in life can help children with ASD acquire self-care, social, and job skills,<ref name="CCD" /> and often can improve functioning, and decrease severity of the signs and observed  behaviors thought of as maladaptive;<ref name="Rogers" /> Available approaches include [[Philosophy:Applied behavior analysis|applied behavior analysis]] (ABA), developmental models, structured teaching, speech and language therapy, [[Philosophy:Social skills|social skills]] therapy, and [[Medicine:Occupational therapy|occupational therapy]].<ref name="CCD" /> Occupational therapists work with autistic children by creating interventions that promote social interaction like sharing and cooperation.<ref name="Case-Smith_2008">{{cite journal | vauthors = Case-Smith J, Arbesman M | title = Evidence-based review of interventions for autism used in or of relevance to occupational therapy | journal = The American Journal of Occupational Therapy | volume = 62 | issue = 4 | pages = 416–29 | date = 2008-07-01 | pmid = 18712004 | doi = 10.5014/ajot.62.4.416 }}</ref> They also support the autistic child by helping them work through a dilemma as the OT imitates the child and waiting for a response from the child.<ref name="Case-Smith_2008" /> Educational interventions have some effectiveness in children: intensive ABA treatment has demonstrated effectiveness in enhancing global functioning in preschool children,<ref name="Eikeseth" /> and is well established for improving intellectual performance of young children.<ref name="Rogers" /> [[Social:Neuropsychology|Neuropsychological]] reports are often poorly communicated to educators, resulting in a gap between what a report recommends and what education is provided.<ref>{{cite journal | vauthors = Kanne SM, Randolph JK, Farmer JE | title = Diagnostic and assessment findings: a bridge to academic planning for children with autism spectrum disorders | journal = Neuropsychology Review | volume = 18 | issue = 4 | pages = 367–84 | date = December 2008 | pmid = 18855144 | doi = 10.1007/s11065-008-9072-z | s2cid = 21108225 }}</ref> The limited research on the effectiveness of adult residential programs shows mixed results.<ref>{{cite journal | vauthors = Van Bourgondien ME, Reichle NC, Schopler E | title = Effects of a model treatment approach on adults with autism | journal = Journal of Autism and Developmental Disorders | volume = 33 | issue = 2 | pages = 131–40 | date = April 2003 | pmid = 12757352 | doi = 10.1023/A:1022931224934 | s2cid = 30125359 }}</ref>

Historically, "conventional" [[Medicine:Pharmacotherapy|pharmacotherapy]] has been used to reduce reduce behaviors and sensitivities associated with ASD.<ref name=Leskovec /> Many such treatments have been prescribed off-label in order to target specific symptoms.<ref name = "Popow_2021">{{cite journal | vauthors = Popow C, Ohmann S, Plener P | title = Practitioner's review: medication for children and adolescents with autism spectrum disorder (ASD) and comorbid conditions | language = English | journal = Neuropsychiatrie | volume = 35 | issue = 3 | pages = 113–134 | date = September 2021 | pmid = 34160787 | pmc = 8429404 | doi = 10.1007/s40211-021-00395-9 }}
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Today, medications are primarily prescribed to autistic adults to avoid any adverse effects in the developing brains of children. Therapy treatments, like behavioural or immersive therapies, are gaining popularity in the treatment plans of autistic children. 
Depending on symptomology, one or multiple psychotropic medications may be prescribed. Namely [[Chemistry:Antidepressant|antidepressants]], [[Chemistry:Anticonvulsant|anticonvulsants]], and [[Chemistry:Antipsychotic|antipsychotics]].<ref name = "Popow_2021" />

As of 2008 the treatments prescribed to children with ASD were expensive;<ref>{{cite journal |vauthors=Shimabukuro TT, Grosse SD, Rice C |title=Medical expenditures for children with an autism spectrum disorder in a privately insured population |journal=Journal of Autism and Developmental Disorders |volume=38 |issue=3 |pages=546–552 |date=March 2008 |pmid=17690969 |doi=10.1007/s10803-007-0424-y |s2cid=38290838 |url=https://zenodo.org/record/1232808}}</ref> indirect costs are more so. For someone born in 2000, a U.S. study estimated an average [[Finance:Net present value|discounted]] lifetime cost of ${{formatprice|{{inflation|US|3160384|2003}}}} ({{CURRENTYEAR}} dollars, inflation-adjusted from 2003 estimate{{inflation-fn|US}}), with about 10% medical care, 30% extra education and other care, and 60% lost economic productivity.<ref>{{cite journal |vauthors=Ganz ML |title=The lifetime distribution of the incremental societal costs of autism |journal=Archives of Pediatrics & Adolescent Medicine |volume=161 |issue=4 |pages=343–349 |date=April 2007 |pmid=17404130 |doi=10.1001/archpedi.161.4.343 |doi-access=free}}<br/>{{cite press release |date=2006-04-25 |title=Autism Has High Costs to U.S. Society |url=http://www.hsph.harvard.edu/news/press-releases/2006-releases/press04252006.html |publisher=Harvard School of Public Health |url-status=dead |archive-date=2008-05-08 |archive-url=https://web.archive.org/web/20080508202313/http://www.hsph.harvard.edu/news/press-releases/2006-releases/press04252006.html}}</ref> A UK study estimated discounted lifetime costs at £{{formatprice|{{inflation|UK|1234044|2006}}}} and £{{formatprice|{{inflation|UK|796050|2006}}}} for an autistic person with and without intellectual disability, respectively<ref>{{cite journal |vauthors=Knapp M, Romeo R, Beecham J |title=Economic cost of autism in the UK |journal=Autism |volume=13 |issue=3 |pages=317–336 |date=May 2009 |pmid=19369391 |doi=10.1177/1362361309104246 |s2cid=20093805}}<br/>{{cite web |title=Autism In The UK Costs More Than $41 Billion Every Year, Shows New Research |date=2009-05-18 |website=ScienceDaily |url=https://www.sciencedaily.com/releases/2009/05/090518101913.htm}}</ref> ({{CURRENTYEAR}} pounds, inflation-adjusted from 2005/06 estimate{{inflation-fn|UK}}). Legal rights to treatment are complex, vary with location and age, and require advocacy by caregivers.<ref name="Aman">{{cite journal |vauthors=Aman MG |title=Treatment planning for patients with autism spectrum disorders |journal=The Journal of Clinical Psychiatry |volume=66 |issue=Suppl 10 |pages=38–45 |date=2005 |pmid=16401149}}</ref> Publicly supported programs are often inadequate or inappropriate for a given child, and unreimbursed out-of-pocket medical or therapy expenses are associated with likelihood of family financial problems;<ref>{{cite journal |journal=Journal of Family and Economic Issues |year=2007 |volume=28 |issue=2 |pages=247–264 |doi=10.1007/s10834-007-9059-6 |title=Financial issues associated with having a child with autism |vauthors=Sharpe DL, Baker DL |s2cid=145663530}}</ref> one 2008 U.S. study found a 14% average loss of annual income in families of children with ASD,<ref>{{cite journal |vauthors=Montes G, Halterman JS |title=Association of childhood autism spectrum disorders and loss of family income |journal=Pediatrics |volume=121 |issue=4 |pages=e821–e826 |date=April 2008 |pmid=18381511 |doi=10.1542/peds.2007-1594 |s2cid=55179}}</ref> and a related study found that ASD is associated with higher probability that child care problems will greatly affect parental employment.<ref>{{cite journal |vauthors=Montes G, Halterman JS |title=Child care problems and employment among families with preschool-aged children with autism in the United States |journal=Pediatrics |volume=122 |issue=1 |pages=e202–e208 |date=July 2008 |pmid=18595965 |doi=10.1542/peds.2007-3037 |s2cid=22686553}}</ref> After childhood, key treatment issues include residential care, job training and placement, sexuality, social skills, and [[Finance:Estate planning|estate planning]].<ref name="Aman"/>


== Educational interventions ==

Educational interventions attempt to help children not only to learn academic subjects and gain traditional readiness skills, but also to improve functional communication and spontaneity, enhance social skills such as [[Social:Joint attention|joint attention]], develop cognitive skills such as symbolic play, reduce disruptive behavior, and generalize learned skills by applying them to new situations. Several program models have been developed, which in practice often overlap and share many features, including:<ref name=CCD />
* early intervention that is not dependent upon a definitive diagnosis;
* intense intervention, at least 25 hours per week, 12 months per year;
* low student/teacher ratio;
* family involvement, including training of parents;
* interaction with neurotypical peers;
* social stories, ABA and other visually based training;<ref>{{cite journal| vauthors = Mitelman S, Von Kohorn O |title=Social Signals – Mike's Crush|journal=American Journal of Sexuality Education |date=September 2012|volume=7|issue=3|pages=282–284|doi=10.1080/15546128.2012.707095|s2cid=144245708}}</ref>
* structure that includes predictable routine and clear physical boundaries to lessen distraction; and
* ongoing measurement of a systematically planned intervention, resulting in adjustments as needed.

Several educational intervention methods are available, as discussed below. They can take place at home, at school, or at a center devoted to autism treatment; they can be implemented by parents, teachers, [[Social:Speech-language pathology|speech and language therapists]], and [[Medicine:Occupational therapist|occupational therapist]]s.<ref name=CCD /><ref name = "Case-Smith_2008" /> A 2007 study found that augmenting a center-based program with weekly home visits by a [[Social:Special education|special education]] teacher improved cognitive development and behavior.<ref>{{cite journal | vauthors = Rickards AL, Walstab JE, Wright-Rossi RA, Simpson J, Reddihough DS | title = A randomized, controlled trial of a home-based intervention program for children with autism and developmental delay | journal = Journal of Developmental and Behavioral Pediatrics | volume = 28 | issue = 4 | pages = 308–16 | date = August 2007 | pmid = 17700083 | doi = 10.1097/DBP.0b013e318032792e | s2cid = 39987661 }}</ref>

Studies of interventions have methodological flaws that prevent definitive conclusions about [[Chemistry:Efficacy|efficacy]].<ref name=Ospina>{{cite journal |vauthors=Ospina MB, Krebs Seida J, Clark B, Karkhaneh M, Hartling L, Tjosvold L, Vandermeer B, Smith V |display-authors=6 |title=Behavioural and developmental interventions for autism spectrum disorder: a clinical systematic review |journal=PLOS ONE |volume=3 |issue=11 |pages=e3755 |year=2008 |pmid=19015734 |pmc=2582449 |doi=10.1371/journal.pone.0003755 |bibcode=2008PLoSO...3.3755O |doi-access=free}}</ref> Although many [[Social:Psychosocial|psychosocial]] interventions have some positive evidence, suggesting that some form of treatment is preferable to no treatment, the methodological quality of [[Systematic review|systematic review]]s of these studies has generally been poor, their clinical results are mostly tentative, and there is little evidence for the relative effectiveness of treatment options.<ref name=Seida>{{cite journal |vauthors=Seida JK, Ospina MB, Karkhaneh M, Hartling L, Smith V, Clark B |title=Systematic reviews of psychosocial interventions for autism: an umbrella review |journal=Developmental Medicine and Child Neurology |volume=51 |issue=2 |pages=95–104 |date=February 2009 |pmid=19191842 |doi=10.1111/j.1469-8749.2008.03211.x |s2cid=39383638 |doi-access=free}}</ref> Concerns about outcome measures, such as their inconsistent use, most greatly affect how the results of scientific studies are interpreted.<ref>{{cite journal |vauthors=Wheeler D, Williams K, Seida J, Ospina M |title=The Cochrane Library and Autism Spectrum Disorder: an overview of reviews |journal=Evidence-Based Child Health |volume=3 |issue=1 |pages=3–15 |year=2008 |doi=10.1002/ebch.218 |url=http://www3.interscience.wiley.com/cgi-bin/fulltext/117947952/main.html,ftx_abs |archive-url=https://archive.today/20121210091839/http://www3.interscience.wiley.com/cgi-bin/fulltext/117947952/main.html,ftx_abs |url-status=dead |archive-date=2012-12-10}}</ref> A 2009 Minnesota study found that parents follow behavioral treatment recommendations significantly less often than they follow medical recommendations, and that they adhere more often to reinforcement than to punishment recommendations.<ref>{{cite journal |vauthors=Moore TR, Symons FJ |title=Adherence to behavioral and medical treatment recommendations by parents of children with autism spectrum disorders |journal=Journal of Autism and Developmental Disorders |volume=39 |issue=8 |pages=1173–84 |date=August 2009 |pmid=19333747 |doi=10.1007/s10803-009-0729-0 |s2cid=20631596}}</ref> Intensive, sustained special education programs and behavior therapy early in life can help children acquire self-care, social, and job skills,<ref name=CCD>{{cite journal |vauthors=Myers SM, Johnson CP |title=Management of children with autism spectrum disorders |journal=Pediatrics |volume=120 |issue=5 |pages=1162–82 |date=November 2007 |pmid=17967921 |doi=10.1542/peds.2007-2362 |s2cid=1656920 |doi-access=free}}</ref> and often improve functioning and decrease symptom severity and maladaptive behaviors;<ref name=Rogers>{{cite journal |vauthors=Rogers SJ, Vismara LA |title=Evidence-based comprehensive treatments for early autism |journal=Journal of Clinical Child and Adolescent Psychology |volume=37 |issue=1 |pages=8–38 |date=January 2008 |pmid=18444052 |pmc=2943764 |doi=10.1080/15374410701817808}}</ref> claims that intervention by around age three years is crucial are not substantiated.<ref name=Howlin09 /> Mind-body therapies are frequently utilized by individuals with Autism Spectrum Disorders (ASD). However, there remains a lack of comprehensive examination into the specific types of mind-body therapies used for ASD and their intended outcomes, signifying a need for further research and exploration in this area.<ref>{{cite journal | vauthors = Hourston S, Atchley R | title = Autism and Mind-Body Therapies: A Systematic Review | journal = Journal of Alternative and Complementary Medicine | volume = 23 | issue = 5 | pages = 331–339 | date = May 2017 | pmid = 28437148 | pmc = 5446600 | doi = 10.1089/acm.2016.0336 }}</ref>

=== National education policies ===

==== U.S. ====
In the United States, there have been three major policies addressing special education in the United States. These policies were the Education for All Handicapped Children Act in 1975, the Individuals with Disabilities Education Act in 1997, and the No Child Left Behind in 2001. The development of those policies showed increased guidelines for special education and requirements; such as requiring states to fund special education, equality of opportunities, help with transitions after secondary schooling, requiring extra qualifications for special education teachers, and creating a more specific class setting for those with disabilities.<ref>Education for All Handicapped Children Act of 1975</ref><ref>Individuals with Disabilities Education Act of 1997</ref><ref>No Child Left Behind Act of 2001</ref> The Individuals with Disabilities Education Act, specifically had a large impact on special education as public schools were then required to employ high qualified staff. In 2009, for one to be a Certified Autism Specialist the requirements included: a master's degree, two years of career experience working with the autism population, earn 14 continuing education hours in autism every two years, and register with the International Institute of Education.<ref>{{cite web|title=Standards|url=http://www.iies.us/|archive-url=https://web.archive.org/web/20090913204803/http://www.iies.us/|archive-date=13 September 2009|work=International Institute of Education Standards, Inc.}}</ref>

===== Perceived disadvantages of autistic people in the U.S. in the 2010s =====
Martha Nussbaum discusses how education is one of the fertile functions that is important for the development of a person and their ability to achieve a multitude of other capabilities within society.<ref>{{cite book|title=Creating Capabilities: The Human Development Approach|vauthors=Nussbaum M|date=2009|publisher=Belknap Press of Harvard University Press|isbn=978-0-674-07235-0|pages=17–45}}</ref> Autism causes many symptoms that interfere with a child's ability to receive a proper education such as deficits in imitation, observational learning, and receptive and expressive communication. As of 2014, of all disabilities affecting the population, autism ranked third lowest in acceptance into a postsecondary education institution.<ref name="Fleury_2014">{{cite journal|display-authors=6|vauthors=Fleury VP, Hedges S, Hume K, Browder DM, Thompson JL, Fallin K, El Zein F, Reutebuch CK, Vaughn S|date=2014-03-01|title=Addressing the Academic Needs of Adolescents With Autism Spectrum Disorder in Secondary Education|journal=Remedial and Special Education|volume=35|issue=2|pages=68–79|doi=10.1177/0741932513518823|issn=1538-4756|s2cid=145044525}}</ref> In a 2012 study funded by the National Institute of Health, Shattuck et al. found that only 35% of autistics are enrolled in a 2 or 4 year college within the first two years after leaving high school compared to 40% of children who have a learning disability.<ref name="Shattuck_2012">{{cite journal|vauthors=Shattuck PT, Narendorf SC, Cooper B, Sterzing PR, Wagner M, Taylor JL|date=June 2012|title=Postsecondary education and employment among youth with an autism spectrum disorder|journal=Pediatrics|volume=129|issue=6|pages=1042–9|doi=10.1542/peds.2011-2864|pmc=3362908|pmid=22585766}}</ref> Due to the growing need for a college education to obtain a job, this statistic shows how autistics are at a disadvantage in gaining many of the capabilities that Nussbaum discusses and makes education more than just a type of therapy for those with autism.<ref name="Fleury_2014" /> According to the 2012 study by Shattuck, only 55% of children with autism participated in any paid employment within the first two years after high school. Furthermore, those with autism that come from low income families tend to have lower success in postsecondary schooling.<ref name="Shattuck_2012" />

Oftentimes, schools lacked the resources to create (what at the time was considered) an optimal classroom setting for those 'in need of special education'. In 2014 in the United States, it could cost between $6,595 to $10,421 extra to educate a child with autism.<ref>{{cite journal|vauthors=Lavelle TA, Weinstein MC, Newhouse JP, Munir K, Kuhlthau KA, Prosser LA|date=March 2014|title=Economic burden of childhood autism spectrum disorders|journal=Pediatrics|volume=133|issue=3|pages=e520-9|doi=10.1542/peds.2013-0763|pmc=7034397|pmid=24515505}}</ref> In the 2011–2012 school year, the average cost of education for a public school student was $12,401. In 2015, some cases, the extra cost required to educate a child with autism nearly doubled the average cost to educate the average public school student.<ref>{{Cite web|date=2015-05-28|title=The Condition of Education 2015|url=https://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2015144|access-date=2015-11-10}}</ref> As the abilities of autistic people varies highly, it is highly challenging to create a standardized curriculum that will fit all autistic learning needs. In the United States, in 2014 many school districts required schools to meet the needs of disabled students, regardless of the number of children with disabilities there are in the school.<ref>{{Cite web|date=2014-08-11|title=Special-education overhaul leaves students less isolated, but schools struggle to keep up|url=http://ny.chalkbeat.org/2014/08/11/special-education-overhaul-leaves-students-less-isolated-but-schools-struggle-to-keep-up/|access-date=2015-11-10|work=Chalkbeat New York|vauthors=Wall P}}</ref> This combined with a shortage of licensed special education teachers has created a deficiency in the special education system. in 2011 the shortage caused some states to give temporary special education licenses to teachers with the caveat that they receive a license within a few years.<ref>{{Cite web|date=2011|title=The Need Grows for Special Education Teachers in the U.S.|url=https://www1.cfnc.org/Plan/For_A_Career/Career_Cluster_Profile/Cluster_Article.aspx?articleId=wmpz3NDihGoZXAP2BPAXoj8Gw4PFAXAP3DPAXXAP3DPAX&cId=BI1JKTSUyth8XAP2FPAXn7VPoxI8gXAP3DPAXXAP3DPAX&sectionId=3|access-date=2015-11-10|work=CFNC}}</ref>

