2.2 Intervening without evidence

From time to time, interventions for autism are proposed with an odd or unconvincing rationale, little or no evidence, and often with grossly exaggerated claims for success. Parents of autistic children may be highly vulnerable to claims for a ‘cure’, ‘recovery’ or dramatic alleviation of symptoms, and understandably, they also feel empowered by doing anything they can to help their child, even if only on the principle of ‘try anything if it might help’.

One such approach, known as packing therapy, has been promoted in France, where some ideas about autism still remain far from those that are widely accepted elsewhere. The child is first wrapped in towels soaked with cold water, and then with blankets to warm the body. The claim is that this develops consciousness of bodily limits, which, according to proponents of the therapy, is lacking in autism. There has been widespread condemnation of this ill-founded practice, which has been described as ‘a form of child abuse and a gross violation of basic human rights’ (Research Autism, 2018).

Another ill-conceived approach assumes that autism is caused by excessive levels of toxins such as mercury and lead in the blood. The ‘therapy’, known as chelation, involves administering substances to eliminate the ‘excess toxic substances’ from the bloodstream. However, chelation has proved to have extremely harmful side effects and in 2005, an autistic child who was being treated in this way died of a cardiac arrest. In 2013, the National Institute for Health and Care Excellence (NICE) published the following statement:

These two techniques provide just two examples of highly dubious interventions. Imagine you had a child with diabetes, and someone offered you a previously unknown medication which they claimed provided a highly effective cure. Before trying out such medication, you would want to know how and why the substance was supposed to work, you would need evidence that the substance actually worked, and assurance that it did not have harmful or dangerous side effects. You would also want to know more about the person promoting the cure, such as whether they had a financial interest in it. The importance of addressing questions like these applies equally to autism as to treatments for medical ailments. Interventions for which the rationale is unclear, and which lack proper evaluation or ethical screening are quite rightly avoided or treated with great caution.