Therapy with Autistic Children

Abstract

If any therapy is to be investigated scientifically one must dispassionately, without romanticism acknowledge that: (1) autism is not a static disorder; (2) we know something about the factors related to outcome (Rutter, 1974) which include initial I.Q., degree of language impairment, total symptom score, and experience of schooling; (3) we adhere to the usual rules of scientific investigation which include statistical comparisons and attempt to decrease the bias of selection. Finally, we must include in all our studies some consideration of the natural history of autism so that when we claim significant change, we are not doing less than or equal to that which would be expected when the child is reared with the humanistic supports that are available. We have on hand Eisenberg’s (1957) careful literature review indicating that if communicative speech is developed by age five, there is a 50% chance for some social recovery, and that within the entire group of psychotic children improvement rates of better than 25% must be recorded in order to do better than natural outcome alone. Our own studies (Shapiro et al., 1974; Shapiro, 1976) on the language development of young psychotic children point to certain parameters which might be used as early prognosticators such as the persistence of echoic speech—the development of out-of-context bizarre utterance, as well as the percentage of communicativeness after brief (three months) observation in nursery milieu.