==== Mexico ====
In 1993, Mexico passed an education law that called for the inclusion of those with disabilities. This law was very important for Mexico education, however, there have been issues in implementing it due to a lack of resources.<ref>{{Cite conference|date=2010-03-26|title=Autism and Special Education Policy in Mexico|ssrn=1578963|vauthors=Tuman JP, Roth-Johnson D, Baker DL, Vecchio J}}</ref>

==== United Nations and internationally ====
There have also been multiple international groups that have issued reports addressing issues in special education. The United Nations on "International Norms and Standards relating to Disability" in 1998. This report cites multiple conventions, statements, declarations, and other reports such as: The Universal Declaration of Human Rights, The Salamanca Statement, the Sundberg Declaration, the Copenhagen Declaration and Programme of Action, and many others. One main point that the report emphasizes is the necessity for education to be a human right. The report also states that the "quality of education should be equal to that of persons without disabilities." The other main points brought up by the report discuss integrated education, special education classes as supplementary, teacher training, and equality for [[Social:Vocational education|vocational education]].<ref>{{Cite web|date=July 2002|title=UN Enable – Compilation of International Norms And Standards Relating to Disability|url=https://www.un.org/esa/socdev/enable/discom00.htm|access-date=2015-11-10|work=United Nations Enable}}</ref> The United Nations also releases a report by the Special Rapporteur that has a focus on persons with disabilities. In 2015, a report titled "Report of the Special Rapporteur to the 52nd Session of the Commission for Social Development: Note by the Secretary-General on Monitoring of the implementation of the Standard Rules on the Equalization of Opportunities for Persons with Disabilities" was released. This report focused on looking at how the many countries involved, with a focus on Africa, have handled policy regarding persons with disabilities. In this discussion, the author also focuses on the importance of education for persons with disabilities as well as policies that could help improve the education system such as a move towards a more inclusive approach.<ref>{{Cite web|date=2015|title=Special Rapporteur on Disability of the Commission for Social Development|url=https://www.un.org/disabilities/default.asp?id=183|url-status=dead|archive-url=https://web.archive.org/web/20150707074651/http://www.un.org/disabilities/default.asp?id=183|archive-date=2015-07-07|access-date=2015-11-10}}</ref> The World Health Organization has also published a report addressing people with disabilities and within this there is a discussion on education in their "World Report on Disability" in 2011.<ref>{{Cite book|title=World report on disability|date=2011|publisher=World Health Organization|isbn=978-92-4-156418-2|location=Geneva, Switzerland}}</ref> Other organizations that have issued reports discussing the topic are UNESCO, UNICEF, and the World Bank.<ref>{{Cite web|title=Global Reports|url=https://www.cec.sped.org/Special-Ed-Topics/International-Special-Education/Global-Reports|url-status=dead|archive-url=https://web.archive.org/web/20151119141947/https://www.cec.sped.org/Special-Ed-Topics/International-Special-Education/Global-Reports|archive-date=2015-11-19|access-date=2015-11-10}}</ref>

=== Applied behavior analysis ===
Applied behavior analysis (ABA) is the applied research field of the science of behavior analysis, and it underpins a wide range of techniques used to treat autism and many other behaviors and diagnoses,<ref>{{cite journal | vauthors = Dillenburger K, Keenan M | title = None of the As in ABA stand for autism: dispelling the myths | journal = Journal of Intellectual & Developmental Disability | volume = 34 | issue = 2 | pages = 193–5 | date = June 2009 | pmid = 19404840 | doi = 10.1080/13668250902845244 | s2cid = 1818966 }}</ref> including those who are patients in rehab or in whom a behavior change is desired. ABA-based interventions focus on teaching tasks one-on-one using the behaviorist principles of stimulus, response and reward,<ref name=Howard>{{cite journal | vauthors = Howard JS, Sparkman CR, Cohen HG, Green G, Stanislaw H | title = A comparison of intensive behavior analytic and eclectic treatments for young children with autism | journal = Research in Developmental Disabilities | volume = 26 | issue = 4 | pages = 359–83 | year = 2005 | pmid = 15766629 | doi = 10.1016/j.ridd.2004.09.005 | s2cid = 15018504 }}</ref> and on reliable measurement and objective evaluation of observed behavior.<ref name=CCD /> There is wide variation in the [[Philosophy:Professional practice of behavior analysis|professional practice of behavior analysis]] and among the assessments and interventions used in school-based ABA programs.<ref name=Steege /> Conversely, various major figures within the autism community have written biographies detailing the harm caused by the provision of ABA, including restraint, sometimes used with mild self stimulatory behaviors such as hand flapping, and verbal abuse. Punishment procedures are very rarely used within the field today; these procedures were once used in the 70s and 80s however now there are ethical guidelines in place to prohibit the use.{{Citation needed|date=January 2022}}

The use of technology has begun to be implemented in ABA therapy for the treatment of autism.<ref name="Alves_2020">{{Cite journal | vauthors = Alves FJ, De Carvalho EA, Aguilar J, De Brito LL, Bastos GS |date=2020 |title=Applied Behavior Analysis for the Treatment of Autism: A Systematic Review of Assistive Technologies |url=https://ieeexplore.ieee.org/document/9127441 |journal=IEEE Access |volume=8 |pages=118664–118672 |doi=10.1109/ACCESS.2020.3005296 |s2cid=220470297 |issn=2169-3536|doi-access=free }}</ref> Robots, [[Philosophy:Gamification of learning|gamification]], image processing, story boards, [[Augmented reality|augmented reality]], and web systems have been shown to be useful in the treatment of autism.<ref name="Alves_2020" /> These technologies are used to teach children with autism skill acquisition.<ref name="Alves_2020" /> The web programs were designed to address skills such as attention, social behavior, communication, and/or reading.<ref name="Alves_2020" />

ABA has faced a great deal of criticism over the years. Recently, studies have shown that ABA may be abusive and can increase PTSD symptoms in patients.<ref>{{Cite journal | vauthors = Kupferstein H |date=2018-01-02 |title=Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis |url=https://www.emerald.com/insight/content/doi/10.1108/AIA-08-2017-0016/full/html |journal=Advances in Autism |language=en |volume=4 |issue=1 |pages=19–29 |doi=10.1108/AIA-08-2017-0016 |s2cid=4638346 |issn=2056-3868}}</ref><ref>{{Cite journal | vauthors = Sandoval-Norton AH, Shkedy G, Shkedy D |date= January 2019 | veditors = Rushby JA |title=How much compliance is too much compliance: Is long-term ABA therapy abuse? |journal=Cogent Psychology |language=en |volume=6 |issue=1 |pages=1641258 |doi=10.1080/23311908.2019.1641258 |s2cid=199041640 |issn=2331-1908|doi-access=free }}</ref><ref>{{cite journal | vauthors = Wilkenfeld DA, McCarthy AM | title = Ethical Concerns with Applied Behavior Analysis for Autism Spectrum "Disorder" | journal = Kennedy Institute of Ethics Journal | volume = 30 | issue = 1 | pages = 31–69 | date = 2020 | pmid = 32336692 | doi = 10.1353/ken.2020.0000 | s2cid = 216557299 }}</ref><ref>{{cite journal | vauthors = Bottema-Beutel K, Crowley S, Sandbank M, Woynaroski TG | title = Research Review: Conflicts of Interest (COIs) in autism early intervention research - a meta-analysis of COI influences on intervention effects | journal = Journal of Child Psychology and Psychiatry, and Allied Disciplines | volume = 62 | issue = 1 | pages = 5–15 | date = January 2021 | pmid = 32353179 | pmc = 7606324 | doi = 10.1111/jcpp.13249 }}</ref><ref>{{Cite journal | vauthors = McGill O, Robinson A |date=2021-10-26 |title="Recalling hidden harms": autistic experiences of childhood applied behavioural analysis (ABA) |url=https://www.emerald.com/insight/content/doi/10.1108/AIA-04-2020-0025/full/html |journal=Advances in Autism |language=en |volume=7 |issue=4 |pages=269–282 |doi=10.1108/AIA-04-2020-0025 |s2cid=225282499 |issn=2056-3868}}</ref><ref>{{Cite journal | vauthors = Shkedy G, Shkedy D, Sandoval-Norton AH |date=June 2021 |title=Long-term ABA Therapy Is Abusive: A Response to Gorycki, Ruppel, and Zane |journal=Advances in Neurodevelopmental Disorders |language=en |volume=5 |issue=2 |pages=126–134 |doi=10.1007/s41252-021-00201-1 |issn=2366-7532|doi-access=free }}</ref> The Autistic Self Advocacy Network campaigns against the use of ABA in autism.<ref name="Autistic Self Advocacy Network">{{cite web |author=Autistic Self Advocacy Network |title=Autistic Self Advocacy Network – Nothing About Us Without Us |url=http://www.autisticadvocacy.org/ |website=www.autisticadvocacy.org}}</ref><ref name="DeVita-Raeburn_2016">{{cite web |date=2016-08-11 |title=Is the Most Common Therapy for Autism Cruel? |url=https://www.theatlantic.com/health/archive/2016/08/aba-autism-controversy/495272/ |website=The Atlantic |vauthors=DeVita-Raeburn E}}</ref> 

Many of those diagnosed with ASD or similar disorders advocate against behavioural therapies more broadly, like ABA and CBT, often as part of the autism rights movement, on the grounds that these approaches frequently reinforce the demand on autistic people to [[Medicine:Autistic masking|mask their neurodivergent characteristics]] or behaviours to favour a more '[[Medicine:Neurotypical|neurotypical]]' and narrow conception of normality.<ref>{{Cite web |title=Commentary: The autistic community is having a reckoning with ABA therapy. We should listen |url=https://fortune.com/2022/05/13/autistic-community-reckoning-aba-therapy-rights-autism-insurance-private-equity-ariana-cernius/ |access-date=2023-11-03 |website=Fortune |language=en}}</ref> <ref>{{Cite journal | vauthors = McGill O, Robinson A |date= January 2020 |title=“Recalling hidden harms”: autistic experiences of childhood applied behavioural analysis (ABA) |journal=Advances in Autism |volume=7 |issue=4 |pages=269–282 |doi=10.1108/AIA-04-2020-0025 |issn=2056-3868}}</ref> <ref>{{cite journal | vauthors = Hull L, Petrides KV, Allison C, Smith P, Baron-Cohen S, Lai MC, Mandy W | title = "Putting on My Best Normal": Social Camouflaging in Adults with Autism Spectrum Conditions | journal = Journal of Autism and Developmental Disorders | volume = 47 | issue = 8 | pages = 2519–2534 | date = August 2017 | pmid = 28527095 | pmc = 5509825 | doi = 10.1007/s10803-017-3166-5 }}</ref> In the case of CBT and talking therapies, the effectiveness varies, with many reporting that they appeared 'too self-aware' to gain significant benefit, as the therapy was designed with neurotypical people in mind.  In autistic children, specifically, they also report that it is only mildly beneficial in aiding with their anxieties. 

==== Discrete trial training ====
{{further|Philosophy:Discrete trial training}}
Many intensive behavioral interventions rely heavily on discrete trial teaching (DTT) methods, which use stimulus-response-reward techniques to teach foundational skills such as attention, compliance, and imitation.<ref>{{cite journal | vauthors = Ryan CS, Hemmes NS | year = 2005 | title = Post-training Discrete-Trial Teaching Performance by Instructors of Young Children with Autism in Early Intensive Behavioral Intervention | url =https://dx.doi.org/10.1037/h0100052 | journal = The Behavior Analyst Today| volume = 6 | issue = 1| pages = 1–16 | doi=10.1037/h0100052}}</ref> However, children have problems using DTT-taught skills in natural environments.<ref name=CCD /> These students are also taught with naturalistic teaching procedures to help generalize these skills. In functional assessment, a common technique, a teacher formulates a clear description of a problem behavior, identifies antecedents, consequences, and other environmental factors that influence and maintain the behavior, develops hypotheses about what occasions and maintains the behavior, and collects observations to support the hypotheses.<ref name=CCD /> A few more-comprehensive ABA programs use multiple assessment and intervention methods individually and dynamically.<ref name=Steege>{{cite journal |journal=Psychology in the Schools|year=2007 |volume=44 |issue=1 |pages=91–9 |title=Applied behavior analysis: beyond discrete trial teaching | vauthors = Steege MW, Mace FC, Perry L, Longenecker H |doi=10.1002/pits.20208 }}</ref>

ABA-based techniques have demonstrated effectiveness in several controlled studies: children have been shown to make sustained gains in academic performance, [[Philosophy:Adaptive behavior|adaptive behavior]], and language, with outcomes significantly better than control groups.<ref name=CCD /> A 2009 review of educational interventions for children, whose mean age was six years or less at intake, found that the higher-quality studies all assessed ABA, that ABA is well-established and no other educational treatment is considered probably efficacious, and that intensive ABA treatment, carried out by trained therapists, is demonstrated effective in enhancing global functioning in pre-school children.<ref name=Eikeseth>{{cite journal | vauthors = Eikeseth S | title = Outcome of comprehensive psycho-educational interventions for young children with autism | journal = Research in Developmental Disabilities | volume = 30 | issue = 1 | pages = 158–78 | year = 2009 | pmid = 18385012 | doi = 10.1016/j.ridd.2008.02.003 }}</ref> These gains maybe complicated by initial IQ.<ref>{{cite journal | vauthors = Weiss MJ, Delmolino L | year = 2006 | title = The Relationship Between Early Learning Rates and Treatment Outcome For Children With Autism Receiving Intensive Home-Based Applied Behavior Analysis | url = https://dx.doi.org/10.1037/h0100140| journal = The Behavior Analyst Today| volume = 7 | issue = 1| pages = 96–100 | doi=10.1037/h0100140}}</ref> A 2008 evidence-based review of comprehensive treatment approaches found that ABA is well established for improving intellectual performance of young children with ASD.<ref name=Rogers /> A 2009 comprehensive synthesis of early intensive behavioral intervention (EIBI), a form of ABA treatment, found that EIBI produces strong effects, suggesting that it can be effective for some children with autism; it also found that the large effects might be an artifact of comparison groups with treatments that have yet to be empirically validated, and that no comparisons between EIBI and other widely recognized treatment programs have been published.<ref>{{cite journal | vauthors = Reichow B, Wolery M | title = Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA young autism project model | journal = Journal of Autism and Developmental Disorders | volume = 39 | issue = 1 | pages = 23–41 | date = January 2009 | pmid = 18535894 | doi = 10.1007/s10803-008-0596-0 | s2cid = 6932830 }}</ref> A 2009 systematic review came to the same principal conclusion that EIBI is effective for some but not all children, with wide variability in response to treatment; it also suggested that any gains are likely to be greatest in the first year of intervention.<ref name=Howlin09>{{cite journal | vauthors = Howlin P, Magiati I, Charman T | title = Systematic review of early intensive behavioral interventions for children with autism | journal = American Journal on Intellectual and Developmental Disabilities | volume = 114 | issue = 1 | pages = 23–41 | date = January 2009 | pmid = 19143460 | doi = 10.1352/2009.114:23-41 }}</ref> A 2009 [[Meta-analysis|meta-analysis]] concluded that EIBI has a large effect on full-scale intelligence and a moderate effect on adaptive behavior.<ref>{{cite journal | vauthors = Eldevik S, Hastings RP, Hughes JC, Jahr E, Eikeseth S, Cross S | title = Meta-analysis of Early Intensive Behavioral Intervention for children with autism | journal = Journal of Clinical Child and Adolescent Psychology | volume = 38 | issue = 3 | pages = 439–50 | date = May 2009 | pmid = 19437303 | doi = 10.1080/15374410902851739 | s2cid = 205873629 }}</ref> However, a 2009 systematic review and meta-analysis found that applied behavior intervention (ABI), another name for EIBI, did not significantly improve outcomes compared with standard care of preschool children with ASD in the areas of cognitive outcome, expressive language, receptive language, and adaptive behavior.<ref>{{cite journal | vauthors = Spreckley M, Boyd R | title = Efficacy of applied behavioral intervention in preschool children with autism for improving cognitive, language, and adaptive behavior: a systematic review and meta-analysis | journal = The Journal of Pediatrics | volume = 154 | issue = 3 | pages = 338–44 | date = March 2009 | pmid = 18950798 | doi = 10.1016/j.jpeds.2008.09.012 }}</ref> ABA is cost effective for administrators.<ref>{{cite journal | vauthors = Jacobson JW | year = 2000 | title = Converting to a Behavior Analysis Format for Autism Services: Decision-Making for Educational Administrators, Principals, and Consultants | url =https://dx.doi.org/10.1037/h0099889 | journal = The Behavior Analyst Today| volume = 1 | issue = 3| pages = 6–16 | doi=10.1037/h0099889}}</ref>

Recently, behavior analysts have built comprehensive models of child development (see [[Philosophy:Behavior analysis of child development|Behavior analysis of child development]]) to generate models for prevention as well as treatment for autism.

==== Pivotal response training ====
Pivotal response treatment (PRT) is a naturalistic intervention derived from ABA principles. Instead of individual behaviors, it targets pivotal areas of a child's development, such as motivation, responsivity to multiple cues, self-management, and social initiations; it aims for widespread improvements in areas that are not specifically targeted. The child determines activities and objects that will be used in a PRT exchange. Intended attempts at the target behavior are rewarded with a natural reinforcer: for example, if a child attempts a request for a stuffed animal, the child receives the animal, not a piece of candy or other unrelated reinforcer.<ref>Pivotal response therapy:
* {{cite book |title=Pivotal Response Treatments for Autism: Communication, Social, & Academic Development | vauthors = Koegel RL, Koegel LK |publisher=Brookes |isbn=1-55766-819-1 |date=2006 }}
* {{cite journal |journal=Journal of the Association for Persons with Severe Handicaps|year=1999 |volume=24 |issue=3 |pages=174–85 |title=Pivotal response intervention I: overview of approach | vauthors = Koegel LK, Koegel RL, Harrower JK, Carter CM | doi=10.2511/rpsd.24.3.174 |s2cid=143633277 }}</ref>

=== Communication interventions ===
The inability to communicate, verbally or non-verbally, is a core deficit in autism. Children with autism are often engaged in repetitive activity or other behaviors because they cannot convey their intent any other way. They do not know how to communicate their ideas to caregivers or others. Helping a child with autism learn to communicate their needs and ideas is absolutely core to any intervention. Communication can either be verbal or non-verbal. Children with autism require intensive intervention to learn how to communicate their intent.

