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Son-Rise Program and Autism Ranking: No evidence

Father and son

The Son-Rise Program (sometimes known as the Options Method) is a type of relationship-based intervention. It is used to help autistic children and children with other disabilities.

The Son-Rise Program is based on the idea that autistic children have trouble forming relationships with other people but can be helped to develop those relationships through playful interaction with an adult.

The adult follows the child’s lead rather than superimposing their own ideas of what the child should do. This includes ‘joining’ the child in his or behaviour rather than trying to stop it. So, if the child is stacking blocks or flapping his hands, the adult does the same.

The aim is not simply to copy the activity but to build trust. By doing the same as the child, the adult shows the child that he or she is loved and accepted without judgment. It then becomes much easier to build a relationship. As the relationship develops the adult is able to use the child’s own motivation to teach him or her new skills based around his or her own interests.

Our Opinion

There is almost no research (two very poor quality studies) to suggest that the Son-Rise Program is an effective intervention for autistic children and young people.

However, we believe that some elements of the approach (such as the emphasis on following the child’s own interests and reciprocal interaction with the parents) may be beneficial to some autistic children and young people.

Because of this, we feel that further research into the programme is justified. This research should

  • be considerably more robust in terms of numbers and methodology used
  • compare the Son-Rise program with other educational interventions which are commonly used to help autistic children and young people
  • investigate variables, such as whether the program is likely to be more effective for specific groups on the autism spectrum or whether it is more effective when delivered by parents or therapists or both
  • investigate whether the program provides any long term benefits in real world settings (such as in the children’s own home)
  • investigate the effects on the emotional well being of the children or the impact on the whole family

Disclaimer

Please read our Disclaimer on Autism Interventions


Audience

The Son-Rise program is aimed at parents and professionals caring for a wide range of people of all ages, including autistic children or children with other developmental difficulties. For example, the Autism Treatment Center of America website, accessed on 26 July 2016, claims that the Program is suitable for:

“Parents, relatives and caring professionals looking to generate meaningful progress in their children (ages 18 months through 60 years) challenged by Autism, Autism Spectrum Disorders, Pervasive Developmental Disorder (PDD), Asperger's Syndrome, High Functioning Autism and other related developmental difficulties”

The aim is not simply to copy the activity but to build trust. By doing the same as the child, the adult shows the child that he or she is loved and accepted without judgment. It then becomes much easier to build a relationship. As the relationship develops the adult is able to use the child’s own motivation to teach him or her new skills based around his or her own interests.

Aims and Claims

Aims

According to the Autism Treatment Center of America website, accessed on 26 July   2016, the Son-Rise program aims to provide a comprehensive treatment programme.

“The Son-Rise Program teaches a specific and comprehensive system of treatment and education designed to help families and caregivers enable their children to dramatically improve in all areas of learning, development, communication and skill acquisition. It offers highly effective educational techniques, strategies and principles for designing, implementing and maintaining a stimulating, high-energy, one-on-one, home-based, child-centered program.”

Claims

There have been various claims for the Son-Rise program ranging from complete cure of autistic children to significant improvements in IQ, communication and social skills.

For example, Raun Kaufman (2005) speaks of “my complete recovery from autism with no trace of my former condition.”

He also states that “Having worked with thousands of people worldwide, we continue to achieve results that have forever changed the face of autism and other developmental disorders.”

However the Autism Treatment Center of America states that its programmes are not a guarantee for any one specific child.

Key Features

The Son-Rise program (also known as the Options Method) is normally delivered by parents and volunteers in the family home, once the parents have received training from the Autism Treatment Center of America. One adult at a time works with the autistic child, usually in a special playroom.

The playroom is designed to be calm, safe and distraction-free. This is because many autistic people find it difficult to concentrate if they are distracted by lights, sounds or other external stimuli.

The adult follows the child’s lead rather than superimposing their own ideas of what the child should do. This includes “joining” the child in his or her behaviour rather than trying to stop it. So, if the child is stacking blocks or flapping his hands, the adult does the same.

The aim is not simply to copy the activity but to build trust. By doing the same as the child, the adult shows the child that he or she is loved and accepted without judgment. It then becomes much easier to build a relationship. As the relationship develops the adult is able to use the child’s own motivation to teach him or her new skills based around his own interests.

The adult may have to learn to communicate with the child in a way that suits the child. For example, they may need to vary the pitch and level of their voice or restrict her language so that it is easier to understand. So they might say ‘Dinner?’ rather than ‘Do you want some dinner?’ They also need to make eye contact at every possible opportunity because it is felt that the more a child looks, the more he or she learns.

