A US study shows that autism can be reversed.
This is not correct, according to experts. The study in question was very limited in scope, involving two girls, and acknowledged this. Autism may present differently over time, but experts say autism is not a disorder or illness and it cannot be reversed or cured.
“Autism can be reversed, scientists discover”
The Telegraph (original headline), 20 July 2024
“‘Miracle’ trial claims severe autism can be reversed with symptoms reduced to an indistinguishable level when treated with regular interventions at a young age”
MailOnline, 20 July 2024
A study published in June has made claims about “reversing” autism diagnoses using a combination of different methods. The findings were reported in mid-July by the MailOnline and the Telegraph, which originally said in its headline that scientists had discovered that “autism can be reversed”, before amending it to say: “‘Autism can be reversed’, scientists claim.”
The study involved two twin girls who were diagnosed with autism at 20 months of age. The girls were subjected to numerous interventions, including some that have not been proven to be effective.
The National Autistic Society has responded, stating that no conclusions can be drawn from this case study and that some of the interventions used were “questionable”. It has also pointed out that autism cannot be cured or reversed.
Both newspapers noted the study was only undertaken in two children, but neither mentioned the key fact that the findings were not applicable more widely.
While both the Telegraph and the MailOnline did publish follow-up articles several days later covering the criticisms of the study, a reader coming across either of the initial articles in isolation could have easily been misled into thinking these findings indicated autism could be generally reversed.
The National Autistic Society has said: “We are completely baffled why this has even been published by UK papers. [...] There are absolutely no conclusions at all that can be drawn from this and to suggest otherwise is just irresponsible journalism.”
Journalists should ensure their reporting of scientific findings is accurate. If a media outlet is made aware of errors or crucial context which is missing in their reporting of scientific research, these should be corrected promptly.
We have written to the authors of the study and the Telegraph, and will update this article if we receive a response. The MailOnline declined to comment.
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Autism is a complex neurodevelopmental condition, whose cause is not precisely known. It is thought to be due to a combination of environmental and genetic factors. Autism is not linked to diet or vaccines.
Autistic characteristics can vary and support needs equally can range from high to low, with some people requiring substantial support for day to day functioning. Common traits include repetitive behaviours, sensory processing difficulties, and difficulties with social interaction and communication.
There are other conditions that may coexist with autism, including mood disorders and behavioural disorders. Gastrointestinal problems are also commonly associated with autism.
Importantly, the way autism presents can fluctuate depending on the circumstances. Certain traits may become apparent with changes in usual patterns, such as school progression. Characteristics may differ in response to an individual’s environment and also through maturing. Autism can also present differently in women and girls, and can be more difficult to detect. There are different reasons for this, including an increased likelihood of ‘hiding’ or ‘masking’ autistic behaviours.
A diagnosis of autism is made when certain criteria have been met and there is some impact on how a person is able to function. There is no single universal form of support or adjustment for autism, and interventions must be individualised according to the person’s needs.
Several interventions were used in the study in question, some of which are evidence-based. For example, Applied Behaviour Analysis (ABA), which has several different treatment models, was used for 11 months, and is a recognised approach for helping to bolster communication as well as improve other behaviours. Speech therapy was also used.
The twins were advised to follow an anti-inflammatory diet and were also given numerous supplements, though as mentioned above, diet is not a recognised cause of autism. Dr Rachel Moseley, Principal Academic in Psychology at Bournemouth University, told Full Fact via the Science Media Centre that “different dietary intakes or habits categorically do not, and cannot, cause autism to develop… There is no one cause for all cases of autism, but the majority have a large genetic component.”
Autistic people may be selective about the types of food they eat as an extension of repetitive behaviours, but there is not enough evidence to support specific diets in autism care.
Other interventions reported in the study included “bio-individualised” homeopathy and environmental assessment of air quality and moisture. The children’s parents also had support from a parent coach.
The authors report that the assortment of interventions led to a significant improvement in the autism assessment scores of both twins, which formed the basis of their claim that the twins’ autism diagnoses were ‘reversed’.
The authors acknowledge that given the number of different interventions carried out, it is not possible to say which might have contributed to the ‘reversal’ of characteristics observed. They also note that due to factors such as cost, it is likely impractical to generalise this approach to others. As such, they acknowledge their findings “may not yet be widely generalizable”.
In addition, the report only involved two participants, which would not normally be considered robust evidence. In its follow-up article, the MailOnline spoke to a specialist in neurodevelopmental disorders, Rosa Hoekstra, Professor of Global Autism and Developmental Disability Research at King’s College London, who explained that the small sample size meant the findings were not generaliseable to others. A note at the bottom of the study declares: “Since there were fewer than three individuals in this report, this is not considered a systematic investigation designed to contribute to generalizable knowledge.”
As already noted, some of the interventions used in this study are not recognised as part of the management of autism, and this includes ‘‘bio-individualised’’ homeopathy. It’s not clear exactly what types of homeopathy were used in the study, but it is worth noting that the Society of Homeopaths in the UK has previously been cautioned against practising or advertising CEASE therapy for autism.
Dr Moseley also told Full Fact other possible limitations in the study included that the results were based on scores from parental reports. She noted these normally tend to vary over time and can be influenced by the fact the parents knew the children were receiving interventions.
She added: “Autism does not go away, but autistic people learn and change, and diagnostic practices are categorical and not always nuanced enough to capture this kind of complexity. If a person is no longer showing those visible signs of autism that would result in their being given a diagnosis, it does not mean that they are not autistic—if you follow them up long enough, signs of their different sociocognitive abilities will likely emerge as they will struggle with increasingly complex social worlds.”
Autism is recognised as part of the spectrum of neurodiversity, which means that it is a fundamental difference in how the brain works, rather than a disorder that can be reversed or cured. Dr Moseley told Full Fact: ‘‘This paper is antithetical to the neurodiversity framework—it is founded in the traditional medical perspective of autism as a disorder to be ‘cured’ or removed.”
The NHS says autism “is not an illness and there is no cure”, and warns that some supposed ‘cures’ have been found to cause harm.
Professor Hoekstra told the MailOnline in its follow-up article: “Particular interventions can really help children or adults thrive. But that doesn’t mean that fundamentally their personality or their being has changed. I don’t want to discourage hope, because hope is important. But the language of ‘reversal’ is an outdated and inappropriate concept in 2024.”
Responding to Reuters, one of the study authors said: “We cited several studies in the paper that demonstrated that autism likely has both genetic and environmental contributors. It is unclear how much can be attributed to either and it likely varies considerably.
“What is clear is that autism is a heterogenous diagnosis where very little can be generalized to the entire population. While scientists continue to better define subtypes of autism to understand both etiology and developmental trajectory of those diagnosed with autism, detailed case reports (such as ours and those provided above) are an invaluable research tool for capturing the experiences of underrepresented populations of autistic individuals.”
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