Communication interventions fall into two major categories. First, many autistic children do not speak, or have little speech, or have difficulties in effective use of language.<ref name="baojournal.com">{{cite journal | vauthors = Gillis JM, Butler RC | year = 2007 | title = Social skills interventions for preschoolers with Autism Spectrum Disorder: A description of single – subject design studies | url = | journal = Journal of Early and Intensive Behavior Intervention| volume = 4 | issue = 3| pages = 532–548 | doi=10.1037/h0100390}}</ref> [[Philosophy:Social skills|Social skills]] have been shown to be effective in treating children with autism.<ref name="baojournal.com" /> Interventions that attempt to improve communication are commonly conducted by speech and language therapists, and work on joint attention, communicative intent, and alternative or augmentative and alternative communication (AAC) methods such as visual methods,<ref name=SIGN /> for example [[Medicine:Visual schedules|visual schedules]]. AAC methods do not appear to impede speech and may result in modest gains.<ref>{{cite journal | vauthors = Schlosser RW, Wendt O | title = Effects of augmentative and alternative communication intervention on speech production in children with autism: a systematic review | journal = American Journal of Speech-Language Pathology | volume = 17 | issue = 3 | pages = 212–30 | date = August 2008 | pmid = 18663107 | doi = 10.1044/1058-0360(2008/021) }}</ref> A 2006 study reported benefits both for joint attention intervention and for symbolic play intervention,<ref>{{cite journal | vauthors = Kasari C, Freeman S, Paparella T | title = Joint attention and symbolic play in young children with autism: a randomized controlled intervention study | journal = Journal of Child Psychology and Psychiatry, and Allied Disciplines | volume = 47 | issue = 6 | pages = 611–20 | date = June 2006 | pmid = 16712638 | doi = 10.1111/j.1469-7610.2005.01567.x | s2cid = 1246968 }} {{cite journal |title=Erratum |date=2007 |quote=no |journal=Journal of Child Psychology and Psychiatry|volume=48 |issue=5 |pages=523 |doi=10.1111/j.1469-7610.2007.01768.x |doi-access=free }}</ref> and a 2007 study found that joint attention intervention is more likely than symbolic play intervention to cause children to engage later in shared interactions.<ref>{{cite journal | vauthors = Gulsrud AC, Kasari C, Freeman S, Paparella T | title = Children with autism's response to novel stimuli while participating in interventions targeting joint attention or symbolic play skills | journal = Autism | volume = 11 | issue = 6 | pages = 535–46 | date = November 2007 | pmid = 17947289 | doi = 10.1177/1362361307083255 | s2cid = 24239762 }}</ref>

Second, social skills treatment attempts to increase social and communicative skills of autistic individuals, addressing a core deficit of autism. A wide range of intervention approaches is available, including modeling and reinforcement, adult and peer mediation strategies, peer tutoring, social games and stories, self-management, pivotal response therapy, [[Social:Video modeling|video modeling]], direct instruction, visual cuing, Circle of Friends and social-skills groups.<ref>{{cite journal | vauthors = Matson JL, Matson ML, Rivet TT | title = Social-skills treatments for children with autism spectrum disorders: an overview | journal = Behavior Modification | volume = 31 | issue = 5 | pages = 682–707 | date = September 2007 | pmid = 17699124 | doi = 10.1177/0145445507301650 | s2cid = 35318587 }}</ref> A 2007 meta-analysis of 55 studies of school-based social skills intervention found that they were minimally effective for children and adolescents with ASD,<ref>{{cite journal | vauthors = Bellini S, Peters JK, Benner L, Hopf A |title=A meta-analysis of school-based social skills interventions for children with autism spectrum disorders |journal=Remedial and Special Education|volume=28 |issue=3 |date=2007 |pages=153–62 |doi=10.1177/07419325070280030401 |s2cid=145700489 }}</ref> and a 2007 review found that social skills training has minimal empirical support for children with [[Medicine:Asperger syndrome|Asperger syndrome]] or [[Medicine:High-functioning autism|high-functioning autism]].<ref name=Rao>{{cite journal | vauthors = Rao PA, Beidel DC, Murray MJ | title = Social skills interventions for children with Asperger's syndrome or high-functioning autism: a review and recommendations | journal = Journal of Autism and Developmental Disorders | volume = 38 | issue = 2 | pages = 353–61 | date = February 2008 | pmid = 17641962 | doi = 10.1007/s10803-007-0402-4 | s2cid = 2507088 }}</ref>

==== SCERTS ====
The SCERTS model<ref name=Prizant>{{cite book| vauthors = Prizant BM, Wetherby AM, Rubin E, Laurent AC, Rydell PJ |title=The SCERTS manual : a comprehensive educational approach for young children with autism spectrum disorders|year=2005|publisher=Paul H. Brookes|location=Baltimore, Md.|isbn=978-1-55766-818-9 }}</ref> is an educational model for working with children with ASD. It was designed to help families, educators and therapists work cooperatively together to maximize progress in supporting the child.

The acronym refers to the focus on:
* SC – social communication – the development of functional communication and emotional expression.
* ER – emotional regulation – the development of well-regulated emotions and ability to cope with stress.
* TS – transactional support – the implementation of supports to help families, educators and therapists respond to children's needs, adapt the environment and provide tools to enhance learning.

=== Relationship based, developmental models ===
Relationship based models give importance to the relationships that help children reach and master early developmental milestones. These are often missed or not mastered in children with ASD. Examples of these early milestones are engagement and interest in the world, intimacy with a caregiver, intentionality of action.

==== Relationship Development Intervention ====
{{Main|Medicine:Relationship Development Intervention}}
Relationship development intervention<ref name=Gutstein_2012>{{cite journal | vauthors = Gutstein SE, Burgess AF, Montfort K | title = Evaluation of the relationship development intervention program | journal = Autism | volume = 11 | issue = 5 | pages = 397–411 | date = September 2007 | pmid = 17942454 | doi = 10.1177/1362361307079603 | s2cid = 9207853 }}</ref> is a family-based treatment program for children with ASD. This program is based on the belief that the development of dynamic intelligence (the ability to think flexibly, take different perspectives, cope with change and process information simultaneously) is key to improving the quality of life of children with autism.

==== Son-Rise ====
{{Main|Medicine:Son-Rise}}
Son-Rise is a home-based program that emphasizes on implementing a color- and sensory-free playroom. Before implementing the home-based program, an institute trains the parents how to accept their child without judgment through a series of dialogue sessions. Like Floortime, parents join their child's ritualistic behavior for relationship-building. To gain the child's "willing engagement", the facilitator continues to join them only this time through parallel play. Proponents claim that children will become non-autistic after parents accept them for who they are and engage them in play. The program was started by the parents of Raun Kaufman, who is claimed to have gone from being autistic to normal via the treatment in the early 1970s.<ref>{{cite book | vauthors = Kaufman BN |title=Son-Rise: the Miracle Continues |publisher=HJ Kramer |year=1995 |isbn=0-915811-61-8 |url-access=registration |url=https://archive.org/details/sonrise00barr }}</ref> A stated goal of the program is to increase eye contact.<ref>{{Cite web|title=Training Parents to Promote Communication and Social Behavior in Children with Autism: The Son-Rise Program|url=https://www.autismtreatmentcenter.org/media/pdf/training-parents-to-promote-communication-and-social-behavior-inchildren-with-autism-the-sonrise-program-2375-4427-1000147.pdf|access-date=2022-01-05 |website=www.autismtreatmentcenter.org|language=en}}</ref> In a 2017 qualitative study it was found that autistic people have reported to find eye contact distressing.<ref>{{cite journal | vauthors = Trevisan DA, Roberts N, Lin C, Birmingham E | title = How do adults and teens with self-declared Autism Spectrum Disorder experience eye contact? A qualitative analysis of first-hand accounts | journal = PLOS ONE | volume = 12 | issue = 11 | pages = e0188446 | date = 2017-11-28 | pmid = 29182643 | pmc = 5705114 | doi = 10.1371/journal.pone.0188446 | bibcode = 2017PLoSO..1288446T | doi-access = free }}</ref> No independent study has tested the efficacy of the program, but a 2003 study found that involvement with the program led to more drawbacks than benefits for the involved families over time,<ref>{{cite journal | vauthors = Williams KR, Wishart JG | title = The Son-Rise Program intervention for autism: an investigation into family experiences | journal = Journal of Intellectual Disability Research | volume = 47 | issue = Pt 4-5 | pages = 291–9 | year = 2003 | pmid = 12787161 | doi = 10.1046/j.1365-2788.2003.00491.x }}</ref> and a 2006 study found that the program is not always implemented as it is typically described in the literature, which suggests it will be difficult to evaluate its efficacy.<ref>{{cite journal | vauthors = Williams KR | title = The Son-Rise Program intervention for autism: prerequisites for evaluation | journal = Autism | volume = 10 | issue = 1 | pages = 86–102 | date = January 2006 | pmid = 16522712 | doi = 10.1177/1362361306062012 | s2cid = 22206988 }}</ref>

=== TEACCH ===
Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH), which has come to be called "structured teaching", emphasises structure by using organized physical environments, predictably sequenced activities, visual schedules and visually structured activities, and structured work/activity systems where each child can practice various tasks.<ref name=CCD /> Parents are taught to implement the treatment at home. A 1998 controlled trial found that children treated with a TEACCH-based home program improved significantly more than a control group.<ref>{{cite journal | vauthors = Ozonoff S, Cathcart K | title = Effectiveness of a home program intervention for young children with autism | journal = Journal of Autism and Developmental Disorders | volume = 28 | issue = 1 | pages = 25–32 | date = February 1998 | pmid = 9546299 | doi = 10.1023/A:1026006818310 | s2cid = 23324899 }}</ref> A 2013 meta-analysis compiling all the clinical trials of TEACCH indicated that it has small or no effects on perceptual, motor, verbal, cognitive, and motor functioning, communication skills, and activities of daily living. There were positive effects in social and maladaptive behavior, but these required further replication due to the methodological limitations of the pool of studies analysed.<ref>{{cite journal | vauthors = Virues-Ortega J, Julio FM, Pastor-Barriuso R | title = The TEACCH program for children and adults with autism: a meta-analysis of intervention studies | journal = Clinical Psychology Review | volume = 33 | issue = 8 | pages = 940–53 | date = December 2013 | pmid = 23988454 | doi = 10.1016/j.cpr.2013.07.005 | doi-access = free | hdl = 20.500.12105/11622 | hdl-access = free }}</ref>

=== Sensory integration ===
{{Main|Medicine:Sensory processing disorder}}
Unusual responses to [[Biology:Stimulus (physiology)|sensory stimuli]] are more common and prominent in children with autism, although there is not good evidence that sensory symptoms differentiate autism from other developmental disorders.<ref>{{cite journal | vauthors = Rogers SJ, Ozonoff S | title = Annotation: what do we know about sensory dysfunction in autism? A critical review of the empirical evidence | journal = Journal of Child Psychology and Psychiatry, and Allied Disciplines | volume = 46 | issue = 12 | pages = 1255–68 | date = December 2005 | pmid = 16313426 | doi = 10.1111/j.1469-7610.2005.01431.x }}</ref> Several therapies have been developed to treat [[Medicine:Sensory processing disorder|sensory processing disorder]] (SPD).<ref>{{cite web |title=Sensory integrative therapy |url=http://www.researchautism.net/interventionitem.ikml?print&ra=28&infolevel=4 |access-date=2007-10-08 |publisher=Research Autism }}</ref> Some of these treatments (for example, [[Biology:Sensory-motor coupling|sensorimotor]] handling) have a questionable rationale and have no empirical evidence. Other treatments have been studied, with small positive outcomes, but few conclusions can be drawn due to methodological problems with the studies. These treatments include prism lenses, physical exercise, [[Medicine:Auditory integration training|auditory integration training]], and sensory stimulation or inhibition techniques such as "deep pressure"—firm touch pressure applied either manually or via an apparatus such as a [[Engineering:Hug machine|hug machine]] or a pressure garment.<ref name="ReferenceA">{{cite journal | vauthors = Baranek GT | title = Efficacy of sensory and motor interventions for children with autism | journal = Journal of Autism and Developmental Disorders | volume = 32 | issue = 5 | pages = 397–422 | date = October 2002 | pmid = 12463517 | doi = 10.1023/A:1020541906063 | s2cid = 16449130 }}</ref> Weighted vests, a popular deep-pressure therapy, have only a limited amount of scientific research available, which on balance indicates that the therapy is ineffective.<ref>{{cite journal | vauthors = Stephenson J, Carter M | title = The use of weighted vests with children with autism spectrum disorders and other disabilities | journal = Journal of Autism and Developmental Disorders | volume = 39 | issue = 1 | pages = 105–14 | date = January 2009 | pmid = 18592366 | doi = 10.1007/s10803-008-0605-3 | s2cid = 28121843 }}</ref> Although replicable treatments have been described and valid outcome measures are known, gaps exist in knowledge related to SPD and therapy.<ref>{{cite journal | vauthors = Schaaf RC, Miller LJ | title = Occupational therapy using a sensory integrative approach for children with developmental disabilities | journal = Mental Retardation and Developmental Disabilities Research Reviews | volume = 11 | issue = 2 | pages = 143–8 | year = 2005 | pmid = 15977314 | doi = 10.1002/mrdd.20067 }}</ref> In a 2011 Cochrane review, no evidence was found to support the use of auditory integration training as an ASD treatment method.<ref>{{cite journal | vauthors = Sinha Y, Silove N, Hayen A, Williams K | title = Auditory integration training and other sound therapies for autism spectrum disorders (ASD) | journal = The Cochrane Database of Systematic Reviews | issue = 12 | pages = CD003681 | date = December 2011 | volume = 2011 | pmid = 22161380 | doi = 10.1002/14651858.CD003681.pub3 | pmc = 7173755 }}</ref> Because empirical support is limited, systematic evaluation is needed if these interventions are used.<ref>{{cite journal | vauthors = Hodgetts S, Hodgetts W | title = Somatosensory stimulation interventions for children with autism: literature review and clinical considerations | journal = Canadian Journal of Occupational Therapy | volume = 74 | issue = 5 | pages = 393–400 | date = December 2007 | pmid = 18183774 | doi = 10.2182/cjot.07.013 | s2cid = 25016676 }}</ref>

The term [[Philosophy:Multisensory integration|multisensory integration]] in simple terms means the ability to use all of ones senses to accomplish a task. [[Medicine:Occupational therapist|Occupational therapist]]s sometimes prescribe sensory treatments for children with Autism however in general there has been little or no scientific evidence of effectiveness.<ref name="ReferenceA" />

=== Animal-assisted therapy ===

==== Old model ====
Animal-assisted therapy, where an animal such as a dog or a horse becomes a basic part of a person's treatment, was a controversial treatment for some symptoms. A 2007 [[Meta-analysis|meta-analysis]] found that animal-assisted therapy was associated with "a moderate improvement in autism spectrum symptoms".<ref>{{cite journal |journal=Anthrozoös|volume=20 |issue=3 |pages=225–38 |date=2007 | vauthors = Nimer J, Lundahl B |title=Animal-assisted therapy: a meta-analysis |doi=10.2752/089279307X224773 |s2cid=53310654 }}</ref> Reviews of published [[Biology:Dolphin|dolphin]]-assisted therapy (DAT) studies found important methodological flaws and concluded that there is no compelling scientific evidence that DAT is a legitimate therapy or that it affords any more than fleeting improvements in mood.<ref>{{cite journal|journal=Anthrozoös|volume=20 |issue=3 |pages=239–49 |date=2007 |doi=10.2752/089279307X224782 | vauthors = Marino L, Lilienfeld SO |title=Dolphin-Assisted Therapy: more flawed data and more flawed conclusions |s2cid=6119940 |url=http://www.marineconnection.org/docs/DAT%20Paper%202007.pdf |access-date=2008-02-20 |url-status=dead |archive-url=https://web.archive.org/web/20080228025018/https://www.marineconnection.org/docs/DAT%20Paper%202007.pdf |archive-date=2008-02-28 }}</ref>

==== New model ====
Modern animal-assisted therapy as relating to autism is not about 'controlling autistic symptoms' but about a natural way to bring about socializing<ref>{{cite journal | vauthors = Ávila-Álvarez A, Alonso-Bidegain M, De-Rosende-Celeiro I, Vizcaíno-Cela M, Larrañeta-Alcalde L, Torres-Tobío G | title = Improving social participation of children with autism spectrum disorder: Pilot testing of an early animal-assisted intervention in Spain | journal = Health & Social Care in the Community | volume = 28 | issue = 4 | pages = 1220–1229 | date = July 2020 | pmid = 32022346 | doi = 10.1111/hsc.12955 | s2cid = 211035217 | hdl = 2183/28097 | doi-access = free | hdl-access = free }}</ref> (via bridging the '[[Philosophy:Double empathy problem|double empathy]] gap') and also for stress reduction.<ref name="pmid31835401">{{cite journal | vauthors = Wijker C, Leontjevas R, Spek A, Enders-Slegers MJ | title = Process Evaluation of Animal-Assisted Therapy: Feasibility and Relevance of a Dog-Assisted Therapy Program in Adults with Autism Spectrum Disorder | journal = Animals | volume = 9 | issue = 12 | date = December 2019 | page = 1103 | pmid = 31835401 | pmc = 6940976 | doi = 10.3390/ani9121103 | doi-access = free }}</ref><ref name="Wijker_2021"/> As in a 2020 program: "the remarkable adherence to the therapy program by study participants and the program's clinically relevant effects indicate that AAT with dogs can be used to reduce perceived stress and symptoms of agoraphobia, and to improve social awareness and communication in adults with ASD with normal to high intelligence."<ref>{{cite journal | vauthors = Wijker C, Leontjevas R, Spek A, Enders-Slegers MJ | title = Effects of Dog Assisted Therapy for Adults with Autism Spectrum Disorder: An Exploratory Randomized Controlled Trial | journal = Journal of Autism and Developmental Disorders | volume = 50 | issue = 6 | pages = 2153–2163 | date = June 2020 | pmid = 30900194 | pmc = 7261269 | doi = 10.1007/s10803-019-03971-9 }}</ref> In 2021, a study was conducted on this topic, specifically on "autonomic and endocrine activity in adults with autism spectrum disorder"<ref name="Wijker_2021" /> in part for stress reduction, particularly as for autistic people the "downside of social camouflaging is that it is a major source of stress".<ref name="Wijker_2021"/>

=== Neurofeedback ===
[[Philosophy:Neurofeedback|Neurofeedback]] attempts to train individuals to regulate their brainwave patterns by letting them observe their brain activity more directly. In its most traditional form, the output of EEG electrodes is fed into a computer that controls a game-like audiovisual display. Neurofeedback has been evaluated 'with positive results for ASD', but studies have lacked random assignment to controls.<ref>{{cite journal | vauthors = Coben R, Linden M, Myers TE | title = Neurofeedback for autistic spectrum disorder: a review of the literature | journal = Applied Psychophysiology and Biofeedback | volume = 35 | issue = 1 | pages = 83–105 | date = March 2010 | pmid = 19856096 | doi = 10.1007/s10484-009-9117-y | s2cid = 8425504 }}</ref> This research is ongoing as of 2019 though now focused on "improving attention" and "reducing anxiety".<ref>{{Cite journal| vauthors = Mercado J, Espinosa-Curiel I, Escobedo L, Tentori M |date=2019-05-01|title=Developing and evaluating a BCI video game for neurofeedback training: the case of autism |journal=Multimedia Tools and Applications|language=en|volume=78|issue=10|pages=13675–13712|doi=10.1007/s11042-018-6916-2|s2cid=54074403|issn=1573-7721}}</ref>

=== Patterning ===
Patterning is a set of exercises that attempts to improve the organization of a child's neurologic impairments. It has been used for decades to treat children with several unrelated neurologic disorders, including autism. The method, taught at The Institutes for the Achievement of Human Potential, is based on oversimplified theories and is not supported by carefully designed research studies.<ref>{{cite journal | vauthors = Ziring PR, brazdziunas D, Cooley WC, Kastner TA, Kummer ME, González de Pijem L, Quint RD, Ruppert ES, Sandler AD | display-authors = 6 | title = American Academy of Pediatrics. Committee on Children with Disabilities. The treatment of neurologically impaired children using patterning | journal = Pediatrics | volume = 104 | issue = 5 Pt 1 | pages = 1149–51 | date = November 1999 | pmid = 10545565 | doi = 10.1542/peds.104.5.1149 | s2cid = 17770231 | doi-access = free }}</ref>

=== Other methods ===
There are many simple methods such as priming, prompt delivery, picture schedules, peer tutoring, and cooperative learning, that have been proven to help autistic students to prepare for class and to understand the material better. Priming is done by allowing the students to see the assignment or material before they are shown in class. Prompt delivery consists of giving prompts to the autistic children in order to elicit a response to the academic material. Picture schedules are used to outline the progression of a class and are visual cues to allow autistic children to know when changes in the activity are coming up. This method has proven to be very useful in helping the students follow the activities. Peer tutoring and cooperative learning are ways in which an autistic student and a nondisabled student are paired together in the learning process. This has shown be very effective for "increasing both academic success and social interaction."<ref>{{cite journal | vauthors = Harrower JK, Dunlap G | title = Including children with autism in general education classrooms. A review of effective strategies | journal = Behavior Modification | volume = 25 | issue = 5 | pages = 762–84 | date = October 2001 | pmid = 11573339 | doi = 10.1177/0145445501255006 | s2cid = 23887538 }}</ref> There are more specific strategies that have been shown to improve an autistic's education, such as LEAP, Treatment and Education of Autistic and Related Communication Handicapped Children, and Non-Model-Specific Special Education Programs for preschoolers. LEAP is "an intensive 12-month program that focuses on providing a highly structured and safe environment that helps students to participate in and derive benefit from educational programming" and focuses on children from 5-21 who have a more severe case of autism.<ref name="LEAP Program 2012">"LEAP Program (Lifeskills and Education for Students with Autism and Other Pervasive Behavioral Challenges)." Kennedy Krieger Institute: Unlocking Potential. 2012. Accessed November 1, 2015.</ref> The goal of the program is to develop functional independence through academic instruction, vocational/translational curriculum, speech/language services, and other services personalized for each student.<ref name="LEAP Program 2012" /> While LEAP, TEACCH, and Non-Model Specific Special Education Programs are all different strategies, there has been no evidence that one is more effective than the other.<ref>{{cite journal | vauthors = Boyd BA, Hume K, McBee MT, Alessandri M, Gutierrez A, Johnson L, Sperry L, Odom SL | display-authors = 6 | title = Comparative efficacy of LEAP, TEACCH and non-model-specific special education programs for preschoolers with autism spectrum disorders | journal = Journal of Autism and Developmental Disorders | volume = 44 | issue = 2 | pages = 366–80 | date = February 2014 | pmid = 23812661 | doi = 10.1007/s10803-013-1877-9 | s2cid = 26813806 }}</ref>

== Environmental enrichment ==

Environmental enrichment is concerned with how the [[Biology:Brain|brain]] is affected by the stimulation of its [[Philosophy:Information processing (psychology)|information processing]] provided by its surroundings (including the opportunity to interact socially). Brains in richer, more-stimulating environments, have increased numbers of [[Biology:Synaptogenesis|synapses]], and the dendrite arbors upon which they reside are more complex. This effect happens particularly during neurodevelopment, but also to a lesser degree in adulthood. With extra synapses there is also increased synapse activity and so increased size and number of glial energy-support cells. [[Biology:Capillary|Capillary]] vasculation also is greater to provide the neurons and glial cells with extra energy. The [[Biology:Neuropil|neuropil]] (neurons, glial cells, capillaries, combined) expands making the cortex thicker. There may also exist (at least in rodents) more [[Biology:Neurogenesis|neurons]].

