New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 4: Treatment and management of ASD
Part 4
While every parent or person with ASD has the
right to seek treatment from any source they
believe may work for them, professionals have
a responsibility to interpret research evidence
for them and be as objective and honest as
possible (Recommendation 4.3.1). The absence of
appropriately supportive data for most of the
treatment approaches underlies the reluctance
that many authorities worldwide share for
publicly funding specific treatment methods 204
274 275
. Furthermore non-established treatments
can be costly in time and money and some have
adverse effects 276 .
As ASD represents a heterogeneous spectrum
of disorders, treatments may have differential
effects in individuals, making the identification
of effective treatments difficult. There is a great
deal of variability in response to treatment
and some individuals may show apparently
spontaneous improvement in symptoms in
a particular area for unidentified reasons. In
such a situation, if an intervention has been
recently implemented, the improvement can be
erroneously attributed to the treatment, even
when the treatment is actually ineffective.
The following intervention guidance has
been suggested (which is also contained in Part
3: Education for learners with ASD – the same
principles apply in both settings) 277 :
• treatment programmes should be individually
designed, taking into account the individual’s
cognitive level, severity of autistic
symptomatology, overall developmental
level, chronological age and temperament/
personality (Recommendation 4.1.2)
• structured educational/daily living
programmes should be considered;
programmes with an emphasis on visually
based cues can provide a predictable and
readily understandable environment,
minimising confusion and distress to the
person with ASD (Recommendation 4.3.2)
• interventions should take account of the
core deficits of autism (eg, communication,
social skills and stereotyped and ritualistic
behaviour) (Good Practice Point 4.2.5)
• many undesirable or challenging behaviours
reflect limited behavioural repertoires or
poor communication skills, so focus on
skill enhancement and establishment of
more effective communication strategies
are often the most successful means of
reducing difficult or disruptive behaviours
(Recommendation 4.3.2)
• family-centred treatment approaches result
in greater generalisation and maintenance of
skills. Development of management strategies
that can be implemented consistently but
do not demand extensive sacrifice in terms
of time, money or other aspects of family
life seem most likely to offer benefits for all
involved (Recommendation 4.3.2).
Guidelines for evaluating treatment options
for people with ASD advise parents, family,
whänau and professionals to:
• ask specific questions about the treatment
regarding its goals, components, style, target
group, outcomes, efficacy, effectiveness (and
the best method for evaluating this), negative
effects, risks and safeguards
• find out about therapist experience,
qualifications and professional association
• be hopeful, but conservative, about any new
treatment where the efficacy of the treatment
has not been proven
• remember that the primary goal of any
treatment should be to help the person with
ASD live as full a life as possible within society
• beware of any programme that claims to be
effective for all people with ASD
• be cautious of programmes that do not allow
individualisation
• recognise that there are likely to be several
suitable treatment options for each person
with ASD
• recognise that treatment choices should
be based on the results of the person’s
individual assessment
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New Zealand Autism Spectrum Disorder Guideline