Evidence-Based Treatment and Assessment of Autism Spectrum Disorder

Background: Although every person on the autism spectrum presents with certain levels of social-communication and behavioral symptoms, the high degree of variability across individuals in symptom profiles can complicate the diagnostic and treatment process. This variability can make it difficult for parents, professionals, and investigators to understand what happens during the diagnostic process, especially for young children, and what evidence-based treatments are available. 

Objectives: To provide a summary of the findings from the recently updated Agency for Healthcare Research and Quality (AHRQ) report on Therapies for Children with Autism Spectrum Disorder: Behavioral Interventions Update, and to familiarize participants with common diagnostic tools and criteria.  

Methods: Information regarding the strength of evidence for behavioral interventions will be drawn from the most recent (2014) Agency for Healthcare Research and Quality (AHRQ) review of behavioral therapies for children with ASD. This collaborative work comprehensively reviewed existing evidence for behavioral interventions through an exhaustive systematic review framework. Some of the most frequently studied interventions and their effectiveness for improving aspects of children’s development will be briefly described. Additional information will be presented on common screening tools and “gold standard” diagnostic instruments, highlighting the core social-communication and behavioral symptoms that define ASD. 

Results: The updated AHRQ review documented a substantial increase in available evidence for the positive effects of behavioral interventions for young children (under 12 years) with ASD. The strongest evidence base was documented for (1) early intensive behavioral intervention with regards to improvements in cognitive and language outcomes and (2) the use of cognitive behavioral therapy for children with ASD and anxiety. Data on parent training, social skills, and relationship-based approaches showed a less substantial evidence base.   

Conclusions: The 2014 AHRQ report reflects increases in the number and methodological rigor of studies available. Consistent with the 2011 report, however, important gaps remain in what we know about behavioral interventions for ASD. In particular, more research is needed on why certain treatments seem to benefit some children more robustly than others.