Research on nonhuman animals finds that more-stimulating environments could aid the treatment and recovery of a diverse variety of brain-related dysfunctions, including [[Medicine:Alzheimer's disease|Alzheimer's disease]] and those connected to aging, whereas a lack of stimulation might impair cognitive development.

Research on humans suggests that lack of stimulation (deprivation—such as in old-style orphanages) delays and impairs cognitive development. Research also finds that higher levels of education (which is both cognitively stimulating in itself, and associates with people engaging in more challenging cognitive activities) results in greater resilience ([[Biology:Cognitive reserve|cognitive reserve]]) to the effects of aging and dementia.

=== Massage therapy ===

A review of massage therapy as a symptomatic treatment of autism found limited evidence of benefit. There were few high quality studies, and due to the risk of bias found in the studies analyzed, no firm conclusions about the efficacy of massage therapy could be drawn.<ref>{{cite journal | vauthors = Lee MS, Kim JI, Ernst E | title = Massage therapy for children with autism spectrum disorders: a systematic review | journal = The Journal of Clinical Psychiatry | volume = 72 | issue = 3 | pages = 406–11 | date = March 2011 | pmid = 21208598 | doi = 10.4088/JCP.09r05848whi }}</ref>

=== Music ===

[[Medicine:Music therapy|Music therapy]] uses the elements of music to let people express their feelings and communicate. A 2014 review (updated in 2022) found that music therapy may help in social interactions and communication.<ref>{{cite journal | vauthors = Geretsegger M, Fusar-Poli L, Elefant C, Mössler KA, Vitale G, Gold C | title = Music therapy for autistic people | journal = The Cochrane Database of Systematic Reviews | volume = 5 | issue = 5 | pages = CD004381 | date = May 2022 | pmid = 35532041 | pmc = 9082683 | doi = 10.1002/14651858.CD004381.pub4 }}</ref>

Music therapy can involve various techniques depending on where the subject is sitting on the ASD scale.<ref>{{cite web | author = NurseJournal Staff | url = https://nursejournal.org/articles/the-benefits-of-music-therapy-for-autistic-children/ | title = The Benefits of Music Therapy for Autistic Children| date = June 2021 | work = NurseJournal.org }}</ref> Somebody who may be considered as 'low-functioning' would require vastly different treatment to somebody on the ASD scale who is 'high-functioning'. Examples of these types of therapeutic techniques include:<ref name="James_2015">{{cite journal| vauthors = James R, Sigafoos J, Green VA, Lancioni GE, O'Reilly MF, Lang R, Davis T, Carnett A, Achmadi D, Gevarter C, Marschik PB | display-authors = 6 |date=2015|title=Music therapy for individuals with autism spectrum disorder: A systematic review.|journal=Review Journal of Autism and Developmental Disorders|volume=2|issue=1|doi=10.1007/s40489-014-0035-4|pages=39–54| s2cid = 145714890 |doi-access=free}}</ref>
* Free improvisation – No boundaries or skills required
* Structured improvisation – Some established parameters within the music
* Performing or recreating music – Reproducing a pre-composed piece of music or song with associated activities
* Composing music – Creating music that caters to the specific needs of that person using instruments or the voice
* Listening – Engaging in specific musical listening base exercises
Improvisational Music Therapy (IMT), is increasing in popularity as a therapeutic technique being applied to children with ASD. The process of IMT occurs when the client and therapist make up music, through the use of various instruments, song and movement. The specific needs of each child or client need to be taken into consideration. Some children with ASD find their different environments chaotic and confusing, therefore, IMT sessions require the presence of a certain routine and be predictable in nature, within their interactions and surroundings.<ref name="Geretsegger_2015">{{cite journal | vauthors = Geretsegger M, Holck U, Carpente JA, Elefant C, Kim J, Gold C | title = Common Characteristics of Improvisational Approaches in Music Therapy for Children with Autism Spectrum Disorder: Developing Treatment Guidelines | journal = Journal of Music Therapy | volume = 52 | issue = 2 | pages = 258–81 | year = 2015 | pmid = 26019303 | doi = 10.1093/jmt/thv005 }}</ref> Music can provide all of this, it can be very predictable, it is highly repetitious with its melodies and sounds, but easily varied with phrasing, rhythm and dynamics giving it a controlled flexibility. The allowance of parents or caregivers to sessions can put the child at ease and allow for activities to be incorporated into everyday life.<ref name="Geretsegger_2015" />

=== Sensory enrichment therapy ===

In all interventions for autistic children, the main strategy is to aim towards the improvement on sensitivity in all senses. Autistic children may lack the ability to name or even feel their own emotions. This can also impact relating to other people's emotions and inferring the moods of others. <ref>{{Cite web|url=http://www.researchautism.net/autism-interventions/types/motor-sensory-interventions/combined-multi-component,%20motor-sensory-interventions|title = Strategies and interventions | work = The National Autistic Society | location = United Kingdom }}</ref> Many autistic children also live with a Sensory Processing Disorder.<ref name="Pfeiffer BA, Koenig K, Kinnealey M, Sheppard M, Henderson L 2011 76–85">{{cite journal | vauthors = Pfeiffer BA, Koenig K, Kinnealey M, Sheppard M, Henderson L | title = Effectiveness of sensory integration interventions in children with autism spectrum disorders: a pilot study | journal = The American Journal of Occupational Therapy | volume = 65 | issue = 1 | pages = 76–85 | year = 2011 | pmid = 21309374 | pmc = 3708964 | doi = 10.5014/ajot.2011.09205 }}</ref> In sensory-based interventions, there have been signs of progress in children responding with an appropriate response when given a stimulus after being in sensory-based therapies for a period of time. However, at this time, there is no concrete evidence that these therapies are effective for autistic children.<ref name="Pfeiffer BA, Koenig K, Kinnealey M, Sheppard M, Henderson L 2011 76–85" /> Autism spectrum disorder varies from child to child, which can make it challenging for clinicians to assess and know what therapies to apply. 

The purpose of these differentiated interventions are to intervene at the neurological level of the brain in hopes to develop appropriate responses to the different sensations from one's body and also to outside stimuli in one's environment. Scientist have used music therapies, massage therapies, occupational therapies and more. With the Autistic Spectrum being so diverse and widespread, each case or scenario is different.<ref name="ReferenceA" />

=== Mindfulness ===
Emerging evidence for [[Philosophy:Mindfulness|mindfulness]]-based interventions for improving mental health in adults with autism has support through a recent systematic review. This includes evidence for decreasing stress, anxiety, ruminating thoughts, anger, and aggression.<ref>{{cite journal|display-authors=6|vauthors=Benevides TW, Shore SM, Andresen ML, Caplan R, Cook B, Gassner DL, Erves JM, Hazlewood TM, King MC, Morgan L, Murphy LE, Purkis Y, Rankowski B, Rutledge SM, Welch SP, Wittig K|date=August 2020|title=Interventions to address health outcomes among autistic adults: A systematic review|journal=Autism|volume=24|issue=6|pages=1345–1359|doi=10.1177/1362361320913664|pmc=7787674|pmid=32390461|doi-access=free}}</ref>

== Parent-mediated interventions ==

Parent-mediated interventions offer support and practical advice to parents of autistic children.<ref name="SIGN">{{cite book |publisher=Scottish Intercollegiate Guidelines Network (SIGN) |date=July 2007 |title=Assessment, diagnosis and clinical interventions for children and young people with autism spectrum disorders |version=SIGN publication no. 98 |url=http://sign.ac.uk/pdf/sign98.pdf |access-date=2008-04-02 |archive-url= https://web.archive.org/web/20080407005442/http://www.sign.ac.uk/pdf/sign98.pdf| archive-date=7 April 2008 |url-status=dead |isbn=978-1-905813-08-7}}</ref> A 2013 [[Cochrane Library|Cochrane Review]] found that there was no evidence of gains in most of the primary measures of the studies (e.g., the child's adaptive behaviour), however there was strong evidence for a positive pattern of change in parent-child interactions. There was some uncertain evidence of changes in the child's language and communication.<ref>{{cite journal | vauthors = Oono IP, Honey EJ, McConachie H | title = Parent-mediated early intervention for young children with autism spectrum disorders (ASD) | journal = The Cochrane Database of Systematic Reviews | issue = 4 | pages = CD009774 | date = April 2013 | pmid = 23633377 | doi = 10.1002/14651858.cd009774.pub2 | publisher = Wiley }}</ref> A very small number of randomized and controlled studies suggest that parent training can lead to reduced maternal depression, improved maternal knowledge of autism and communication style, and improved child communicative behavior, but due to the design and number of studies available, definitive evidence of effectiveness is not available.<ref>{{cite journal | vauthors = McConachie H, Diggle T | title = Parent implemented early intervention for young children with autism spectrum disorder: a systematic review | journal = Journal of Evaluation in Clinical Practice | volume = 13 | issue = 1 | pages = 120–129 | date = February 2007 | pmid = 17286734 | doi = 10.1111/j.1365-2753.2006.00674.x | s2cid = 913255 | doi-access = free }}</ref>

Early detection of ASD in children can often occur before a child reaches the age of three years old. Methods that target early behavior can influence the quality of life for a child with ASD. Parents can learn methods of interaction and behavior management to best assist their child's development. A 2013 Cochrance review concluded that there were some improvements when parent intervention was used.<ref>{{cite journal | vauthors = Oono IP, Honey EJ, McConachie H | title = Parent-mediated early intervention for young children with autism spectrum disorders (ASD) | journal = The Cochrane Database of Systematic Reviews | volume = 4 | issue = 4 | pages = CD009774 | date = April 2013 | pmid = 23633377 | doi = 10.1002/14651858.CD009774.pub2 }}</ref>

== Medical management ==

Drugs, supplements, or diets are often used to alter physiology in an attempt to relieve common autistic symptoms such as seizures, sleep disturbances, irritability, and hyperactivity that can interfere with education or social adaptation or (more rarely) cause autistic individuals to harm themselves or others.<ref name=Levy /> There is plenty of anecdotal evidence to support medical treatment; many parents who try one or more therapies report some progress, and there are a few well-publicized reports of children who are able to return to mainstream education after treatment, with dramatic improvements in health and well-being. However, this evidence may be confounded by improvements seen in autistic children who grow up without treatment, by the difficulty of verifying reports of improvements, and by the lack of reporting of treatments' negative outcomes.<ref>{{cite book | vauthors = Schreibman L |title=The Science and Fiction of Autism |date=2005 |publisher=Harvard University Press |isbn=0-674-01931-8 |chapter=Critical evaluation of issues in autism|url-access=registration |url=https://archive.org/details/sciencefictiono00laur }}</ref> Only a very few medical treatments are well supported by scientific evidence using controlled experiments.<ref name=Levy />

=== Medication ===
Many medications are used to treat problems associated with ASD.<ref name=Leskovec>{{cite journal | vauthors = Leskovec TJ, Rowles BM, Findling RL | title = Pharmacological treatment options for autism spectrum disorders in children and adolescents | journal = Harvard Review of Psychiatry | volume = 16 | issue = 2 | pages = 97–112 | date = 2008 | pmid = 18415882 | doi = 10.1080/10673220802075852 | s2cid = 26112061 }}</ref> More than half of U.S. children diagnosed with ASD are prescribed psychoactive drugs or [[Chemistry:Anticonvulsant|anticonvulsant]]s, with the most common drug classes being [[Chemistry:Antidepressant|antidepressant]]s, [[Chemistry:Stimulant|stimulant]]s, and [[Chemistry:Antipsychotic|antipsychotic]]s.<ref name=medication-use>Medications for U.S. children with ASD:
* {{cite journal | vauthors = Oswald DP, Sonenklar NA | title = Medication use among children with autism spectrum disorders | journal = Journal of Child and Adolescent Psychopharmacology | volume = 17 | issue = 3 | pages = 348–55 | date = June 2007 | pmid = 17630868 | doi = 10.1089/cap.2006.17303 }}
* {{cite journal | vauthors = Mandell DS, Morales KH, Marcus SC, Stahmer AC, Doshi J, Polsky DE | title = Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders | journal = Pediatrics | volume = 121 | issue = 3 | pages = e441-8 | date = March 2008 | pmid = 18310165 | pmc = 2861431 | doi = 10.1542/peds.2007-0984 }}</ref> Only the antipsychotics have clearly demonstrated efficacy.<ref name=Posey />

Between the 1950s and 1970s [[Chemistry:LSD|LSD]] was studied, however, has not been studied in this capacity since.<ref>{{cite journal|vauthors=Sigafoos J, Green VA, Edrisinha C, Lancioni GE|date=2006|title=Flashback to the 1960s: LSD in the treatment of autism|journal=Developmental Neurorehabilitation|volume=10|issue=1|pages=75–81|doi=10.1080/13638490601106277|pmid=17608329|s2cid=23563951}}</ref>

Research has focused on atypical antipsychotics, especially [[Chemistry:Risperidone|risperidone]], which has the largest amount of evidence that consistently shows improvements in irritability, self-injury, aggression, and tantrums associated with ASD.<ref>{{cite journal | vauthors = Chavez B, Chavez-Brown M, Sopko MA, Rey JA | title = Atypical antipsychotics in children with pervasive developmental disorders | journal = Paediatric Drugs | volume = 9 | issue = 4 | pages = 249–66 | year = 2007 | pmid = 17705564 | doi = 10.2165/00148581-200709040-00006 | s2cid = 6690106 }}</ref> Risperidone is approved by the [[Organization:Food and Drug Administration|Food and Drug Administration]] (FDA) for treating symptomatic irritability in autistic children and adolescents.<ref name=Posey /> In short-term trials (up to six months) most adverse events were mild to moderate, with weight gain, drowsiness, and high blood sugar requiring monitoring; long term efficacy and safety have not been fully determined.<ref name=Scott>{{cite journal | vauthors = Scott LJ, Dhillon S | title = Risperidone: a review of its use in the treatment of irritability associated with autistic disorder in children and adolescents | journal = Paediatric Drugs | volume = 9 | issue = 5 | pages = 343–54 | year = 2007 | pmid = 17927305 | doi = 10.2165/00148581-200709050-00006 | doi-access = free }}</ref> It is unclear whether risperidone improves autism's core social and communication deficits.<ref name=Posey>{{cite journal | vauthors = Posey DJ, Stigler KA, Erickson CA, McDougle CJ | title = Antipsychotics in the treatment of autism | journal = The Journal of Clinical Investigation | volume = 118 | issue = 1 | pages = 6–14 | date = January 2008 | pmid = 18172517 | pmc = 2171144 | doi = 10.1172/JCI32483 }}</ref> The FDA's decision was based in part on a study of autistic children with severe and enduring problems of tantrums, aggression, and self-injury; risperidone is not recommended for autistic children with mild aggression and explosive behavior without an enduring pattern.<ref>{{cite journal | vauthors = Scahill L | title = How do I decide whether or not to use medication for my child with autism? Should I try behavior therapy first? | journal = Journal of Autism and Developmental Disorders | volume = 38 | issue = 6 | pages = 1197–8 | date = July 2008 | pmid = 18463973 | doi = 10.1007/s10803-008-0573-7 | s2cid = 20767044 }}</ref>

Other drugs are prescribed off-label in the U.S., which means they have not been approved for treating ASD. Large [[Medicine:Placebo|placebo]]-controlled studies of [[Chemistry:Olanzapine|olanzapine]] and [[Chemistry:Aripiprazole|aripiprazole]] were underway in early 2008.<ref name=Posey /> Aripiprazole may be effective for treating autism in the short term, but is also associated with side effects, such as weight gain and sedation.<ref>{{cite journal | vauthors = Hirsch LE, Pringsheim T | title = Aripiprazole for autism spectrum disorders (ASD) | journal = The Cochrane Database of Systematic Reviews | issue = 6 | pages = CD009043 | date = June 2016 | volume = 2016 | pmid = 27344135 | doi = 10.1002/14651858.CD009043.pub3 | pmc = 7120220 }}</ref>

