New drugs for patients may be on the horizon, but “early, intense” behavioral treatment remains “the very best intervention for autism.”

How Can Autism Be Treated?

Wilczynski: What is the current state of treatment for autism?  Anyone?

Bookheimer:  There are many treatments for autism, but I think that we would agree that the most effective treatments are still behavioral treatments.  There are some drug treatments, which perhaps Chris can tell us about. But behaviorally I think that most of us agree that early intense treatment is still the very best interventions for autism and usually involving increasing joint attention, getting children to learn how to attend together with their caregivers, involving parents in the care giving in the treatment process, and doing it intensely and as early as possible.  Most people think that still gives us the best outcome in autism.

Wilczynski:  Very good, and Chris, did you want to add to that?

Walsh:  Yeah.  I agree.  The tried and true and the best documented methods of treatment involve this early behavioral intervention and it’s interesting that in animal models if you take a mouse and you do an enriched environment it changes patterns of gene expression in the brain. And so it will be interesting to see whether this kind of early behavioral intervention in humans may have actually some genetic or gene-expression profile in the human brain as well. 

Fischbach:  I bet it’s going to end up being a combination of behavioral therapy and some medicine.  We just don’t know what the medicine is yet.  It’s strange that we’re all saying genes point to synapses, to connections. But none of the traditional therapies used in other neuropsychiatric disorders that either increase or decrease the action of a certain transmitter at a synapse seem to be effective in autism, in the core symptoms of autism.  They may help in reducing the anxiety component or the aggressive component, but the social cognition seems to be resistant to traditional synoptically active drugs.  Something new is going to be needed here. 

Bookheimer:  I think in part that reflects a general problem in that we tend to want to find interventions, particularly pharmacal interventions that are going to treat autism as a whole when in fact I think that we’re going to end up being more successful in treating specific features of autism—the repetitive behaviors aspect of it, the anxiety aspect of it and so forth—rather than finding a single bullet, a magic pill that is going to do everything for us.