New national autism guideline will finally give families a roadmap for therapy decisions

Australian’s first national guideline outlining the best ways of providing clinical support to autistic children and their families will be launched in Canberra today.

The guideline, which we co-authored with others, represents a landmark moment for autism in Australia. It is the culmination of a decades-long effort to build better evidence into clinical practice for autistic children.

For the first time, families of children with autism will have a clear description of what is and what is not safe and effective clinical practice, and a roadmap to empower their choices.

Read more: Treating suspected autism at 12 months of age improves children's language skills

Autism in Australia

Autism became a formal diagnosis in Australia with the introduction of the third edition of the Diagnostic and Statistical Manual in 1980. But it was not until 1994 it was diagnosed in large numbers. Today, autism is diagnosed in more than 1% of people.

The most common types of therapies or supports for autistic children are focused on supporting their learning, participation, and wellbeing. This might involve directly teaching the child learning strategies, or changing the environment around the child. For many children, these therapies are used at the same time as prescribed medication.

There is good evidence to underpin the safety and effectiveness of many such therapies. However, like all areas of health and medicine, it can be hard to ensure measures are rolled out in the same way in different settings and locations. This can lead to confusion for children and families, and expose them to clinical therapies that may be ineffective or harmful.

With the increased focused on evidence-based medicine over the past two decades, there have been important steps taken to provide better guidance to clinicians and policymakers about what represents good practice. However, until now there hasn’t been an evidence-based guide they can refer to that brings together international expertise and research evidence.

Read more: We examined the research evidence on 111 autism early intervention approaches. Here's what we found

84 recommendations

We developed the new guideline at the Autism CRC – established in 2013 as the world’s first national, cooperative research effort focused on autism across the lifespan. It brought together a group of researchers, clinicians, and autistic people, who consulted with more than 1,000 community members.

These community voices were then combined with evidence from three systematic reviews of international research to develop 84 recommendations.

The recommendations are presented as statements that describe key elements of practice. Clinicians follow these to deliver evidence-based therapies. Some examples are:

• Practitioners should have relevant qualifications, be regulated, work within their scope of practice with appropriate supervision, and engage in continuing professional development
• practitioners should engage in open and regular communication with other practitioners, the child’s educators, and other service providers, with appropriate consent, to ensure supports are coordinated
• practitioners should ensure the child and family understand the rationale for recommended supports, along with potential benefits, costs, and alternative options.

The recommendations will help clinicians work with children and families to set therapy goals, select and deliver the most appropriate therapies to meet those goals, and then monitor therapies to ensure they are safe and effective.