Some [[Chemistry:Selective serotonin reuptake inhibitor|selective serotonin reuptake inhibitor]]s (SSRIs) and [[Biology:Dopamine|dopamine]] blockers can reduce some maladaptive behaviors associated with ASD.<ref name=pharmacotherapy>{{cite journal | vauthors = Myers SM | title = The status of pharmacotherapy for autism spectrum disorders | journal = Expert Opinion on Pharmacotherapy | volume = 8 | issue = 11 | pages = 1579–603 | date = August 2007 | pmid = 17685878 | doi = 10.1517/14656566.8.11.1579 | s2cid = 24674542 }}</ref> Although SSRIs reduce levels of repetitive behavior in autistic adults,<ref>{{cite journal | vauthors = Volkmar FR | title = Citalopram treatment in children with autism spectrum disorders and high levels of repetitive behavior | journal = Archives of General Psychiatry | volume = 66 | issue = 6 | pages = 581–2 | date = June 2009 | pmid = 19487622 | doi = 10.1001/archgenpsychiatry.2009.42 }}</ref> a 2009 multisite randomized controlled study found no benefit and some adverse effects in children from the SSRI [[Chemistry:Citalopram|citalopram]], raising doubts whether SSRIs are effective for treating repetitive behavior in autistic children.<ref>{{cite journal |vauthors=King BH, Hollander E, Sikich L, McCracken JT, Scahill L, Bregman JD, Donnelly CL, Anagnostou E, Dukes K, Sullivan L, Hirtz D, Wagner A, Ritz L |display-authors=6 |title=Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism |journal=Archives of General Psychiatry |volume=66 |issue=6 |pages=583–590 |date=June 2009 |pmid=19487623 |pmc=4112556 |doi=10.1001/archgenpsychiatry.2009.30 |doi-access=free}}<br/>{{cite web | vauthors = Kaplan K |title=Study finds antidepressant doesn't help autistic children |url=https://www.latimes.com/news/science/la-sci-autism-drugs2-2009jun02,0,6717060.story |date=2009-06-02 |website=Los Angeles Times}}</ref> A further study of related medical reviews determined that the prescription of SSRI antidepressants for treating ASDs in children lacked any evidence, and could not be recommended.<ref>{{cite journal | vauthors = Williams K, Brignell A, Randall M, Silove N, Hazell P | title = Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD) | journal = The Cochrane Database of Systematic Reviews | volume = 8 | issue = 8 | pages = CD004677 | date = August 2013 | pmid = 23959778 | doi = 10.1002/14651858.CD004677.pub3 }}</ref>

Reviews of evidence found that the psychostimulant [[Chemistry:Methylphenidate|methylphenidate]] may be efficacious against hyperactivity and possibly impulsivity associated with ASD, although the findings were limited by low quality evidence.<ref name=Sturman2017>{{cite journal |vauthors=Sturman N, Deckx L, van Driel ML |title=Methylphenidate for children and adolescents with autism spectrum disorder |journal=The Cochrane Database of Systematic Reviews |volume=2017 |pages=CD011144 |date=November 2017 |issue=11 |pmid=29159857 |pmc=6486133 |doi=10.1002/14651858.CD011144.pub2 |collaboration=Cochrane Developmental, Psychosocial and Learning Problems Group}}</ref> There was no evidence that methylphenidate "has a negative impact on the core symptoms of ASD, or that it improves social interaction, stereotypical behaviours, or overall ASD."<ref name=Sturman2017/> Of the many medications studied for treatment of aggressive and self-injurious behavior in children and adolescents with autism, only risperidone and methylphenidate demonstrate results that have been replicated.<ref>{{cite journal |vauthors=Parikh MS, Kolevzon A, Hollander E |title=Psychopharmacology of aggression in children and adolescents with autism: a critical review of efficacy and tolerability |journal=Journal of Child and Adolescent Psychopharmacology |volume=18 |issue=2 |pages=157–178 |date=April 2008 |pmid=18439113 |doi=10.1089/cap.2007.0041}}</ref>

A 1998 study of the hormone [[Biology:Secretin|secretin]] reported improved symptoms and generated tremendous interest, but several controlled studies since have found no benefit.<ref name=Francis>{{cite journal | vauthors = Francis K | title = Autism interventions: a critical update | journal = Developmental Medicine and Child Neurology | volume = 47 | issue = 7 | pages = 493–9 | date = July 2005 | pmid = 15991872 | doi = 10.1017/S0012162205000952 }}</ref> An experimental drug STX107 has stopped overproduction of metabotropic glutamate receptor 5 in rodents, and it has been hypothesized that this may help in about 5% of autism cases, but this hypothesis has not been tested in humans.<ref name=Opar />

[[Chemistry:Oxytocin|Oxytocin]] may play a role in autism and may be a possible treatment for repetitive and affiliative behaviors;<ref>{{cite book |year=2008 |volume=170 |issue=451–62 |chapter=Oxytocin and experimental therapeutics in autism spectrum disorders | vauthors = Bartz JA, Hollander E |title=Advances in Vasopressin and Oxytocin — from Genes to Behaviour to Disease |pmid=18655901 |doi=10.1016/S0079-6123(08)00435-4 |pages=451–62 |series=Progress in Brain Research |isbn=978-0-444-53201-5 }}</ref> Two related studies in adults found that oxytocin decreased repetitive behaviors and improved interpretation of emotions, but these preliminary results do not necessarily apply to children.<ref name=Opar>{{cite journal | vauthors = Opar A | title = Search for potential autism treatments turns to 'trust hormone' | journal = Nature Medicine | volume = 14 | issue = 4 | pages = 353 | date = April 2008 | pmid = 18391923 | doi = 10.1038/nm0408-353 | s2cid = 200768 | doi-access = free }}</ref> Recent research suggests that oxytocin may decrease the noisiness of the brain's auditory system, increasing perception of social cues and the ability to react in social situations. However, the cues detected may not always be positive: increasing awareness of a trusted adult may be beneficial, but increasing awareness of an aggressor may increase distress. The possibility that oxytocin's effects are context-dependent means that its use as a treatment in ASD should be carefully monitored.<ref name="Holmes">{{cite journal | vauthors = Holmes B |title=Oxytocin's effects aren't just about love |journal=Knowable Magazine |date=11 February 2022 |doi=10.1146/knowable-021122-1 |url= https://knowablemagazine.org/article/mind/2022/oxytocins-effects-arent-just-about-love |doi-access=free |access-date=15 February 2022}}</ref><ref name="Froemke">{{cite journal | vauthors = Froemke RC, Young LJ | title = Oxytocin, Neural Plasticity, and Social Behavior | journal = Annual Review of Neuroscience | volume = 44 | issue = 1 | pages = 359–381 | date = July 2021 | pmid = 33823654 | pmc = 8604207 | doi = 10.1146/annurev-neuro-102320-102847 }}</ref> According to a 2022 systematic review/network meta-analysis, evidence from large trials didn't show efficacy in children/adolescent for oxytocin and [[Chemistry:Balovaptan|balovaptan]] (both vasopressin-V<sub>1A</sub> receptor antagonist), however in adults oxytocin improved repetitive behaviors with small-to-medium effect-sizes and moderate-quality evidence (this result needs to be replicated since participants were mainly high-functioning autistic and age-dependent treatment response isn't excluded). Moreover, according to the same systematic review/network meta-analysis, based on two large studies balovaptan wasn't found efficiacious in adults, but small improvements in quality of life were noted.<ref name="pmid35246237">{{cite journal | vauthors = Siafis S, Çıray O, Wu H, Schneider-Thoma J, Bighelli I, Krause M, Rodolico A, Ceraso A, Deste G, Huhn M, Fraguas D, San José Cáceres A, Mavridis D, Charman T, Murphy DG, Parellada M, Arango C, Leucht S | display-authors = 6 | title = Pharmacological and dietary-supplement treatments for autism spectrum disorder: a systematic review and network meta-analysis | journal = Molecular Autism | volume = 13 | issue = 1 | pages = 10 | date = March 2022 | pmid = 35246237 | pmc = 8896153 | doi = 10.1186/s13229-022-00488-4 | doi-access = free }}</ref>

Aside from antipsychotics,<ref name=Posey/> there is scant reliable research about the effectiveness or safety of drug treatments for adolescents and adults with ASD.<ref name=Angley1>{{cite journal |vauthors= Angley M, Young R, Ellis D, Chan W, McKinnon R |title=Children and autism--Part 1--recognition and pharmacological management |journal=Australian Family Physician |volume=36 |issue=9 |pages=741–244 |date=September 2007 |pmid=17915375 |url=http://www.racgp.org.au/Content/NavigationMenu/Publications/AustralianFamilyPhys/2007issues/afp200709/200709angley.pdf |url-status=dead |archive-date=2007-10-25 |archive-url=https://web.archive.org/web/20071025195309/http://www.racgp.org.au/Content/NavigationMenu/Publications/AustralianFamilyPhys/2007issues/afp200709/200709angley.pdf}}</ref> Results of the handful of [[Randomized controlled trial|randomized controlled trial]]s that have been performed suggest that risperidone, the SSRI [[Chemistry:Fluvoxamine|fluvoxamine]], and the typical antipsychotic [[Chemistry:Haloperidol|haloperidol]] may be effective in reducing some behaviors, that haloperidol may be more effective than the tricyclic antidepressant [[Chemistry:Clomipramine|clomipramine]], and that the opioid antagonist naltrexone hydrochloride is not effective.<ref name=Broadstock>{{cite journal |vauthors=Broadstock M, Doughty C, Eggleston M |title=Systematic review of the effectiveness of pharmacological treatments for adolescents and adults with autism spectrum disorder |journal=Autism |volume=11 |issue=4 |pages=335–48 |date=July 2007 |pmid=17656398 |doi=10.1177/1362361307078132 |s2cid=42629626}}</ref> In small studies, [[Chemistry:Memantine|memantine]] has been shown to significantly improve language function and social behavior in children with autism.<ref>{{cite journal |vauthors=Chez MG, Burton Q, Dowling T, Chang M, Khanna P, Kramer C |title=Memantine as adjunctive therapy in children diagnosed with autistic spectrum disorders: an observation of initial clinical response and maintenance tolerability |journal=Journal of Child Neurology |volume=22 |issue=5 |pages=574–579 |date=May 2007 |pmid=17690064 |doi=10.1177/0883073807302611 |s2cid=41428656}}</ref><ref>{{cite journal |vauthors=Erickson CA, Posey DJ, Stigler KA, Mullett J, Katschke AR, McDougle CJ |title=A retrospective study of memantine in children and adolescents with pervasive developmental disorders |journal=Psychopharmacology |volume=191 |issue=1 |pages=141–147 |date=March 2007 |pmid=17016714 |doi=10.1007/s00213-006-0518-9 |s2cid=13128356}}</ref> Research is underway on the effects of memantine in adults with ASDs.<ref>{{cite web|title=A Study of Memantine Hydrochloride (Namenda®) for Cognitive and Behavioral Impairment in Adults With Autism Spectrum Disorders|date=26 February 2016|url=http://clinicaltrials.gov/ct2/show/NCT01333865 |vauthors=Joshi G}}</ref> A person with ASD may respond atypically to medications and the medications can have adverse side effects.<ref name=Buitelaar>{{cite book |date=2003 |volume=251 |pages=235–44; discussion 245–9, 281–97 |chapter=Why have drug treatments been so disappointing? |vauthors=Buitelaar JK |title=Autism: Neural Basis and Treatment Possibilities |doi=10.1002/0470869380.ch14 |pmid=14521196 |series=Novartis Foundation Symposia |isbn=978-0-470-85099-2}}</ref><ref>{{cite web |vauthors=Strock M |year=2007 |title=Autism spectrum disorders (pervasive developmental disorders) |publisher=National Institute of Mental Health |url= http://nimh.nih.gov/health/publications/autism/complete-publication.shtml |access-date=2007-10-05 |archive-url=https://web.archive.org/web/20071004203140/http://www.nimh.nih.gov/health/publications/autism/complete-publication.shtml |archive-date=2007-10-04}}</ref>

=== Prosthetics ===
Unlike conventional neuromotor prostheses, neurocognitive prostheses would sense or modulate neural function in order to physically reconstitute cognitive processes such as executive function and language. No neurocognitive prostheses are currently available but the development of implantable neurocognitive brain-computer interfaces has been proposed to help treat conditions such as autism.<ref>{{cite journal | vauthors = Serruya MD, Kahana MJ | title = Techniques and devices to restore cognition | journal = Behavioural Brain Research | volume = 192 | issue = 2 | pages = 149–65 | date = October 2008 | pmid = 18539345 | pmc = 3051349 | doi = 10.1016/j.bbr.2008.04.007 }}</ref>

Affective computing devices, typically with image or voice recognition capabilities, have been proposed to help autistic individuals improve their social communication skills.<ref>{{cite journal |journal=Journal of Computer Assisted Learning|date=2003 |title=The Internet for educating individuals with social impairments |volume=19 |issue=4 | vauthors = Bishop J |doi=10.1046/j.0266-4909.2003.00057.x |pages=546–56 }}</ref> These devices are still under development. Robots have also been proposed as educational aids for autistic children.<ref>{{cite journal | vauthors = el Kaliouby R, Picard R, Baron-Cohen S | title = Affective computing and autism | journal = Annals of the New York Academy of Sciences | volume = 1093 | issue = 1 | pages = 228–48 | date = December 2006 | pmid = 17312261 | doi = 10.1196/annals.1382.016 | bibcode = 2006NYASA1093..228K | s2cid = 405379 }}</ref>

=== Transcranial magnetic stimulation ===
[[Physics:Transcranial magnetic stimulation|Transcranial magnetic stimulation]], which is a somewhat well established treatment for depression, has been proposed, and used, as a treatment for autism.<ref>{{cite web | url=http://theness.com/neurologicablog/index.php/transcranial-magnetic-stimulation-for-autism/ | title=Transcranial Magnetic Stimulation for Autism | work=Neurologica Blog | date=1 July 2013 | access-date=15 December 2013 | vauthors = Novella S }}</ref> A review published in 2013 found insufficient evidence to support its widespread use for ASDs.<ref>{{cite journal | vauthors = Oberman LM, Rotenberg A, Pascual-Leone A | title = Use of transcranial magnetic stimulation in autism spectrum disorders | journal = Journal of Autism and Developmental Disorders | volume = 45 | issue = 2 | pages = 524–36 | date = February 2015 | pmid = 24127165 | pmc = 4519010 | doi = 10.1007/s10803-013-1960-2 }}</ref> A 2015 review found tentative but insufficient evidence to justify its use outside of clinical studies.<ref>{{cite journal | vauthors = Oberman LM, Enticott PG, Casanova MF, Rotenberg A, Pascual-Leone A, McCracken JT | title = Transcranial magnetic stimulation in autism spectrum disorder: Challenges, promise, and roadmap for future research | journal = Autism Research | volume = 9 | issue = 2 | pages = 184–203 | date = February 2016 | pmid = 26536383 | pmc = 4956084 | doi = 10.1002/aur.1567 }}</ref> New findings show TMS can positively affect gamma brainwave oscillations and help improve performance accuracy.<ref>{{Cite web|date=August 2020|title=How Gamma Oscillations Can Be Used as a Vital Biometric for Autism Spectrum Disorder (ASD) Diagnosis|url=https://nevadaautism.com/how-gamma-oscillations-can-be-used-as-a-vital-biometric-for-autism-spectrum-disorder-asd-diagnosis/|access-date=2022-11-25}}</ref>

== Alternative medicine ==
Many [[Social:Alternative therapies for developmental and learning disabilities|alternative therapies and interventions]] used to be popular in the 1990s and early 2000s, ranging from [[Medicine:Elimination diet|elimination diet]]s to [[Unsolved:Chelation therapy|chelation therapy]], though few were supported by scientific studies.<ref name="Rao" /><ref name="Levy2008" /><ref name="Angley2">{{cite journal|vauthors=Angley M, Semple S, Hewton C, Paterson F, McKinnon R|date=October 2007|title=Children and autism--Part 2--management with complementary medicines and dietary interventions|url=http://www.racgp.org.au/Content/NavigationMenu/Publications/AustralianFamilyPhys/2007issues/afp200710/200710angley.pdf|url-status=dead|journal=Australian Family Physician |volume=36|issue=10|pages=827–30|pmid=17925903|archive-url=https://web.archive.org/web/20071201164323/http://www.racgp.org.au/Content/NavigationMenu/Publications/AustralianFamilyPhys/2007issues/afp200710/200710angley.pdf|archive-date=2007-12-01}}</ref><ref name="Schechtman">{{cite journal|vauthors=Schechtman MA|date=August 2007|title=Scientifically unsupported therapies in the treatment of young children with autism spectrum disorders |journal=Pediatric Annals|volume=36|issue=8|pages=497–8, 500–2, 504–5|doi=10.3928/0090-4481-20070801-12|pmid=17849608}}</ref><ref>Lack of support for interventions:

* {{cite journal | vauthors = Howlin P | title = The effectiveness of interventions for children with autism | journal = Journal of Neural Transmission. Supplementum | issue = 69 | pages = 101–119 | date = 2005 | pmid = 16355605 | doi = 10.1007/3-211-31222-6_6 | publisher = Springer | isbn = 3-211-26291-1 | veditors = Fleischhacker WW, Brooks DJ | s2cid = 21986640 }}
* {{cite journal|vauthors=Sigman M, Spence SJ, Wang AT|year=2006|title=Autism from developmental and neuropsychological perspectives|journal=Annual Review of Clinical Psychology|volume=2|pages=327–355 |pmid=17716073 |doi=10.1146/annurev.clinpsy.2.022305.095210}}
* {{cite journal|vauthors=Williams White S, Keonig K, Scahill L|date=November 2007|title=Social skills development in children with autism spectrum disorders: a review of the intervention research|journal=Journal of Autism and Developmental Disorders|volume=37|issue=10|pages=1858–68|doi=10.1007/s10803-006-0320-x|pmid=17195104|s2cid=14573426}}</ref> Treatment approaches lacked empirical support in quality-of-life contexts, and many programs focused on success measures that lack predictive validity and real-world relevance.<ref name="Gutstein_2007">{{cite journal|vauthors=Burgess AF, Gutstein SE|date=May 2007|title=Quality of Life for People with Autism: Raising the Standard for Evaluating Successful Outcomes|journal=Child and Adolescent Mental Health|volume=12|issue=2|pages=80–86|doi=10.1111/j.1475-3588.2006.00432.x|pmid=32811109}}</ref> [[Scientific evidence]] appeared to matter less to service providers than program marketing, training availability, and parent requests.<ref>{{cite journal|vauthors=Stahmer AC, Collings NM, Palinkas LA|date=2005|title=Early Intervention Practices for Children With Autism: Descriptions From Community Providers|journal=Focus on Autism and Other Developmental Disabilities|volume=20|issue=2|pages=66–79|doi=10.1177/10883576050200020301|pmc=1350798|pmid=16467905}}</ref> Back then, it was presumed that even if they did not help, conservative treatments such as changes in diet were "expected to be harmless aside from their bother and cost"<ref name="Christison" /> except that didn't take into account the mental health toll that attitude would have on the children in question who are now adults speaking out against such practices.<ref name="neuroclastic.com">{{Cite web|date=2019-06-10|title=I Wanted to "Cure My Autism," Too– One Autistic Woman's Story of Internalized Ableism|url=https://neuroclastic.com/i-wanted-to-cure-my-autism-too-one-autistic-womans-story-of-internalized-ableism/|access-date=2022-01-05|website=NeuroClastic|language=en-US}}</ref>

=== Acupuncture ===
[[Unsolved:Acupuncture|Acupuncture]] was studied and has not been found to be 'helpful in treating autism'.<ref>{{cite journal | vauthors = Lee MS, Choi TY, Shin BC, Ernst E | title = Acupuncture for children with autism spectrum disorders: a systematic review of randomized clinical trials | journal = Journal of Autism and Developmental Disorders | volume = 42 | issue = 8 | pages = 1671–1683 | date = August 2012 | pmid = 22124580 | doi = 10.1007/s10803-011-1409-4 | s2cid = 30628519 }}</ref><ref>{{cite journal | vauthors = Cheuk DK, Wong V, Chen WX | title = Acupuncture for autism spectrum disorders (ASD) | journal = The Cochrane Database of Systematic Reviews | volume = 9 | issue = 9 | pages = CD007849 | date = September 2011 | pmid = 21901712 | doi = 10.1002/14651858.CD007849.pub2 | pmc = 8939294 | veditors = Cheuk DK }}</ref>

