The National Center for Evidence-Based Practice
in Communication Disorders
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Summary of Clinical Practice Guideline

National Autism Center

National Standards Report
(2009).
National Autism Center, 1-161.

AGREE Rating: Highly Recommended

Description:
This guideline provides recommendations for treatment of children and adolescents with autism spectrum disorders. The audience for this guideline includes parents, caregivers, educators, and service providers. Treatments have been evaluated and determined to be established, emerging, or unestablished. No treatments were determined to be ineffective or harmful.

Recommendations:

Autism Spectrum Disorders

  • Treatment

    • Cognition/Language

      • General Findings, Behavioral Video Modeling, Peer Mediated/Implemented, Pivotal Response, Social Stories™

        • The guideline authors stress that treatment selection should be made by a team of individuals and that this document should not dictate which treatments can or cannot be used for individuals with autism. However, the following suggestions are made to assist in decision making.

        • “We recommend the decision-making team give serious consideration to [Established Treatments] because these treatments have produced beneficial effects for individuals involved in the research studies published in the scientific literature, b) access to treatments that work can be expected to produce more positive long-term outcomes, and c) there is no evidence of harmful effects” (p. 76).

        • Established interventions that have been shown to increase communication skills include:

          • Antecedent Package

          • Behavioral Package

          • Comprehensive Behavioral Treatment for Young Children

          • Joint Attention

          • Modeling

          • Naturalistic Teaching Strategies

          • Peer Training

          • Pivotal Response Treatment

        • Established interventions that have been shown to increase interpersonal skills include:

          • Antecedent Package

          • Behavioral Package

          • Comprehensive Behavioral Treatment for Young Children

          • Joint Attention

          • Modeling

          • Naturalistic Teaching Strategies

          • Peer Training

          • Pivotal Response Treatment

          • Self-management

          • Story-based

      • General Findings, Cognitive Behavioral Therapy, Peer-Mediated Intervention, Social Scripts, and AAC – General Findings, PECS, Sign Language

        • The guideline authors stress that treatment selection should be made by a team of individuals and that this document should not dictate which treatments can or cannot be used for individuals with autism. However, the following suggestions are made to assist in decision making.

        • “Given the limited research support for Emerging Treatments, we generally do not recommend beginning with these treatments. However, Emerging Treatments should be considered promising and warrant serious consideration if Established Treatments are deemed inappropriate by the decision-making team” (p. 76).

        • Emerging treatments that have been shown to increase communication skills include:

          • Augmentative and alternative communication

          • Developmental relationship-based treatment

          • Language training

          • Multi-component packages

          • Picture exchange communication system

          • Sign instruction

          • Social communication intervention

          • Structured teaching

          • Technology-based treatment

        • Emerging treatments that have been shown to increase interpersonal skills include:

          • Cognitive behavioral intervention package

          • Developmental relationship-based treatment

          • Imitation training

          • Multi-component package

          • Peer-mediated instructional arrangement

          • Picture exchange communication system

          • Scripting

          • Social communication

          • Social skills package

          • Structured teaching

      • TEACCH

        • The guideline authors stress that treatment selection should be made by a team of individuals and that this document should not dictate which treatments can or cannot be used for individuals with autism. However, the following suggestions are made to assist in decision making.

          • “Given the limited research support for Emerging Treatments, we generally do not recommend beginning with these treatments. However, Emerging Treatments should be considered promising and warrant serious consideration if Established Treatments are deemed inappropriate by the decision-making team” (p. 76).

          • Structured teaching (also referred to as TEACCH) is an emerging treatment that has been shown to increase communication skills.

      • General Findings, Auditory/Sensory Integration Training, Facilitated Communication

        • The guideline authors stress that treatment selection should be made by a team of individuals and that this document should not dictate which treatments can or cannot be used for individuals with autism. However, the following suggestions are made to assist in decision making.

        • “Unestablished Treatments either have no research support or the research that has been conducted does not allow us to draw firm conclusions about treatment effectiveness for individuals with ASD… Given how little is known about these treatments, we would recommend considering these treatments only after additional research has been conducted and this research shows tem to produce favorable outcomes for individuals with ASD” (p. 76).

