The American Academy of Pediatrics (Meyer, Johnson, and the Council on Children with Disabilities, 2007) has made a clear statement about the basic principles that underlie effective ASD interventions: “There is a growing consensus that important principles and components of effective early childhood intervention for children with ASDs include the following:

Entry into intervention as soon as an ASD diagnosis is seriously considered rather than deferring until a definitive diagnosis is made;

Provision of intensive intervention, with active engagement of the child at least 25 hours per week, 12 months per year, in systematically planned, developmentally appropriate educational activities designed to address identified objectives;

Low student-to-teacher ratio to allow sufficient amounts of 1-on-1 time and small-group instruction to meet specific individualized goals;

Inclusion of a family component (including parent training as indicated);

Promotion of opportunities for interaction with typically developing peers to the extent that these opportunities are helpful in addressing specific educational goals;

Ongoing measurement and documentation of the individual child’s progress toward educational objectives, resulting in adjustments in programming when indicated;

Incorporation of a high degree of structure through elements such as predictable routine, visual activity schedules, and clear physical boundaries to minimize distractions;

Implementation of strategies to apply learned skills to new environments and situations (generalization) and to maintain functional use of these skills; and

Use of assessment-based curricula that address:

functional, spontaneous communication;

social skills, including joint attention, imitation, reciprocal interaction, initiation, and self-management;

functional adaptive skills that prepare the child for increased responsibility and independence;

reduction of disruptive or maladaptive behavior by using empirically supported strategies, including functional assessment;

cognitive skills, such as symbolic play and perspective taking; and

traditional readiness skills and academic skills as developmentally indicated.”

In this analysis of ASD interventions, the focus was on identifying treatments that are based on strong scientific evidence. Medical, behavioral, cognitive, and educational interventions were reviewed. This analysis relied on data obtained from five primary sources of consensus judgments about ASD treatments: (1) the American Academy of Pediatrics (AAP) Council on Children with Disabilities, (2) the National Autism Center (NAC), (3) the Association for Science in Autism Treatment (ASAT), (4) the National Professional Development Center (NPDC) on Autism Spectrum Disorders, and (5) the detailed 2005 review of ASD interventions completed by Simpson and his colleagues. The NPDC review in particular establishes a balanced view of how to combine the results of randomized, quasi-experimental, and single-subject studies to establish an evidence base for a particular type of treatment or for a specific intervention strategy.

For the purposes of this analysis, we have categorized each type of ASD treatment into one of four categories based on the scientific evidence supporting the treatment:

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The following is a summary of the results of this analysis and a brief description of each type of intervention reviewed. When there was general consensus among the five data sources, classification decisions regarding specific interventions were straightforward. Additional analysis and explanation were required when there were differing conclusions among the five sources or when it was necessary to clarify the conditions under which a treatment could be confidently recommended for use. We also supplemented the conclusions reached by each data source when additional new findings have clarified the conclusions for a particular type of treatment. The data sources often varied in how specific interventions were defined or labeled, as well as in the content and scope of the scientific evidence that was reviewed to validate each intervention. Despite these variations in approach, there was still substantial agreement among the consensus sources.