=== Hyperbaric oxygen ===
[[File:FatherandSoninChamber.jpg#Summary|thumb|A boy with ASD, and his father, in a hyperbaric oxygen chamber. (Photo submitted in 2005)|link=File:FatherandSoninChamber.jpg]]
In 2007 further studies were needed in order for practitioners and families to make more conclusive and valid decisions concerning HBOT treatments.<ref>{{cite journal | vauthors = Rossignol DA, Rossignol LW, James SJ, Melnyk S, Mumper E | year = 2007 | title = The Effects of Hyperbaric Oxygen Therapy on Oxidative Stress, Inflammation, and Symptoms in Children with Autism: An Open-label Pilot Study | url = | journal = BMC Pediatrics| volume = 7 | issue = 36| pages = 1–13 | doi = 10.1186/1471-2431-7-36 | pmid = 18005455 | pmc = 2244616 | doi-access = free }}</ref> One small 2009 double-blind study of autistic children found that 40 hourly treatments of 24% oxygen at 1.3 atmospheres provided significant improvement in the children's behavior immediately after treatment sessions but this study has not been independently confirmed.<ref>{{cite journal | vauthors = Rossignol DA, Rossignol LW, Smith S, Schneider C, Logerquist S, Usman A, Neubrander J, Madren EM, Hintz G, Grushkin B, Mumper EA | display-authors = 6 | title = Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial | journal = BMC Pediatrics | volume = 9 | pages = 21 | date = March 2009 | pmid = 19284641 | pmc = 2662857 | doi = 10.1186/1471-2431-9-21 | doi-access = free }}<br/>{{cite web |title=Oxygen therapy benefit in autism |url=http://news.bbc.co.uk/1/hi/health/7940149.stm |date=2009-03-14 |website=BBC News}}</ref> This spawned a relatively large-scale controlled studies since to investigate HBOT. For example, in 2010 using treatments of 24% oxygen at 1.3 atmospheres, though it found less promising results. A 2010 double-blind study compared HBOT to a placebo treatment in children with autistic disorder. Both direct observational measures of behavioral symptoms and standardized psychological assessments were used to evaluate the treatment. No differences were found between the HBOT group and the placebo group on any of the outcome measures.<ref>{{cite journal | vauthors = Granpeesheh D, Tarbox J, Dixon DR, Wilke AE, Allen MS, Bradstreet J | year = 2010 | title = Randomized trial of hyperbaric oxygen therapy for children with autism | url = | journal = Research in Autism Spectrum Disorders| volume = 4 | issue = 2| pages = 268–275 | doi = 10.1016/j.rasd.2009.09.014 }}</ref> A second 2011 single-subject design study also investigated the effects of 40 HBOT treatments of 24% oxygen at 1.3 atmospheres on directly observed behaviors using multiple baselines across 16 participants. Again, no consistent outcomes were observed across any group and further, no significant improvements were observed within any individual participant.<ref name="Jepson">{{cite journal | vauthors = Jepson B, Granpeesheh D, Tarbox J, Olive ML, Stott C, Braud S, Yoo JH, Wakefield A, Allen MS | display-authors = 6 | title = Controlled evaluation of the effects of hyperbaric oxygen therapy on the behavior of 16 children with autism spectrum disorders | journal = Journal of Autism and Developmental Disorders | volume = 41 | issue = 5 | pages = 575–88 | date = May 2011 | pmid = 20680427 | doi = 10.1007/s10803-010-1075-y | s2cid = 653316 }}</ref> Together, these studies suggest that HBOT at 24% oxygen at 1.3 atmospheric pressure does not result in a clinically significant improvement of the behavioral symptoms of autistic disorder. Nonetheless, news reports and related blogs indicated that HBOT was used for many cases of children with autism in the 2010s.

When considering the financial and time investments required in order to participate in this treatment and the inconsistency of the present findings, HBOT seems to be a riskier and thus, often less favorable. As of May 2011 HBOT could cost up to $150 per hour with individuals using anywhere from 40 to 120 hours as a part of their integrated treatment programs. In addition, purchasing (at $8,495–27,995) and renting ($1,395 per month) of the HBOT chambers is another option some families use.<ref name="Jepson" />

As of 2017, "Hyperbaric oxygen therapy provides a higher concentration of oxygen delivered in a chamber or tube containing higher than sea level atmospheric pressure. Case series and randomized controlled trials show no evidence to support the benefit of HBOT for children with ASD. Only 1 randomized controlled trial reported effectiveness of this treatment, and those results have yet to be repeated."<ref>{{cite journal | vauthors = Sakulchit T, Ladish C, Goldman RD | title = Hyperbaric oxygen therapy for children with autism spectrum disorder | journal = Canadian Family Physician | volume = 63 | issue = 6 | pages = 446–448 | date = June 2017 | pmid = 28615394 | pmc = 5471082 }}</ref>

=== Chiropractic ===
[[Unsolved:Chiropractic|Chiropractic]] is an alternative medical practice whose main hypothesis is that mechanical disorders of the spine affect general health via the nervous system, and whose main treatment is [[Medicine:Spinal manipulation|spinal manipulation]]. A significant portion of the profession rejects [[Biology:Vaccination|vaccination]], as traditional chiropractic philosophy equates vaccines to poison.<ref name=Campbell>{{cite journal | vauthors = Campbell JB, Busse JW, Injeyan HS | title = Chiropractors and vaccination: A historical perspective | journal = Pediatrics | volume = 105 | issue = 4 | pages = E43 | date = April 2000 | pmid = 10742364 | doi = 10.1542/peds.105.4.e43 | s2cid = 14561867 | doi-access = free }}</ref> Most chiropractic writings on vaccination focus on its negative aspects,<ref name=Busse>{{cite journal | vauthors = Busse JW, Morgan L, Campbell JB | title = Chiropractic antivaccination arguments | journal = Journal of Manipulative and Physiological Therapeutics | volume = 28 | issue = 5 | pages = 367–73 | date = June 2005 | pmid = 15965414 | doi = 10.1016/j.jmpt.2005.04.011 }}</ref> claiming that it is hazardous, ineffective, and unnecessary,<ref name=Campbell /> and in some cases suggesting that vaccination causes autism<ref name=Busse /> or that chiropractors should be the primary contact for treatment of autism and other neurodevelopmental disorders.<ref>{{cite journal | vauthors = Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen P, Olsen J, Melbye M | display-authors = 6 | title = A population-based study of measles, mumps, and rubella vaccination and autism | journal = The New England Journal of Medicine | volume = 347 | issue = 19 | pages = 1477–82 | date = November 2002 | pmid = 12421889 | pmc = 2504909 | doi = 10.1056/NEJMoa021134 }}</ref> Chiropractic treatment has not been shown to be effective for medical conditions other than back pain,<ref>{{cite journal | vauthors = Ernst E | title = Chiropractic: a critical evaluation | journal = Journal of Pain and Symptom Management | volume = 35 | issue = 5 | pages = 544–62 | date = May 2008 | pmid = 18280103 | doi = 10.1016/j.jpainsymman.2007.07.004 | doi-access = free }}</ref> and there is insufficient scientific evidence to make conclusions about chiropractic care for autism.<ref>{{cite journal | vauthors = Hawk C, Khorsan R, Lisi AJ, Ferrance RJ, Evans MW | title = Chiropractic care for nonmusculoskeletal conditions: a systematic review with implications for whole systems research | journal = Journal of Alternative and Complementary Medicine | volume = 13 | issue = 5 | pages = 491–512 | date = June 2007 | pmid = 17604553 | doi = 10.1089/acm.2007.7088 }}</ref>

=== Craniosacral therapy ===
[[Unsolved:Craniosacral therapy|Craniosacral therapy]] is an alternative medical practice whose main hypothesis is that restrictions at cranial sutures of the skull affect rhythmic impulses conveyed via [[Biology:Cerebrospinal fluid|cerebrospinal fluid]], and that gentle pressure on external areas can improve the flow and balance of the supply of this fluid to the brain, relieving symptoms of many conditions.<ref name=Green /> There is no scientific support for major elements of the underlying model,<ref>{{cite journal |vauthors=Hartman SE, Norton JM |year=2002 |title=Interexaminer reliability and cranial osteopathy |journal=The Scientific Review of Alternative Medicine |volume=6 |issue=1 |pages=23–34 |url=http://faculty.une.edu/com/shartman/sram.pdf |access-date=2007-10-08 |url-status=dead |archive-date=2007-07-08 |archive-url=https://web.archive.org/web/20070708153030/http://faculty.une.edu/com/shartman/sram.pdf}}</ref> there is little scientific evidence to support the therapy, and research methods that could conclusively evaluate the therapy's effectiveness have not been applied.<ref name=Green>{{cite journal |vauthors=Green C, Martin CW, Bassett K, Kazanjian A |title=A systematic review of craniosacral therapy: biological plausibility, assessment reliability and clinical effectiveness |journal=Complementary Therapies in Medicine |volume=7 |issue=4 |pages=201–207 |date=December 1999 |pmid=10709302 |doi=10.1016/S0965-2299(99)80002-8}}<br/>An earlier version of the paper is available without a subscription: {{cite report |title=A systematic review and critical appraisal of the scientific evidence on craniosacral therapy |vauthors=Green C, Martin CW, Bassett K, Kazanjian A |url=http://chspr.ubc.ca/files/publications/1999/bco99-01J_cranio.pdf |date=May 1999 |access-date=2007-10-08 |series=Joint Health Technology Assessment Series |id=BCOHTA 99:1J |publisher=British Columbia Office of Health Technology Assessment |url-status=dead |archive-url=https://web.archive.org/web/20080229034840/http://chspr.ubc.ca/files/publications/1999/bco99-01J_cranio.pdf |archive-date=2008-02-29}}</ref> No published studies are available on the use of this therapy for autism.<ref name=Levy2008>{{cite journal |vauthors=Levy SE, Hyman SL |title=Complementary and alternative medicine treatments for children with autism spectrum disorders |journal=Child and Adolescent Psychiatric Clinics of North America |volume=17 |issue=4 |pages=803–820, ix |date=October 2008 |pmid=18775371 |pmc=2597185 |doi=10.1016/j.chc.2008.06.004}}</ref>

=== Chelation therapy ===
Based on the speculation that heavy metal poisoning may trigger the symptoms of autism, particularly in small subsets of individuals who cannot excrete toxins effectively, some parents have turned to [[Medicine:Alternative medicine|alternative medicine]] practitioners who provide detoxification treatments via [[Unsolved:Chelation therapy|chelation therapy]]. However, evidence to support this practice has been [[Social:Anecdote|anecdotal]] and not rigorous. Strong [[Social:Epidemiology|epidemiological]] evidence refutes links between environmental triggers, in particular [[Chemistry:Thiomersal|thiomersal]]-containing [[Biology:Vaccine|vaccine]]s, and the onset of autistic symptoms. In 2002 [[Physics:Thiamine|Thiamine]] tetrahydrofurfuryl disulfide (TTFD) was hypothesized to act as a chelating agent in children with autism and a 2002 pilot study administered TTFD rectally to ten [[Medicine:Autism spectrum|autism spectrum]] children, and seemed to find beneficial clinical effect.<ref>{{cite journal | vauthors = Lonsdale D, Shamberger RJ, Audhya T | title = Treatment of autism spectrum children with thiamine tetrahydrofurfuryl disulfide: a pilot study | journal = Neuro Endocrinology Letters | volume = 23 | issue = 4 | pages = 303–8 | date = August 2002 | pmid = 12195231 | url = http://nel.edu/pdf_w/23_4/NEL230402A02_Lonsdale_rw.pdf | archive-url = https://web.archive.org/web/20080229034845/http://nel.edu/pdf_w/23_4/NEL230402A02_Lonsdale_rw.pdf | archive-date = 2008-02-29 }}</ref> This study has not been replicated, and a 2006 review of thiamine by the same author did not mention thiamine's possible effect on [[Medicine:Autism|autism]].<ref>{{cite journal | vauthors = Lonsdale D | title = A review of the biochemistry, metabolism and clinical benefits of thiamin(e) and its derivatives | journal = Evidence-Based Complementary and Alternative Medicine | volume = 3 | issue = 1 | pages = 49–59 | date = March 2006 | pmid = 16550223 | pmc = 1375232 | doi = 10.1093/ecam/nek009 | url = http://ecam.oxfordjournals.org/cgi/content/full/3/1/49 | url-status = dead | archive-url = https://web.archive.org/web/20071025032658/http://ecam.oxfordjournals.org/cgi/content/full/3/1/49 | archive-date = 2007-10-25 }}</ref> There is not sufficient evidence to support the use of thiamine (vitamin B<sub>1</sub>) to treat autism.<ref name=Angley2 /> [[Philosophy:Doubt|Dubious]] invasive treatments are a much more serious matter: for example, in 2005, botched [[Unsolved:Chelation therapy|chelation therapy]] killed a five-year-old boy with autism.<ref name="hypocalcemia">Hazards of chelation therapy:

* {{cite journal|vauthors=Brown MJ, Willis T, Omalu B, Leiker R|date=August 2006|title=Deaths resulting from hypocalcemia after administration of edetate disodium: 2003-2005|journal=Pediatrics|volume=118|issue=2|pages=e534-6|doi=10.1542/peds.2006-0858|pmid=16882789|s2cid=28656831}}
* {{cite journal|vauthors=Baxter AJ, Krenzelok EP|date=December 2008|title=Pediatric fatality secondary to EDTA chelation|journal=Clinical Toxicology|volume=46|issue=10|pages=1083–4|doi=10.1080/15563650701261488|pmid=18949650|s2cid=24576683}}</ref>

No scientific data supports the claim that the mercury in the vaccine preservative thiomersal causes autism<ref>{{cite journal | vauthors = Doja A, Roberts W | title = Immunizations and autism: a review of the literature | journal = The Canadian Journal of Neurological Sciences | volume = 33 | issue = 4 | pages = 341–6 | date = November 2006 | pmid = 17168158 | doi = 10.1017/s031716710000528x | s2cid = 4670282 | doi-access = free }}</ref> or its symptoms,<ref>{{cite journal | vauthors = Thompson WW, Price C, Goodson B, Shay DK, Benson P, Hinrichsen VL, Lewis E, Eriksen E, Ray P, Marcy SM, Dunn J, Jackson LA, Lieu TA, Black S, Stewart G, Weintraub ES, Davis RL, DeStefano F | display-authors = 6 | title = Early thimerosal exposure and neuropsychological outcomes at 7 to 10 years | journal = The New England Journal of Medicine | volume = 357 | issue = 13 | pages = 1281–92 | date = September 2007 | pmid = 17898097 | doi = 10.1056/NEJMoa071434 | doi-access = free }}</ref> and there is no scientific support for chelation therapy as a treatment for autism.<ref name="Weber">{{cite journal | vauthors = Weber W, Newmark S | title = Complementary and alternative medical therapies for attention-deficit/hyperactivity disorder and autism | journal = Pediatric Clinics of North America | volume = 54 | issue = 6 | pages = 983–1006; xii | date = December 2007 | pmid = 18061787 | doi = 10.1016/j.pcl.2007.09.006 }}</ref><ref>{{cite journal | doi = 10.1016/j.rasd.2012.06.005 | quote = The research reviewed here does not support the use of chelation as a treatment for ASD | title = Chelation treatment for autism spectrum disorders: A systematic review | year = 2013 | vauthors = Davis TN, O'Reilly M, Kang S, Lang R, Rispoli M, Sigafoos J, Lancioni G, Copeland D, Attai S, Mulloy A | display-authors = 6 | journal = Research in Autism Spectrum Disorders| volume = 7 | pages = 49–55 | issue=1}}</ref>

=== Diets and dietary supplements ===

'''1990s hypotheses'''

In the early 1990s, it was hypothesized that autism could be caused or aggravated by [[Biology:Opioid peptide|opioid peptide]]s like casomorphine that are metabolic products of gluten and casein.<ref>{{cite journal | vauthors = Reichelt KL, Knivsberg AM, Lind G, Nødland M |title=Probable etiology and possible treatment of childhood autism |journal=Brain Dysfunction |year=1991 |volume=4 |pages=308–319}}</ref> Based on that hypothesis, diets that eliminate foods containing either gluten or casein, or both, are widely promoted, and many testimonials can be found describing benefits in autism-related symptoms, notably social engagement and verbal skills. Studies supporting those claims had significant flaws, so those data were inadequate to guide treatment recommendations.<ref name=Christison>{{cite journal | vauthors = Christison GW, Ivany K | title = Elimination diets in autism spectrum disorders: any wheat amidst the chaff? | journal = Journal of Developmental and Behavioral Pediatrics | volume = 27 | issue = 2 Suppl | pages = S162-71 | date = April 2006 | pmid = 16685183 | doi = 10.1097/00004703-200604002-00015 }}</ref><ref>{{cite journal | vauthors = Millward C, Ferriter M, Calver S, Connell-Jones G | title = Gluten- and casein-free diets for autistic spectrum disorder | journal = The Cochrane Database of Systematic Reviews | issue = 2 | pages = CD003498 | date = April 2008 | pmid = 18425890 | pmc = 4164915 | doi = 10.1002/14651858.CD003498.pub3 }} {{Retracted |doi=10.1002/14651858.cd003498.pub4}}</ref> [[Biology:Vitamin C|Vitamin C]] decreased stereotyped behavior in a small 1993 study.<ref>{{cite journal | vauthors = Dolske MC, Spollen J, McKay S, Lancashire E, Tolbert L | title = A preliminary trial of ascorbic acid as supplemental therapy for autism | journal = Progress in Neuro-Psychopharmacology & Biological Psychiatry | volume = 17 | issue = 5 | pages = 765–74 | date = September 1993 | pmid = 8255984 | doi = 10.1016/0278-5846(93)90058-Z | s2cid = 29370921 }}</ref> The study had not been replicated as of 2005, and vitamin C had limited popularity as an autism treatment. High doses might cause kidney stones or gastrointestinal upset such as diarrhea.<ref name="Levy" />

'''2000-2014 hypotheses and research'''

In the early 2000s, many parents gave their children dietary supplements in an attempt to 'treat autism' or to 'alleviate its symptoms'. The range of supplements given was wide and few are supported by scientific data.<ref name="Angley2" /><ref name="Levy" />

In 2005, it was thought that: although some children with autism also have gastrointestinal (GI) symptoms, there is a lack of published rigorous data to support the theory that autistic children have more or different GI symptoms than usual;<ref>{{cite journal | vauthors = Erickson CA, Stigler KA, Corkins MR, Posey DJ, Fitzgerald JF, McDougle CJ | title = Gastrointestinal factors in autistic disorder: a critical review | journal = Journal of Autism and Developmental Disorders | volume = 35 | issue = 6 | pages = 713–27 | date = December 2005 | pmid = 16267642 | doi = 10.1007/s10803-005-0019-4 | s2cid = 26829936 }}</ref> studies report conflicting results, and the relationship between GI problems and ASD is unclear.<ref name="CCD" /> Atypical eating behavior was thought to occur in about three-quarters of children with ASD, to the extent that it was formerly a diagnostic indicator. Selectivity is the most common problem, although eating rituals and food refusal also occur;<ref name="Dominick">{{cite journal | vauthors = Dominick KC, Davis NO, Lainhart J, Tager-Flusberg H, Folstein S | title = Atypical behaviors in children with autism and children with a history of language impairment | journal = Research in Developmental Disabilities | volume = 28 | issue = 2 | pages = 145–62 | year = 2007 | pmid = 16581226 | doi = 10.1016/j.ridd.2006.02.003 }}</ref> at the time it did not appear to result in [[Medicine:Malnutrition|malnutrition]] in studies. Other [[Medicine:Elimination diet|elimination diet]]s were also proposed, targeting salicylates, food dyes, [[Biology:Yeast|yeast]], and simple sugars. No scientific evidence has established the efficacy of such diets in 'treating autism' in children. An elimination diet may create nutritional deficiencies that harm overall health unless care is taken to assure proper nutrition.<ref name="Angley2" />

