Dear Ms. Singh,
We are writing in response to your article, “Adjunctive therapies providing positive results for autism and other conditions.” In the article, you describe the experience of the Dalton family, who enrolled their son Jaron in a circus arts program for children with autism. The Dalton family noticed improvements in Jaron’s coordination and balance as a result of his participation. We agree that children with autism, like their typically developing peers, may enjoy and even benefit from participating in recreational activities such as circus arts. However, it is worth noting that there are currently over 400 advertised therapies for autism, the vast majority of which lack scientific support. We feel that journalists must exercise care and caution when describing potential “therapies” in the mainstream media, and we would like to raise some specific concerns regarding the circus arts program discussed in your article.
You write that complimentary therapies, such as circus arts programs, are proving effective as adjuncts to mainstream treatment. Kristy Seymour, director of the Gold Coast Circus Arts Program, states that the children enrolled in the circus program learn important skills beyond the trapeze and rola bars, that they “learn about each other’s behaviour, how to interact socially, and how to push themselves.” Seymour is also quoted as saying, “It is absolutely a therapeutic process, but we don’t present it to them in that way. [We say] ‘here’s something that’s a positive experience for you physically, emotionally or socially’.”
We agree that it is very important for children with autism to learn social skills, balance and coordination skills, and to push and challenge themselves. However, in the absence of published peer-reviewed research, we believe that circus arts programs do not meet the definition of a “therapy.” This word, “therapy,” is a powerful yet often overused word in the world of autism treatment. There are several faulty assumptions associated with the word “therapy” that we believe journalists should consider when reporting on autism treatment:
- Anything involving the word “therapy” must have therapeutic value. In today’s booming autism treatment market, many recreational experiences are touted as “therapy” when, in fact, they have no demonstrated therapeutic value. It is the responsibility of the provider to demonstrate that the “therapy” treats autism in observable and measurable ways, either by teaching functional skills or decreasing behaviours of concern.
- Providers of “therapy” are actually therapists. A provider may offer an enjoyable recreational experience, but that does not make the provider a qualified therapist. In the therapeutic disciplines, providers (e.g., behaviour analysts, psychologists, speech pathologists) must meet specific educational and training requirements before achieving certification or licensure, and must abide by ethical and professional practice guidelines.
- All “therapies” are grounded in research, and are delivered in accordance with established protocols and guidelines. This is not true for many autism “therapies.” Most therapies lack scientific support and are carried out in inconsistent and haphazard ways across providers.
While we do not believe that circus arts programs should be labelled “therapy,” we do believe that circus arts may be an enjoyable recreational activity for people with autism. Circus arts programs provide opportunities for children with autism to socialise with peers, to practice skills, and participate in a fun and pleasurable experience. While some children with autism may benefit from such programs on a case-by-case basis, there is no research to support the effectiveness of the program for ameliorating the core symptoms of autism.
We commend parents who seek out these experiences for their children with autism, and the talented staff who provide them. However, misusing the term “therapy” when describing these experiences may have unwanted consequences. Parents may spend enormous time and money on ineffective “therapies,” instead of pursuing therapeutic interventions with a demonstrated track record of success. We feel that the term “therapy” should be reserved for interventions that are scientifically proven to be therapeutic. Circus arts, like many other adjunctive “therapies,” are simply enjoyable recreational activities for people with autism. We at the Association for Science in Autism Treatment believe that such a change in how we refer to these experiences is not meant to cheapen their value, but to clarify our expectations with regard to outcomes.
Sincerely,
Erin Leif, PhD, BCBA-D and Elizabeth Callahan, MA, BCaBA
Association for Science in Autism Treatment