        • Unestablished treatments include academic interventions, auditory integration training, facilitated communication gluten- and casein-free diet, and sensory integrative package.

Social Communication Disorders

  • Treatment

    • Cognition/Language

      • Behavioral Interventions/Techniques

        • General Findings and Pivotal Response Training

          • The guideline authors stress that treatment selection should be made by a team of individuals and that this document should not dictate which treatments can or cannot be used for individuals with autism. However, the following suggestions are made to assist in decision making.

          •  “We recommend the decision-making team give serious consideration to [Established Treatments] because these treatments have produced beneficial effects for individuals involved in the research studies published in the scientific literature, b) access to treatments that work can be expected to produce more positive long-term outcomes, and c) there is no evidence of harmful effects” (p. 76).

          • Established interventions that have been shown to increase [social] communication skills include:

          • Antecedent Package

          • Behavioral Package

          • Comprehensive Behavioral Treatment for Young Children

          • Joint Attention Intervention

          • Modeling

          • Naturalistic Teaching

          • Peer Training Package

          • Pivotal Response Treatment

      • Aided AAC, Unaided AAC, Computer-Based Instruction and Developmental Interventions, Relationship-Based Interventions, Pragmatic/Social Skills Treatment

        • The guideline authors stress that treatment selection should be made by a team of individuals and that this document should not dictate which treatments can or cannot be used for individuals with autism. However, the following suggestions are made to assist in decision making.

        • “Given the limited research support for Emerging Treatments, we generally do not recommend beginning with these treatments. However, Emerging Treatments should be considered promising and warrant serious consideration if Established Treatments are deemed inappropriate by the decision-making team” (p. 76).

        • Emerging treatments that have been shown to increase [social] communication skills include:

          • Augmentative and Alternative Communication Devices

          • Developmental Relationship-based Treatment

          • Language Training (Production)

          • Language Training (Production and Understanding)

          • Multi-component Package

          • Peer-mediated Instructional Arrangement

          • Picture Exchange Communication System

          • Scripting

          • Sign Instruction

          • Social Communication Intervention

          • Social Skills Package

          • Structured Teaching

          • Technology-based Treatment

          • Theory of Mind Training

      • Peer-Mediated/Implemented

        • The guideline authors stress that treatment selection should be made by a team of individuals and that this document should not dictate which treatments can or cannot be used for individuals with autism. However, the following suggestions are made to assist in decision making.

        •  “We recommend the decision-making team give serious consideration to [Established Treatments] because these treatments have produced beneficial effects for individuals involved in the research studies published in the scientific literature, b) access to treatments that work can be expected to produce more positive long-term outcomes, and c) there is no evidence of harmful effects” (p. 76).

          • Established interventions that have been shown to increase [social] communication skills include:

          • Antecedent Package

          • Behavioral Package

          • Comprehensive Behavioral Treatment for Young Children

          • Joint Attention Intervention

          • Modeling

          • Naturalistic Teaching

          • Peer Training Package

          • Pivotal Response Treatment

        • “Given the limited research support for Emerging Treatments, we generally do not recommend beginning with these treatments. However, Emerging Treatments should be considered promising and warrant serious consideration if Established Treatments are deemed inappropriate by the decision-making team” (p. 76).

        • Emerging treatments that have been shown to increase [social] communication skills include:

          • Augmentative and Alternative Communication Devices

          • Developmental Relationship-based Treatment

          • Language Training (Production)

          • Language Training (Production and Understanding)

          • Multi-component Package

          • Peer-mediated Instructional Arrangement

          • Picture Exchange Communication System

          • Scripting

          • Sign Instruction

          • Social Communication Intervention

          • Social Skills Package

          • Structured Teaching

          • Technology-based Treatment

          • Theory of Mind Training

Keywords:
Augmentative and Alternative Communication, American Sign Language, Behavioral Treatments, Parent-Mediated Intervention, Sensory Integration, Social Skills, Picture Exchange Communication System (PECS), Pivotal Response, Relationship-Based Intervention, Autism Spectrum Disorders

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