In 2006 studies suggested that complementary and alternative medical (CAM) therapy use in children with chronic illnesses is higher than in children in the general population. In a study by Helen H L Wong and Ronald G Smith, they investigated patterns of CAM therapy use in children diagnosed with ASD (n = 50) as compared to a control population of children with no ASD (n = 50). Over half of the parents in the ASD group reported using, or had used at least one CAM therapy for their child (52%) as compared to 28% of the control group (P = 0.024). Seventy percent of therapies used in the ASD group were biologically based therapies consisting of special diets or supplements, and parents felt that 75% of the therapies used were beneficial.<ref>{{cite journal|vauthors=Wong HH, Smith RG|date=October 2006|title=Patterns of complementary and alternative medical therapy use in children diagnosed with autism spectrum disorders|journal=Journal of Autism and Developmental Disorders|volume=36|issue=7|pages=901–9|doi=10.1007/s10803-006-0131-0|pmid=16897395|s2cid=30307579}}</ref>

For example, a 2008 study found that autistic boys on casein-free diets had significantly thinner bones than usual, presumably because the diets contribute to calcium and [[Chemistry:Vitamin D#Deficiency|vitamin D deficiencies]].<ref>{{cite journal|vauthors=Hediger ML, England LJ, Molloy CA, Yu KF, Manning-Courtney P, Mills JL|title=Reduced bone cortical thickness in boys with autism or autism spectrum disorder|journal=Journal of Autism and Developmental Disorders|year=2008 |volume=38|issue=5|pages=848–56|doi=10.1007/s10803-007-0453-6|pmid=17879151|s2cid=31255839}}</ref> A 2009 review found some low-quality evidence to support the use of [[Biology:Vitamin B6|vitamin B6]] in combination with [[Chemistry:Magnesium|magnesium]] at high doses, but the evidence was equivocal and the review noted the possible danger of fatal [[Medicine:Hypermagnesemia|hypermagnesemia]].<ref>{{cite journal | vauthors = Rossignol DA | title = Novel and emerging treatments for autism spectrum disorders: a systematic review | journal = Annals of Clinical Psychiatry | volume = 21 | issue = 4 | pages = 213–36 | year = 2009 | pmid = 19917212 | url = https://www.aacp.com/pdf%2F2104%2F2104ACP_Review2.pdf | url-status = dead |  archive-url = https://web.archive.org/web/20150715175954/http://www.aacp.com/pdf/2104/2104ACP_Review2.pdf | archive-date = 2015-07-15 }}</ref> A 2005 [[Cochrane Library|Cochrane Review]] of the evidence for the use of B6 and magnesium found that "[d]ue to the small number of studies, the methodological quality of studies, and small sample sizes, no recommendation can be advanced regarding the use of B6-Mg as a treatment for autism."<ref>{{cite journal | vauthors = Nye C, Brice A | title = Combined vitamin B6-magnesium treatment in autism spectrum disorder | journal = The Cochrane Database of Systematic Reviews | issue = 4 | pages = CD003497 | date = October 2005 | volume = 2005 | pmid = 16235322 | doi = 10.1002/14651858.CD003497.pub2 | pmc = 7003675 | veditors = Nye C }}</ref>

[[Biology:Probiotic|Probiotic]]s containing potentially beneficial [[Biology:Bacteria|bacteria]] were hypothesized to 'relieve some symptoms of autism' by minimizing [[Medicine:Candidiasis|yeast overgrowth]] in the colon. The hypothesized yeast overgrowth has not been confirmed by endoscopy, the mechanism connecting yeast overgrowth to autism is only hypothetical, and no clinical trials as of 2005 had been published in the peer-reviewed literature.<ref name="Levy">{{cite journal | vauthors = Levy SE, Hyman SL | title = Novel treatments for autistic spectrum disorders | journal = Mental Retardation and Developmental Disabilities Research Reviews | volume = 11 | issue = 2 | pages = 131–42 | year = 2005 | pmid = 15977319 | doi = 10.1002/mrdd.20062 }}</ref>

[[Chemistry:Dimethylglycine|Dimethylglycine]] (DMG) was hypothesized to improve speech and 'reduce autistic behaviors',<ref name="Angley2" /> and was a commonly used supplement.<ref name="Levy" /> Two double-blind, [[Medicine:Placebo|placebo]]-controlled studies found no statistically significant effect on 'autistic behaviors',<ref name="Angley2" /> and no peer-reviewed studies have addressed treatment with the related compound [[Chemistry:Trimethylglycine|trimethylglycine]].<ref name="Levy" />

[[Chemistry:Melatonin|Melatonin]] is sometimes used to manage sleep problems. Adverse effects were generally reported to be mild, including drowsiness, headache, dizziness, and nausea; however, an increase in seizure frequency was reported among susceptible children.<ref name="Angley2" /> Several small RCTs indicated that melatonin was effective in treating insomnia in autistic children, but further large studies are needed.<ref>{{cite journal | vauthors = Malow BA, Byars K, Johnson K, Weiss S, Bernal P, Goldman SE, Panzer R, Coury DL, Glaze DG | display-authors = 6 | title = A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents with autism spectrum disorders | journal = Pediatrics | volume = 130 | issue = Supplement 2 | pages = S106-24 | date = November 2012 | pmid = 23118242 | doi = 10.1542/peds.2012-0900I | pmc = 9923883 | s2cid = 15066964 | doi-access = free }}</ref> A 2013 literature review found 20 studies that reported improvements in sleep parameters as a result of melatonin supplementation, and concluded that "the administration of exogenous melatonin for abnormal sleep parameters in ASD is evidence-based."<ref>{{cite journal | vauthors = Rossignol DA, Frye RE | title = Melatonin in autism spectrum disorders | journal = Current Clinical Pharmacology | volume = 9 | issue = 4 | pages = 326–34 | year = 2013 | pmid = 24050742 | doi = 10.2174/15748847113086660072 }}</ref>

Although omega-3 fatty acids, which are [[Chemistry:Polyunsaturated fatty acid|polyunsaturated fatty acid]]s (PUFA), were 'a popular treatment for children with ASD' in the 2000s and 2010s, there is very little high-quality scientific evidence supporting their effectiveness.<ref>{{cite journal | vauthors = Bent S, Bertoglio K, Hendren RL | title = Omega-3 fatty acids for autistic spectrum disorder: a systematic review | journal = Journal of Autism and Developmental Disorders | volume = 39 | issue = 8 | pages = 1145–54 | date = August 2009 | pmid = 19333748 | pmc = 2710498 | doi = 10.1007/s10803-009-0724-5 }}</ref><ref>{{cite journal | vauthors = James S, Montgomery P, Williams K | title = Omega-3 fatty acids supplementation for autism spectrum disorders (ASD) | journal = The Cochrane Database of Systematic Reviews | volume = | issue = 11 | pages = CD007992 | date = November 2011 | pmid = 22071839 | doi = 10.1002/14651858.CD007992.pub2 | veditors = James S }}</ref> Several other supplements were hypothesized 'to relieve autism symptoms', including [[Chemistry:BDTH2|BDTH<sub>2</sub>]],<ref>{{cite news | vauthors = Tsouderos T |title=OSR#1: industrial chemical or autism treatment? |url=http://www.chicagotribune.com/health/chi-autism-chemicaljan17,0,3036818,full.story |work=Chicago Tribune |date=2010-01-17 |access-date=2010-02-11 |archive-url=https://web.archive.org/web/20100221055658/http://www.chicagotribune.com/health/chi-autism-chemicaljan17,0,3036818,full.story |archive-date=2010-02-21 }}</ref> carnosine, [[Chemistry:Cholesterol|cholesterol]],<ref>{{cite journal | vauthors = Aneja A, Tierney E | title = Autism: the role of cholesterol in treatment | journal = International Review of Psychiatry | volume = 20 | issue = 2 | pages = 165–70 | date = April 2008 | pmid = 18386207 | doi = 10.1080/09540260801889062 | s2cid = 13175585 }}</ref> [[Chemistry:Cyproheptadine|cyproheptadine]], D-cycloserine, folic acid, [[Chemistry:Glutathione|glutathione]], [[Biology:Metallothionein|metallothionein]] promoters, other PUFA such as omega-6 fatty acids, [[Chemistry:Tryptophan|tryptophan]], [[Chemistry:Tyrosine|tyrosine]], thiamine (see Chelation therapy), [[Biology:Vitamin B12|vitamin B<sub>12</sub>]], and [[Chemistry:Zinc|zinc]]. These lack reliable scientific evidence of efficacy or safety in treatment of autism.<ref name="Angley2" /><ref name="Levy" />

'''2015–Present research'''

It is now known that "children with ASD are at risk of having alimentary tract disorders – mainly, they are at a greater risk of general gastrointestinal (GI) concerns, constipation, diarrhea, and abdominal pain"<ref>{{cite journal | vauthors = Wasilewska J, Klukowski M | title = Gastrointestinal symptoms and autism spectrum disorder: links and risks - a possible new overlap syndrome | journal = Pediatric Health, Medicine and Therapeutics | volume = 6 | pages = 153–166 | date = 2015-09-28 | pmid = 29388597 | pmc = 5683266 | doi = 10.2147/PHMT.S85717 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Gorrindo P, Williams KC, Lee EB, Walker LS, McGrew SG, Levitt P | title = Gastrointestinal dysfunction in autism: parental report, clinical evaluation, and associated factors | journal = Autism Research | volume = 5 | issue = 2 | pages = 101–108 | date = April 2012 | pmid = 22511450 | pmc = 3335766 | doi = 10.1002/aur.237 }}</ref><ref>{{cite journal | vauthors = Abdelrahman HM, Sherief LM, Alghobashy AA, Abdel Salam SM, Hashim HM, Abdel Fattah NR, Mohamed RH | title = Association of 5-HT2A receptor gene polymorphisms with gastrointestinal disorders in Egyptian children with autistic disorder | journal = Research in Developmental Disabilities | volume = 36C | pages = 485–490 | date = January 2015 | pmid = 25462508 | doi = 10.1016/j.ridd.2014.10.023 }}</ref> and as succinctly summarized the Mayo Clinic website in 2019, "Yes, children with autism spectrum disorder (ASD) tend to have more medical issues, including gastrointestinal (GI) symptoms such as abdominal pain, constipation and diarrhea, compared with their peers."<ref>{{Cite web|title=Autism spectrum disorder and digestive symptoms|url=https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/expert-answers/autism-and-digestive-symptoms/faq-20322778|access-date=2022-01-05|website=Mayo Clinic|language=en}}</ref> Presently, there is not 'a diet for autism' just advice to not ingest things the individual's body seems to reject, for example: gluten if the person happens to have Celiac disease.<ref name="neuroclastic.com"/> As of 2021, "there is no clinical evidence for applying specific (e.g., gluten-free or pro-biotic) diets" to the topic of autism.<ref name = "Popow_2021" />

=== Electroconvulsive therapy ===
In 2009 studies indicated that 12–17% of adolescents and young adults with autism satisfy diagnostic criteria for [[Medicine:Catatonia|catatonia]], which is loss of or hyperactive motor activity. [[Biology:Electroconvulsive therapy|Electroconvulsive therapy]] (ECT) have been used to treat cases of catatonia and related conditions in people with autism but as of 2009 no controlled trials had been performed of ECT in autism, and there are serious ethical and legal obstacles to its use.<ref>{{cite journal | vauthors = Dhossche DM, Reti IM, Wachtel LE | title = Catatonia and autism: a historical review, with implications for electroconvulsive therapy | journal = The Journal of ECT | volume = 25 | issue = 1 | pages = 19–22 | date = March 2009 | pmid = 19190507 | doi = 10.1097/YCT.0b013e3181957363 }}</ref>

=== Stem cell therapy ===

==== 2007-2012 ====
Mesenchymal stem cells and [[Biology:Cord blood|cord blood]] [[Biology:CD34|CD34]]+ cells have been proposed to treat autism in 2007<ref name="Ichim">{{cite journal | vauthors = Ichim TE, Solano F, Glenn E, Morales F, Smith L, Zabrecky G, Riordan NH | title = Stem cell therapy for autism | journal = Journal of Translational Medicine | volume = 5 | issue = 30 | pages = 30 | date = June 2007 | pmid = 17597540 | pmc = 1914111 | doi = 10.1186/1479-5876-5-30 | doi-access = free }}</ref> and as of 2012 it was thought they may represent a future treatment.<ref>{{cite journal | vauthors = Siniscalco D, Sapone A, Cirillo A, Giordano C, Maione S, Antonucci N | title = Autism spectrum disorders: is mesenchymal stem cell personalized therapy the future? | journal = Journal of Biomedicine & Biotechnology | volume = 2012 | pages = 480289 | year = 2012 | pmid = 22496609 | pmc = 3151496 | doi = 10.1155/2012/480289 | doi-access = free }}</ref> Since immune system deregulation has been implicated in autism, mesenchymal stem cells show the greatest promise as treatment for the disorder. Changes in the innate and adaptive immune system have been observed- those with autism show an imbalance in CD3+, CD4+, and CD8+ T cells, as well as in NK cells.<ref name="Siniscalco">{{cite journal | vauthors = Siniscalco D, Sapone A, Cirillo A, Giordano C, Maione S, Antonucci N | title = Autism spectrum disorders: is mesenchymal stem cell personalized therapy the future? | journal = Journal of Biomedicine & Biotechnology | volume = 2012 | pages = 480289 | date = 1 January 2012 | pmid = 22496609 | pmc = 3151496 | doi = 10.1155/2012/480289 | doi-access = free }}</ref> In addition, peripheral blood mononuclear cells (PBMCs) overproduce IL-1β.<ref name="Siniscalco" /> It was theorized that MSC mediated immune suppressive activity could restore this immune imbalance.

=== Other ===

==== Pseudoscience ====
A number of [[Unsolved:Naturopathy|naturopathic]] practitioners claim that [[Unsolved:CEASE therapy|CEASE therapy]], a mixture of homeopathy, supplements and 'vaccine detoxing', can help people with autism however no robust evidence is available for this.

==== Packing ====
In packing, children were wrapped tightly for up to an hour in wet sheets that have been refrigerated, with only their heads left free. The treatment was repeated several times a week, and could continue for years. It was intended as treatment for autistic children who harm themselves and mostly children who could not speak. Similar envelopment techniques had been used for centuries, such as to calm violent patients in Germany in the 19th century; it was re-popularized in France in the 1960s, based on psychoanalytic theories such as the theory of the [[Unsolved:Refrigerator mother theory|refrigerator mother]]. As of 2007, packing was used in hundreds of French clinics. There was no scientific evidence for the effectiveness of packing in 2007, and there was some concern about risk of adverse health effects.<ref>{{cite journal|vauthors=Spinney L|date=August 2007|title=Therapy for autistic children causes outcry in France|journal=Lancet|volume=370|issue=9588|pages=645–6|doi=10.1016/S0140-6736(07)61322-1|pmid=17726792|s2cid=30354968}}</ref> As of 2019: "The main French associations of parents with autistic children succeeded in obtaining the prohibition of packing, announced by the French Secretary of State to the Ministry of Health in April 2016."<ref>{{Cite journal| vauthors = Chamak B |date=2019-06-01|title=Lobbying by association: The case of autism and the controversy over packing therapy in France |journal=Social Science & Medicine|language=en|volume=230|pages=256–263|doi=10.1016/j.socscimed.2019.04.027|pmid=31035204|s2cid=140304275|issn=0277-9536| url=https://hal.archives-ouvertes.fr/hal-02115503/file/S0277953619302278.pdf }}</ref>

==== Exorcism ====
The ''Table Talk'' of [[Biography:Martin Luther|Martin Luther]] contains the story of a twelve-year-old boy who some believe was 'severely autistic'.<ref>{{cite journal |journal=Autism |volume=1 |issue=1 |pages=13–23 |year=1997 |doi=10.1177/1362361397011004 |title=The history of ideas on autism: legends, myths and reality | vauthors = Wing L |s2cid=145210370 }}</ref> According to Luther's notetaker Mathesius, Luther thought the boy was a soulless mass of flesh [[Unsolved:Demonic possession|possessed by the devil]], and suggested that he be suffocated.<ref>{{cite web | vauthors = Miles M |year=2005 |title=Martin Luther and childhood disability in 16th century Germany: what did he write? what did he say? |publisher=Independent Living Institute |url=http://www.independentliving.org/docs7/miles2005b.html |access-date=2008-12-23 }}</ref>

====Abuse under the guise of religion====
In 2003, an autistic boy in Wisconsin suffocated during an [[Unsolved:Exorcism|exorcism]] by an Evangelical minister in which he was wrapped in sheets.<ref>{{cite news |url=http://www.cbsnews.com/stories/2003/08/25/national/main570077.shtml |title=Autistic boy dies during exorcism | vauthors = Collins D |date=2003-08-25 |work=CBS News }}</ref><ref>{{Cite web|title=Exorcisms often claim the most innocent -- our children|url=http://www.nbcnews.com/news/all/exorcisms-often-claim-most-innocent-our-children-flna6C10245416|access-date=2022-01-05|website=NBC News|date=7 June 2013 |language=en}}</ref>

====Other religious practices====
Ultraorthodox Jewish parents in Israel sometimes used spiritual and mystical interventions such as prayers, blessings, recitations of religious text, amulets, changing the child's name, and exorcism.<ref>{{cite journal | vauthors = Shaked M, Bilu Y | title = Grappling with affliction: autism in the Jewish ultraorthodox community in Israel | journal = Culture, Medicine and Psychiatry | volume = 30 | issue = 1 | pages = 1–27 | date = March 2006 | pmid = 16783528 | doi = 10.1007/s11013-006-9006-2 | s2cid = 25565277 }}</ref>

==== Other practices involving spirituality ====
A 2009 study has suggested that [[Philosophy:Spirituality|spirituality]] of mothers with ASDs led to positive outcomes whereas religious activities of mothers were associated with negative outcomes for the child.<ref>{{cite journal | vauthors = Ekas NV, Whitman TL, Shivers C | title = Religiosity, spirituality, and socioemotional functioning in mothers of children with autism spectrum disorder | journal = Journal of Autism and Developmental Disorders | volume = 39 | issue = 5 | pages = 706–19 | date = May 2009 | pmid = 19082877 | doi = 10.1007/s10803-008-0673-4 | s2cid = 6735662 }}</ref>

== Historical outlooks ==

=== U.S., U.K., and France ===
Children in Britain and America would often be put in institutions on the instruction of doctors and the parents told to forget about them, for example, "in Britain, until 1961, almost all doctors regarded these symptoms as part of some general "childhood psychosis" or junior version of schizophrenia".<ref>{{Cite web|date=2011-11-13|title=Autism's early child|url=http://www.theguardian.com/society/2011/nov/13/autism-first-child-growing-up|access-date=2022-01-05|website=The Guardian|language=en}}</ref> Observer journalist Christopher Stevens, father of an autistic child, reports how a British doctor told him that after a child was admitted to such an institution, usually "nature would take its course" and the child would die due to the prevalence of [[Medicine:Tuberculosis|tuberculosis]].<ref>[https://www.theguardian.com/society/2011/nov/13/autism-first-child-growing-up ''Autism's early child''], Guardian, retrieved 13/11/2011</ref>

