Evidence-based vs non-evidence-based therapies

Navigating therapy options can be overwhelming for families who simply want to find the best support available for their child.

The large volume of information, conflicting opinions, and the variety of interventions available can be challenging for families to navigate, particularly when they are new to autism. One of the most important distinctions parents need to make is between evidence-based therapies and those that lack evidence.

What does ‘evidence-based’ really mean?

When we talk about evidence-based therapy or support, we are referring to an intervention that has been thoroughly researched and proven effective through rigorous scientific methods. This means that the therapy has undergone careful studies, which typically include:

• Randomised controlled trials (RCTs): These trials randomly assign participants into groups to receive either the therapy being tested or a placebo. This helps researchers determine whether the therapy works.
• Double-blind studies: In these studies, neither the participants nor the researchers know who is receiving the actual therapy and who is receiving a placebo, ensuring that the results aren't influenced by expectations or biases.
• Placebo-controlled trials: This is where one group receives the therapy, while another group receives a placebo (something with no therapeutic effect). Comparing the two helps establish if the therapy is genuinely effective.

The goal of these research methods is to ensure that any claims about a therapy's effectiveness are backed by reliable, unbiased data. If a therapy option lacks this rigorous validation and is only based on testimonials, anecdotal evidence and claims that seem too good to be true, it is probably an example of pseudoscience.

The dangers of approaches that lack evidence

Many non-evidence-based therapies and supports make bold promises but fail to live up to them when investigated further. While some may seem harmless, others can be downright dangerous. Parents and carers might hear miraculous success stories from other families or alternative practitioners, but it’s essential to be aware that these stories often fail to mention the risks and negative outcomes.

For example, some therapies, like restrictive diets or chelation therapy, have been promoted as ‘cures’ for autism. However, these interventions can have serious side effects. Consider the case of restrictive diets, such as gluten-free or casein-free diets, which are sometimes promoted as a way to 'treat' autism. While these diets may benefit children with specific food sensitivities, they can also lead to nutritional deficiencies, like low calcium intake, which can affect bone health. In extreme cases, children have developed low bone density or even broken bones because their diet lacked essential nutrients.

Similarly, chelation therapy, which is intended to remove heavy metals from the body, has been promoted by some as a therapy or 'cure' for autism. However, there is no scientific evidence to support this claim, and the therapy can be dangerous, leading to severe side effects.

The appeal of approaches that are not evidence-based

One of the reasons why non-evidence-based therapies are so appealing to families is that there are relatively few therapies available for autism. Autism is a complex condition, and each child is different, so finding the right approach can take time. In the absence of clear, universally-effective support, alternative 'therapies' fill the gap, often presenting themselves as quick fixes or miracle cures.

Additionally, non-evidence-based therapies are often accompanied by very convincing testimonials. Personal stories from other families or from practitioners can be powerful, and it's natural for families to want to believe in something that could help their child. However, it's important to remember that personal stories, while emotionally convincing, do not replace scientific evidence.

Why evidence-based therapies are important

The most important advantage of evidence-based therapies is that they are proven to work through controlled and methodical studies. This means families can have greater confidence that the time, effort, and money they invest in these therapies will result in real improvements for their child. 

Evidence-based therapies for autism typically focus on helping the child build skills and reduce challenging behaviours. These therapies are often educational or behavioural in nature. They are widely used because they have been tested in clinical trials and have shown positive outcomes. Importantly, they focus on individualised approaches to meet each child’s unique needs rather than offering a one-size-fits-all solution.

How to be a savvy consumer

With so many therapies and services presented as helpful for autistic people, separating fact from fiction and making informed decisions can feel daunting. Here are some practical steps for families to ensure they are choosing the best, evidence-based interventions for their child:

Do your research

Before committing to any therapy or support service, take the time to read and understand your options. Look for reliable sources, such as Autism: What Next?, that provide comprehensive information on evidence-based therapies. 

It’s also helpful to understand the types of research behind each therapy. If a therapy claims to be evidence-based, check whether it has been tested in randomised, controlled trials or if it relies on case studies and testimonials.

Take your time

There’s often a rush to start interventions as soon as possible after an autism diagnosis. While early intervention is important, it’s equally important to take the time to evaluate different services and professionals. Visit them, ask questions, and get a feel for the people who will be working with your child. 

Speak with other families

While testimonials should be taken with caution, it can still be helpful to speak with other families who are currently using the service. They can provide insight into their experiences and the results they've seen, though it’s important to remember that each child is unique, and what works for one may not work for another.

Be wary of pseudoscience

If a therapy promises rapid results or claims to ‘cure’ autism, be wary. These therapies are often based on pseudoscience and can be harmful. Always question extravagant claims, and remember that if something seems too good to be true, it probably is.

Consider the costs

Early intervention and therapy services can be expensive, especially when they require many hours of one-on-one sessions with a specialist. Make sure you understand the costs upfront and question any provider that seems excessively priced compared to other providers offering the same service.

Remain flexible

As your child grows and their needs change, the types of services that are best for them may also change. It’s normal for families to start with one approach and then pivot to another as they learn more about what works for their child. Flexibility is key.

Prioritise high-quality providers 

Choose professionals who respect your input, involve you in decision-making, and are transparent about how progress will be measured. Avoid anyone who dismisses your concerns or fails to engage you in your child’s care.

Above all, remember that autism is part of who your child is, and they deserve love and support—not a cure. With the right interventions, your child and your entire family can thrive. The key is finding what works best and sticking to interventions grounded in solid evidence.