Management of Autism in Children and Young People: A Good Clinical Practice Guideline
Veereman, G., Holdt Henningsen, K., et al. (2014).
Brussels (Belgium): Belgian Health Care Knowledge Centre (KCE), (KCE Report 223), 1-118.
This guideline provides recommendations for the treatment of children and adolescents (under the age of 19) on the autism spectrum. The recommendations are intended for all care providers in the health care, social care, or educational sectors. Some included recommendations are directly adapted from two other guideline development groups. The full citations of those documents can be found in the "Notes on This Article" section below.
Belgian Health Care Knowledge Centre (KCE)
<p>This guideline includes recommendations from the additional supporting documents listed here and in the Associated Article section below:</p><ul><li>Haute Autorité de la Santé. (2012). <em>Autisme et Autres Troubles Envahissants du Développement: Interventions Éducatives et Thérapeutiques Coordonnées Chez L’Enfant et L’Adolescent [Autism and Other PDDs: Coordinated Education and Treatment Interventions in Children and Adolescents]</em>. Retrieved from <a href="https://www.has-sante.fr/" title="https://www.has-sante.fr/" class="ApplyClass">https://www.has-sante.fr/</a></li></ul>
<p>"In children and young people [on the autism spectrum] ..., consider a specific social-communication intervention for the core feature of impaired reciprocal social communication and interaction. This intervention should include play-based strategies with parents, carers, and teachers to increase joint attention, engagement, and reciprocal communication in the child or young person. Strategies should:</p>
<ul>
<li>be adjusted to the child or young person's developmental level;</li>
<li>aim to increase the parents', carers', teachers' or peers' understanding of, and sensitivity and responsiveness to, the child or young person's patterns of communication and interaction; and</li>
<li>include techniques to expand the child or young person's communication, interactive play, and social routines.</li>
</ul>
<p>The intervention should be delivered by a trained professional. For preschool children, consider parent, carer, or teacher mediation. For school-aged children, consider peer mediation" (p. 97). </p>
"Based on expert consensus speech and language problems in children [on the autism spectrum] ... should be addressed within a personalized project including functional objectives in the field of verbal or non-verbal communication. This program could include augmentative communication, such as [picture exchange communication system] PECS and should be initiated early on" (p. 102).
"It is recommended not to use the 'hands on' techniques of 'facilitated communication' for speech and language problems in children" (p. 102).
"Based on expert consensus the [Guideline Development Group] GDG recommended to involve parents when addressing speech and language problems in children" on the autism spectrum (p. 102).
"It is recommended not to use neurofeedback for speech and language problems in children" (p. 102).
"The indication for speech therapy should be determined independent of the child’s IQ and should be integrated in a multidisciplinary approach" (p. 102)
"There is insufficient evidence to recommend arts-based interventions to address speech and language problems in children" (p. 102).
"It is recommended not to use auditory integration training for speech and language problems in children" (p. 102).
"Based on expert consensus, the implementation of an educational intervention such as [Learning Experience and Alternative Program for Preschoolers and their Parents] LEAP, an alternative program for preschoolers and parents, should be considered and studied to improve IQ, academic skills, and learning in children" on the autism spectrum (p. 102).
"Based on expert consensus speech therapy is recommended in autistic children with identified speech and language problems" (p. 102).
"The goals of speech therapy should be clearly defined and the effect be evaluated regularly" (p. 102).
There is insufficient scientific evidence to recommend the following interventions to improve IQ, academic skills, and learning in children on the autism spectrum:
<ul>
<li>behavioral treatment;</li>
<li>parent training (although expert consensus encourages parent involvement); and</li>
<li>specific social-communication interventions.</li>
</ul>