== Anti-cure perspective and autism rights movement ==
The exact cause of autism is unclear, yet some organizations advocate researching a cure. Many self-advocacy autism rights organizations such as the Autistic Self Advocacy Network view autism as a different neurology rather than as a [[Medicine:Mental disorder|mental disorder]], advocate acceptance, and are against ABA as it is seen as trying to force conformity to "neuronormative" society.<ref name="Autistic Self Advocacy Network" /><ref name="DeVita-Raeburn_2016" /><ref name=Harmon>{{cite news| vauthors = Harmon A |title=How About Not 'Curing' Us, Some Autistics Are Pleading |date=2004-12-20 |work=The New York Times |url=https://www.nytimes.com/2004/12/20/health/20autism.html |access-date=2007-11-07 |archive-url=https://web.archive.org/web/20111202073041/http://www.nytimes.com/2004/12/20/health/20autism.html |archive-date=December 2, 2011 |url-status=live }}</ref><ref name=SanerDisease>{{cite news| vauthors = Saner E |title=It is not a disease, it is a way of life |work=The Guardian |date=2007-08-07 |url=http://society.guardian.co.uk/health/story/0,,2143123,00.html |access-date=2007-08-07 |archive-url=https://web.archive.org/web/20070820055604/http://society.guardian.co.uk/health/story/0%2C%2C2143123%2C00.html |archive-date=20 August 2007 |url-status=live }}</ref>

Criticisms of most educational, social, and behavioral focused autism therapies as put forth by autistic adults, teachers, and researchers frequently fall into the idea of these programs encouraging<ref name="Ne'eman_2021">{{cite journal | vauthors = Ne'eman A | title = When Disability Is Defined by Behavior, Outcome Measures Should Not Promote "Passing" | journal = AMA Journal of Ethics | volume = 23 | issue = 7 | pages = E569–E575 | date = July 2021 | pmid = 34351268 | doi = 10.1001/amajethics.2021.569 | pmc = 8957386 | s2cid = 236926326 }}</ref> or even training behavioral responses directed toward "[[Medicine:Autistic masking|camouflaging]]",<ref name="DeThorne_2021">{{Cite journal| vauthors = DeThorne LS, Searsmith K |date=2021-02-23|title=Autism and Neurodiversity: Addressing Concerns and Offering Implications for the School-Based Speech-Language Pathologist |journal=Perspectives of the ASHA Special Interest Groups|volume=6|issue=1|pages=184–190|doi=10.1044/2020_PERSP-20-00188|s2cid=233919959}}</ref><ref>{{cite journal | vauthors = Belcher HL, Morein-Zamir S, Mandy W, Ford RM | title = Camouflaging Intent, First Impressions, and Age of ASC Diagnosis in Autistic Men and Women | journal = Journal of Autism and Developmental Disorders | date = August 2021 | volume = 52 | issue = 8 | pages = 3413–3426 | pmid = 34342806 | doi = 10.1007/s10803-021-05221-3 | pmc = 9296412 | s2cid = 236884857 }}</ref><ref>{{cite journal | vauthors = Cook J, Crane L, Hull L, Bourne L, Mandy W | title = Self-reported camouflaging behaviours used by autistic adults during everyday social interactions | journal = Autism | pages = 406–421 | date = June 2021 | volume = 26 | issue = 2 | pmid = 34180249 | doi = 10.1177/13623613211026754 | pmc = 8814950 | s2cid = 235661866 | url = https://discovery.ucl.ac.uk/id/eprint/10130518/ }}</ref><ref>{{cite journal | vauthors = Hull L, Lai MC, Baron-Cohen S, Allison C, Smith P, Petrides KV, Mandy W | title = Gender differences in self-reported camouflaging in autistic and non-autistic adults | journal = Autism | volume = 24 | issue = 2 | pages = 352–363 | date = February 2020 | pmid = 31319684 | doi = 10.1177/1362361319864804 | s2cid = 197664299 | url = https://discovery.ucl.ac.uk/id/eprint/10080352/ }}</ref><ref>{{cite journal | vauthors = Hull L, Mandy W, Lai MC, Baron-Cohen S, Allison C, Smith P, Petrides KV | title = Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q) | journal = Journal of Autism and Developmental Disorders | volume = 49 | issue = 3 | pages = 819–833 | date = March 2019 | pmid = 30361940 | pmc = 6394586 | doi = 10.1007/s10803-018-3792-6 }}</ref><ref name="Camouflage and autism">{{cite journal | vauthors = Fombonne E | title = Camouflage and autism | journal = Journal of Child Psychology and Psychiatry, and Allied Disciplines | volume = 61 | issue = 7 | pages = 735–738 | date = July 2020 | pmid = 32658354 | doi = 10.1111/jcpp.13296 | s2cid = 220500153 | doi-access = free }}</ref><ref>{{Cite journal| vauthors = Cage E, Troxell-Whitman Z |date=2020-12-01|title=Understanding the Relationships Between Autistic Identity, Disclosure, and Camouflaging|journal=Autism in Adulthood|volume=2|issue=4|pages=334–338|doi=10.1089/aut.2020.0016|pmid=36600960 |pmc=8992868 |s2cid=225399823|issn=2573-9581}}</ref><ref name="Mandy_2019">{{cite journal | vauthors = Mandy W | title = Social camouflaging in autism: Is it time to lose the mask? | journal = Autism | volume = 23 | issue = 8 | pages = 1879–1881 | date = November 2019 | pmid = 31552745 | doi = 10.1177/1362361319878559 | s2cid = 202762080 | doi-access = free }}</ref> "[[Medicine:Autistic masking|passing as non-autistic]]",<ref name="Ne'eman_2021" /><ref>{{cite journal | vauthors = Libsack EJ, Keenan EG, Freden CE, Mirmina J, Iskhakov N, Krishnathasan D, Lerner MD | title = A Systematic Review of Passing as Non-autistic in Autism Spectrum Disorder | journal = Clinical Child and Family Psychology Review | volume = 24 | issue = 4 | pages = 783–812 | date = December 2021 | pmid = 34505231 | doi = 10.1007/s10567-021-00365-1 | s2cid = 237472360 | url = https://osf.io/x4hf9/ | pmc = 10613328 }}</ref><ref>{{Cite journal| vauthors = Benham JL, Kizer JS |date=2016-10-31|title=Aut-ors of our Experience: Interrogating Intersections of Autistic Identity |journal=Canadian Journal of Disability Studies|language=en|volume=5|issue=3|pages=77–113|doi=10.15353/cjds.v5i3.298|issn=1929-9192|doi-access=free}}</ref>  or "[[Medicine:Autistic masking|masking]]".<ref name="DeThorne_2021" /><ref name="Mandy_2019" /><ref>{{Cite journal| vauthors = Corscadden P, Casserly AM |date=2021-09-19|title=Identification of Autism in Girls: Role of Trait Subtleties, Social Acceptance and Masking.|url=https://www.reachjournal.ie/index.php/reach/article/view/313|journal=REACH: Journal of Inclusive Education in Ireland|language=en|volume=34|issue=1|issn=0790-8695}}</ref><ref>{{Cite book| vauthors = Lawrence C |url=https://books.google.com/books?id=LqGDDwAAQBAJ&pg=PA29|title=Teacher Education and Autism: A Research-Based Practical Handbook|date=2019-04-18|publisher=Jessica Kingsley Publishers|isbn=978-1-78592-608-2|language=en}}</ref><ref>{{Cite journal| vauthors = Pearson A, Rose K |date=2021-03-01|title=A Conceptual Analysis of Autistic Masking: Understanding the Narrative of Stigma and the Illusion of Choice |journal=Autism in Adulthood|volume=3|issue=1|pages=52–60|doi=10.1089/aut.2020.0043|pmid=36601266 |pmc=8992880 |s2cid=234215884|issn=2573-9581|url=https://osf.io/6rwa5/}}</ref><ref>{{Cite journal| vauthors = Miller D, Rees J, Pearson A |date=2021-12-01|title="Masking Is Life": Experiences of Masking in Autistic and Nonautistic Adults |journal=Autism in Adulthood|volume=3|issue=4|pages=330–338|doi=10.1089/aut.2020.0083|pmid=36601640 |pmc=8992921 |issn=2573-9581|url=https://osf.io/t6vp2/}}</ref><ref>{{Cite book| vauthors = Sedgewick F, Hull L, Ellis H |url= https://books.google.com/books?id=5As4EAAAQBAJ&pg=PP1 |title=Autism and Masking: How and Why People Do It, and the Impact It Can Have|date=2021-12-21|publisher=Jessica Kingsley Publishers|isbn=978-1-78775-580-2|language=en}}</ref><ref name="Camouflage and autism"/><ref>{{cite journal | vauthors = Parsloe SM, Babrow AS | title = Removal of Asperger's syndrome from the DSM V: community response to uncertainty | journal = Health Communication | volume = 31 | issue = 4 | pages = 485–494 | date = 2016-04-02 | pmid = 26400415 | doi = 10.1080/10410236.2014.968828 | s2cid = 23520937 }}</ref> Recent studies indicate that, among autistic people, [[Medicine:Autistic burnout|burnout]] and mental health difficulties associated with masking<ref>{{cite journal | vauthors = Raymaker DM, Teo AR, Steckler NA, Lentz B, Scharer M, Delos Santos A, Kapp SK, Hunter M, Joyce A, Nicolaidis C | display-authors = 6 | title = "Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew": Defining Autistic Burnout | journal = Autism in Adulthood | volume = 2 | issue = 2 | pages = 132–143 | date = June 2020 | pmid = 32851204 | pmc = 7313636 | doi = 10.1089/aut.2019.0079 }}</ref><ref>{{cite journal | vauthors = Ghanouni P, Quirke S, Blok J, Casey A | title = Independent living in adults with autism spectrum disorder: Stakeholders' perspectives and experiences | journal = Research in Developmental Disabilities | volume = 119 | pages = 104085 | date = December 2021 | pmid = 34600352 | doi = 10.1016/j.ridd.2021.104085 | s2cid = 238254134 }}</ref> "driven by the stress of masking and living in an unaccommodating neurotypical world"<ref>{{cite journal | vauthors = Higgins JM, Arnold SR, Weise J, Pellicano E, Trollor JN | title = Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout | journal = Autism | volume = 25 | issue = 8 | pages = 2356–2369 | date = November 2021 | pmid = 34088219 | doi = 10.1177/13623613211019858 | s2cid = 235346830 }}</ref><ref>{{Cite journal| vauthors = Mantzalas J, Richdale AL, Adikari A, Lowe J, Dissanayake C |date=2021-09-20|title=What Is Autistic Burnout? A Thematic Analysis of Posts on Two Online Platforms |journal=Autism in Adulthood|volume=4|issue=1 |pages=52–65|doi=10.1089/aut.2021.0021|pmid=36605565 |pmc=8992925 |s2cid=240600343|issn=2573-9581}}</ref> is an issue (which also impacts autistic young people<ref>{{cite journal | vauthors = Phung J, Penner M, Pirlot C, Welch C | title = What I Wish You Knew: Insights on Burnout, Inertia, Meltdown, and Shutdown From Autistic Youth | journal = Frontiers in Psychology | volume = 12 | pages = 741421 | date = 2021 | pmid = 34803822 | pmc = 8595127 | doi = 10.3389/fpsyg.2021.741421 | doi-access = free }}</ref> and children).<ref>{{Cite journal| vauthors = McGuinness K |date=2021-05-31|title=An evaluation of a tool, based on spoon theory, to promote self-regulation and avoidance of burnout in autistic children and young people |url= https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000001/art00006 |journal=Good Autism Practice (GAP)|volume=22|issue=1|pages=59–72}}</ref> Animal-assisted therapy used to be directed toward symptoms of autism and some studies of the programs are now directed toward burnout.<ref name="Wijker_2021">{{cite journal | vauthors = Wijker C, Kupper N, Leontjevas R, Spek A, Enders-Slegers MJ | title = The effects of Animal Assisted Therapy on autonomic and endocrine activity in adults with autism spectrum disorder: A randomized controlled trial | journal = General Hospital Psychiatry | volume = 72 | pages = 36–44 | date = 2021-09-01 | pmid = 34237553 | doi = 10.1016/j.genhosppsych.2021.05.003 | s2cid = 235778636 }}</ref>

In 2018 more studies began involving the experiences of autistic adults<ref>{{cite journal | vauthors = Tint A, Weiss JA | title = A qualitative study of the service experiences of women with autism spectrum disorder | journal = Autism | volume = 22 | issue = 8 | pages = 928–937 | date = November 2018 | pmid = 28914071 | doi = 10.1177/1362361317702561 | s2cid = 45067365 }}</ref><ref>{{cite journal | vauthors = Cage E, Di Monaco J, Newell V | title = Experiences of Autism Acceptance and Mental Health in Autistic Adults | journal = Journal of Autism and Developmental Disorders | volume = 48 | issue = 2 | pages = 473–484 | date = February 2018 | pmid = 29071566 | pmc = 5807490 | doi = 10.1007/s10803-017-3342-7 }}</ref> including their experiences with general practice medicine.<ref>{{cite journal | vauthors = Bradshaw P, Pickett C, van Driel ML, Brooker K, Urbanowicz A | title = Recognising, supporting and understanding Autistic adults in general practice settings | journal = Australian Journal of General Practice | volume = 50 | issue = 3 | pages = 126–130 | date = March 2021 | pmid = 33634275 | doi = 10.31128/AJGP-11-20-5722 | s2cid = 232057052 | doi-access = free }}</ref> Subsequent related studies have focused on communication preferences of autistic adults<ref>{{cite journal | vauthors = Howard PL, Sedgewick F | title = 'Anything but the phone!': Communication mode preferences in the autism community | journal = Autism | volume = 25 | issue = 8 | pages = 2265–2278 | date = November 2021 | pmid = 34169750 | doi = 10.1177/13623613211014995 | hdl = 1983/9e9e3795-ff6d-4fbc-b794-27d0a808cc0e | s2cid = 235635726 | doi-access = free | hdl-access = free }}</ref> and the idea of "the 'Autistic Advantage', a strengths-based model".<ref>{{Cite journal| vauthors = Grant A, Kara H |date=2021-12-08|title=Considering the Autistic advantage in qualitative research: the strengths of Autistic researchers |journal=Contemporary Social Science|volume=16|issue=5|pages=589–603|doi=10.1080/21582041.2021.1998589|s2cid=243907591|issn=2158-2041|doi-access=free}}</ref><ref>{{Cite journal| vauthors = Wilson C |date=2018-07-14|title=The autistic advantage |journal=New Scientist|language=en|volume=239|issue=3186|pages=32–33|doi=10.1016/S0262-4079(18)31254-5|bibcode=2018NewSc.239...32W|s2cid=125917495|issn=0262-4079}}</ref><ref>{{cite journal | vauthors = Russell G, Kapp SK, Elliott D, Elphick C, Gwernan-Jones R, Owens C | title = Mapping the Autistic Advantage from the Accounts of Adults Diagnosed with Autism: A Qualitative Study | journal = Autism in Adulthood | volume = 1 | issue = 2 | pages = 124–133 | date = June 2019 | pmid = 31058260 | pmc = 6493410 | doi = 10.1089/aut.2018.0035 }}</ref>

== See also ==
*Autism rights movement
*Autism friendly
* Effects of equine assisted therapy on autism
* Equine therapy on autistic people
* [[Medicine:Ryan's Law|Ryan's Law]]
* [[Social:Special education|Special education]]

== References ==
{{reflist|30em}}

== Further reading ==
{{refbegin|30em}}
* {{cite report | vauthors = Adams JB | title = Summary of Dietary, Nutritional, and Medical Treatments for Autism – based on over 150 published research studies. | publisher = ARI publication | date = 2013 | volume = 40 | pages = 1–53 | url = http://autism.asu.edu/Docs/2013/Summary_of_Treatments_for_Autism-2013.pdf | work = ASU Autism/Asperger's Research Program | archive-url = https://web.archive.org/web/20130319100738/http://autism.asu.edu/Docs/2013/Summary_of_Treatments_for_Autism-2013.pdf | archive-date = 2013-03-19 }}
* {{cite book | vauthors = Fitzpatrick M |title=Defeating Autism: A Damaging Delusion |location=London |publisher=Routledge |year=2008 |isbn=978-0-415-44981-6 }} Reviewed in: {{cite web | work = spiked |url=http://spiked-online.com/index.php?/site/reviewofbooks_article/6045/ |title='Autistic children are now seen as a burden' | vauthors = Guldberg H |date=2008-12-19 }}
* {{cite book | vauthors = Foxx RM, Mulick JA | title = Controversial therapies for autism and intellectual disabilities. | publisher = Routledge | date = 2016 }}
* {{cite book | vauthors = Monteiro MJ | title = Family therapy and the autism spectrum. | publisher = Routledge | date = 2016 }}
* {{cite book | vauthors = Shaw W, Rimland B | title = Biological treatments for autism and PDD | edition = 3rd | publisher = Great Plains Laboratory Incorporated | date = 2008 | isbn = 978-0-9661238-1-4 }}
* {{cite book | author = Ministries of Health and Education |title=New Zealand Autism Spectrum Disorder Guideline |location=Wellington |publisher=Ministry of Health |year=2008 |isbn=978-0-478-31257-7 |url=http://nzgg.org.nz/guidelines/0062/ASD_Guideline.pdf |access-date=2009-01-23 |archive-url=https://web.archive.org/web/20081016133900/http://www.nzgg.org.nz/guidelines/0062/ASD_Guideline.pdf |archive-date=2008-10-16 |url-status=dead }} {{Webarchive|url=https://web.archive.org/web/20081016133900/http://www.nzgg.org.nz/guidelines/0062/ASD_Guideline.pdf |date=2008-10-16 }}
* {{cite journal | vauthors = Bryson SE, Rogers SJ, Fombonne E | title = Autism spectrum disorders: early detection, intervention, education, and psychopharmacological management | journal = Canadian Journal of Psychiatry | volume = 48 | issue = 8 | pages = 506–16 | date = September 2003 | pmid = 14574826 | doi = 10.1177/070674370304800802 | s2cid = 18876545 | doi-access = free }}
* {{cite journal | vauthors = Erickson CA, Posey DJ, Stigler KA, McDougle CJ | title = Pharmacologic treatment of autism and related disorders | journal = Pediatric Annals | volume = 36 | issue = 9 | pages = 575–85 | date = September 2007 | pmid = 17910205 | doi = 10.3928/0090-4481-20070901-09 }}
* {{cite journal | vauthors = Keogh K | title = Autism therapy 'reduces core symptoms in children | journal = Learning Disability Practice | date = 2014 | volume = 19 | issue = 10 | page = 6 | doi = 10.7748/ldp.19.10.6.s2 }}
* {{cite journal | vauthors = Naviaux RK | title = Antipurinergic therapy for autism-An in-depth review | journal = Mitochondrion | volume = 43 | issue = | pages = 1–15 | date = November 2018 | pmid = 29253638 | doi = 10.1016/j.mito.2017.12.007 | doi-access = free }}
* {{cite journal | vauthors = Posey DJ, McDougle CJ | title = Treating autism spectrum disorders. Preface | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 17 | issue = 4 | pages = xv-xviii | date = October 2008 | pmid = 18775365 | doi = 10.1016/j.chc.2008.07.001 }} This describes a special issue of the journal ''Child and Adolescent Psychiatric Clinics of North America'', titled "Treating Autism Spectrum Disorders" (volume 17, issue 4, pages 713–932) and dated October 2008.
{{refend}}

== External links ==
* "[https://therapistndc.org/therapy/applied-behavior-analysis-aba/ Applied Behavior Analysis (ABA)]" at [https://therapistndc.org/ Therapist Neurodiversity Collective]. 
*{{cite web | title = Applied Behavior Analysis (ABA) | url = https://www.autismspeaks.org/applied-behavior-analysis-aba-0 | work = Autism Speaks }}

{{Pervasive developmental disorders}}

[[Category:Treatment of autism]]

{{Sourceattribution|Autism therapies}}