Questions to Ask Marketers of Autism Interventions
Written by Daniel Mruzek, PhD, BCBA-D
Families with a member with autism know that there is a vast selection of potential treatment options. Some of these treatments are purported to address one or more of the core features of autism (e.g., a pill that supposedly improves spoken communication), while others are marketed as treatments for other difficulties commonly experienced by individuals with autism (e.g., exercises to reduce tantrums). Many of these interventions are expensive and time-consuming, and some are potentially dangerous (e.g., hyperbaric chamber). Like other “purchasing” decisions, families need to consider treatment options carefully.
How does one investigate these options? One way is to ask a trusted expert (e.g., a physician, psychologist, behavior analyst). Another way is to reference science-based “quick reference” guides, such as ASAT’s web-based Summaries of Scientific Research on Interventions on Autism. A third way to investigate the soundness of a potential autism treatment is to ask the marketer or practitioner polite, but direct questions about the treatment that they recommend. Below, we have eight questions that you can ask the marketer of an autism intervention that might be helpful as you make treatment decisions.
Family members might be a little apprehensive about asking marketers of purported autism interventions direct questions about the state-of-the-science of their interventions; however, a legitimate interventionist will appreciate good questions and the resultant opportunities to partner with the family in the development of effective treatments. This process of direct questioning is one way we can practice scientific skepticism – a quality of the scientific process that makes it such a powerful means of positive change. Also, this process increases the likelihood that hard-earned family income is spent wisely in maximizing the independence of their member with autism.
Additional information on selecting treatments for your family member is found in an article entitled, The Road Less Traveled: Charting a Clear Course for Autism Treatment, authored by David Celiberti and colleagues and found at this web address: http://www.asatonline.org/pdf/roadless.pdf
|1||“What is the rationale or theory underlying this intervention?”||The marketer’s description of the rationale should sound reasonable. Be aware of scientific-sounding explanations that sound impressive but, upon consideration, are not plausible, logical or realistic.|
|2||“Do any scientific papers (e.g., peer–reviewed journal articles) indicate that the proposed treatment is effective?”||Watch out for references to testimonials, opinion pieces, case studies and “articles” that have been posted without scientific peer review. They can provide an illusion of legitimacy and effectiveness when, in fact, no scientific evidence may exist.|
|3||“What should the benefits of the intervention look like, and how will we monitor/measure these?”||The practitioner or marketer should be able to offer specific and observable potential benefits and an objective method of measuring for gains for your family member.|
|4||“Do you have (de-identified) data sets from your practice that suggests that this treatment works?”||If the practitioner cannot point to scientific studies supporting their proposed intervention, ask to see treatment data for other individuals with whom they have worked in the past. The practitioner should not provide you with the name or other identifiers of the individual they treated- just a good description of what they did and data that demonstrate functional improvement for the individual.|
|5||“What are the possible side effects, and how will we monitor/measure these?”||Many interventions have potential unintended consequences that should be considered beforehand and, if concerning, monitored for during implementation.|
|6||“How much time does it take, and when will it be done?”||Even a brief intervention (such as a 10-minute exercise during the school day) adds up to substantial time lost for other, possibly important activities (e.g., skill building); therefore, one question to consider is what will not be done during implementation of the proposed intervention?|
|7||“How will we monitor treatment data for my family member?”||Watch for the use of objective (i.e., measurable) data to assess for possible treatment effectiveness. And, of course, objective data are of no use if the intervention team is not regularly reviewing these data and incorporating these data into treatment decisions. Will the data “pile up” in a folder or drawer, or will the intervention team maintain a schedule of ongoing review?|
|8||“How difficult is it to implement this treatment correctly?”||Beware of proposed interventions that require that they be implemented “just right” in order to be helpful. This quality can be an excuse that marketers use when unwary consumers question a lack of progress. Usually, an effective intervention is helpful even if not implemented with perfect fidelity.|