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NICE Guidance on Interventions for Adults on the Autism Spectrum
The following extracts are from "Autism in adults: diagnosis and management." (2012). London: NICE.
Interventions for Autism
Psychosocial interventions for the core symptoms of autism
9.3.1.1 For adults with autism without a learning disability or with a mild to moderate learning disability, who have identified problems with social interaction, consider:
- a group-based social learning programme focused on improving social interaction
- an individually delivered social learning programme for people who find group-based activities difficult.
9.3.1.2 Social learning programmes to improve social interaction should typically include:
- modelling
- peer feedback (for group-based programmes) or individual feedback (for individually delivered programmes)
- discussion and decision-making
- explicit rules
- suggested strategies for dealing with socially difficult situations.
9.3.1.3 Do not provide 'facilitated communication' for adults with autism.
Psychosocial interventions focused on life skills
9.3.1.4 For adults with autism of all ranges of intellectual ability, who need help with activities of daily living, consider a structured and predictable training programme based on behavioural principles.
9.3.1.5 For adults with autism without a learning disability or with a mild to moderate learning disability, who are socially isolated or have restricted social contact, consider:
- a group-based structured leisure activity programme
- an individually delivered structured leisure activity programme for people who find group-based activities difficult.
9.3.1.6 A structured leisure activity programme should typically include:
- a focus on the interests and abilities of the participant(s)
- regular meetings for a valued leisure activity
- for group-based programmes, a facilitator with a broad understanding of autism to help integrate the participants
- the provision of structure and support.
9.3.1.7 For adults with autism without a learning disability or with a mild to moderate learning disability, who have problems with anger and aggression, offer an anger management intervention, adjusted to the needs of adults with autism.
9.3.1.8 Anger management interventions should typically include:
- functional analysis of anger and anger-provoking situations
- coping-skills training and behaviour rehearsal
- relaxation training
- development of problem-solving skills.
9.3.1.9 For adults with autism without a learning disability or with a mild learning disability, who are at risk of victimisation, consider anti-victimisation interventions based on teaching decision-making and problem-solving skills.
9.3.1.10 Anti-victimisation interventions should typically include:
- identifying and, where possible, modifying and developing decision making skills in situations associated with abuse
- developing personal safety skills.
9.3.1.11 For adults with autism without a learning disability or with a mild learning disability, who are having difficulty obtaining or maintaining employment, consider an individual supported employment programme.
9.3.1.12 An individual supported employment programme should typically include:
- help with writing CVs and job applications and preparing for interviews
- training for the identified work role and work-related behaviours
- carefully matching the person with autism with the job
- advice to employers about making reasonable adjustments to the workplace
- continuing support for the person after they start work
- support for the employer before and after the person starts work, including autism awareness training.
Biomedical (pharmacological, physical and dietary) interventions and the core symptoms of autism
9.3.1.13 Do not use anticonvulsants for the management of core symptoms of autism in adults.
9.3.1.14 Do not use chelation for the management of core symptoms of autism in adults.
Summary of recommendations
9.3.1.15 Do not use the following interventions for the management of core symptoms of autism in adults:
- exclusion diets (such as gluten- or casein-free and ketogenic diets)
- vitamins, minerals and dietary supplements (such as vitamin B6 or iron supplementation).
9.3.1.16 Do not use drugs specifically designed to improve cognitive functioning (for example, cholinesterase inhibitors) for the management of core symptoms of autism or routinely for associated cognitive or behavioural problems in adults.
9.3.1.17 Do not use oxytocin for the management of core symptoms of autism in adults.
9.3.1.18 Do not use secretin for the management of core symptoms of autism in adults.
9.3.1.19 Do not use testosterone regulation for the management of core symptoms of autism in adults.
9.3.1.20 Do not use hyperbaric oxygen therapy for the management of core symptoms of autism in adults.
9.3.1.21 Do not use antipsychotic medication for the management of core symptoms of autism in adults.
9.3.1.22 Do not use antidepressant medication for the routine management of core symptoms of autism in adults.
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- Updated
- 23 Aug 2021