Autism

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As the father of an autistic child and a physician, I was disappointed to note the omission of useful scientific information about therapeutic options for autism in Lorna Wing's (Dec 13, p 1761)1Wing L The autistic spectrum.Lancet. 1997; 350: 1761-1766Summary Full Text Full Text PDF PubMed Scopus (278) Google Scholar otherwise excellent article.She states (1764) that “Many therapies have been promulgated on anecdotal grounds but scientific evidence for their efficacy is lacking”. I feel sure that she must be aware of the pioneering work of Ivor Lovaas and others in the USA in the application of behavioural analysis in autism, published in peer-reviewed and reputable journals and replicated in Australia. Lovaas and others have shown2Lovaas OI Behavioural treatment and normal educational and intellectual functioning in young autistic children.J Consult Clin Psychol. 1987; 56: 3-9Crossref Google Scholar, 3McEachin JJ Smith T Lovaas OI Long term outcome for children with autism who received early intensive behavioral treatment.Am J Ment Retard. 1993; 97: 359-372PubMed Google Scholar, 4Birnbrauer JS Leach DL The Murdoch early intervention program after two years.Behavior Change. 1993; 10: 63-74Google Scholar in both short-term and long-term follow-up of treated children, much better outcomes than in their non-treated controls, and this method of therapy has been applied widely in the USA and latterly Australia with substantial improvement in quality of life for both the affected children and their families.It is important that scientifically and statistically demonstrated advances in the treatment of this difficult condition receive adequate attention so that the best possible outcomes can be achieved. As the father of an autistic child and a physician, I was disappointed to note the omission of useful scientific information about therapeutic options for autism in Lorna Wing's (Dec 13, p 1761)1Wing L The autistic spectrum.Lancet. 1997; 350: 1761-1766Summary Full Text Full Text PDF PubMed Scopus (278) Google Scholar otherwise excellent article. She states (1764) that “Many therapies have been promulgated on anecdotal grounds but scientific evidence for their efficacy is lacking”. I feel sure that she must be aware of the pioneering work of Ivor Lovaas and others in the USA in the application of behavioural analysis in autism, published in peer-reviewed and reputable journals and replicated in Australia. Lovaas and others have shown2Lovaas OI Behavioural treatment and normal educational and intellectual functioning in young autistic children.J Consult Clin Psychol. 1987; 56: 3-9Crossref Google Scholar, 3McEachin JJ Smith T Lovaas OI Long term outcome for children with autism who received early intensive behavioral treatment.Am J Ment Retard. 1993; 97: 359-372PubMed Google Scholar, 4Birnbrauer JS Leach DL The Murdoch early intervention program after two years.Behavior Change. 1993; 10: 63-74Google Scholar in both short-term and long-term follow-up of treated children, much better outcomes than in their non-treated controls, and this method of therapy has been applied widely in the USA and latterly Australia with substantial improvement in quality of life for both the affected children and their families. It is important that scientifically and statistically demonstrated advances in the treatment of this difficult condition receive adequate attention so that the best possible outcomes can be achieved.