Although not part of the Son-Rise program, the Autism Treatment Center of America also suggests looking into complementary and alternative therapies such as auditory integration training, dietary interventions and sensory integration interventions.

Foundation

According to Kaufman (2005)

“The foundation of the program rests upon this idea: the children show us the way in, and then we show them the way out. In this way, we establish a mutual connection and relationship, which is the platform for all education and growth. Then, we can teach our children everything we want them to learn with exponentially greater success, speed, and ease” 

Cost and Time

Cost

The Autism Treatment Center of America (ATCA) provides a wide range of training courses. For example, the Start Up Program is a five day introductory course designed to give people the tools to design and implement their own home program and costs $2,200.

The ATCA sells a wide range of publications, DVDs and other materials.

It also provides information for families who may need financial assistance or help with fundraising.

Time

The Autism Treatment Center of America recommends that the Son-Rise program for autistic children should run at least 20 hours per week to start (40+ hours per week being optimal).

The Autism Treatment Center of America does not state how much parental, or professional or volunteer time is required to run the Son-Rise program for autistic children.

It does recommend that parents sign up for at least five days training in how to use the techniques. It also recommends that volunteers should be asked to work for at least four to eight hours a week

Risks and Safety

Hazards

There are no known adverse effects of the Son-Rise program as a treatment for autistic children. However the Program has been criticised by a number of people over a number of issues. For example

The study by Williams and Wishart (2003) reported “Overall, the findings suggest that involvement led to family drawbacks as well as benefits, with pressures on the parents’ time being the most frequent drawback, and increased happiness in families still using the SRP a year after training being more common when the child did not have intellectual disabilities in addition to a diagnosis on the autistic spectrum and when few financial difficulties were caused by running the programme. The fact that a significant number of families did experience some areas of difficulty emphasizes the importance of intervention providers focusing on the needs of the whole family rather than solely on the child with autism.”

The ABA Resources website, accessed on 27 July 2016, contains an article by someone called Autistic and Proud who has made a number of criticisms of the Son-Rise Programe from the perspective of someone who is autistic.  They wrote, for example, “The constant claims about the gentle and ‘accepting’ nature of Options obscure the fact that for many children, being trapped in a room all day with a constant succession of people trying to interact socially and ‘bond’ with them, and, for example, seize every opportunity to make eye contact, may in fact be highly aversive and stressful. It's supposed to be gentle but actually, looked at from an autistic point of view, seems very intrusive. All children, especially autistic children, need respect for their space and a chance to have solitude when they want it, not to be ‘working’ all the time. “

Contraindications

There are no known contraindications (something which makes a particular treatment or procedure potentially inadvisable) the Son-Rise program for autistic children.

 

Suppliers and Availability

Suppliers

The Son-Rise program for autistic children is available to anyone anywhere, although the Autism Treatment Center of America recommends that parents should receive training first. This training is available in the US, Europe and elsewhere

Credentials

There are no formal, internationally validated registered qualifications for people running the Son-Rise program for autistic children since any parent or carer can choose to do so.

However, the Autism Treatment Center of America does provide a variety of training courses for the staff who lead the parent courses.

Related Suppliers and Availability


History

The Son-Rise program was developed by Barry Neil Kaufman and Samahria Kaufman in the early 1980’s to treat autistic children.

They decided to develop their own home-based programme for their son Raun after finding nothing that was suitable.

Following the success of the book and film about their experiences, they set up the Autism Treatment Center of America, which now provides the Son-Rise program.

They also set up the Option Institute, a commercial organisation which provides personal growth training. This explains why the method is sometimes called the ‘Option method’.

Current Research

We have identified two efficacy studies of the Son-Rise program in peer-reviewed journals published in English. The published studies included a total of more than 50 autistic children aged between 3 and 7 years old.

  • The study by Houghton et al (2013) included a total of 6 children aged from 3 to 6 years old, all of whom were diagnosed with autism. It reported “Results showed an increase in the frequency of spontaneous social orienting and gestural communication for the experimental children, compared to six age- and behaviorally-matched control children with autism. In addition, for the children who received treatment, the duration of social dyadic interactions and total time spent engaged in social interaction increased from pre- to post-treatment.”
  • The study by Thompson C. K.  Jenkins T. (2016) included a total of 49 parents of children aged from 3 to 7, all of whom were diagnosed as having ASD. It reported “Parents who administered Son-Rise Program intervention reported improvements in communication, sociability, and sensory and cognitive awareness in their children, with greater gains associated with greater hours of treatment per week.”

We also identified three other research studies which looked at other aspects of the programme (but were not efficacy studies).

  • The study by Williams K. R. Wishart J. (2001) examined parent’s use of the Son-Rise Progam through a one-year longitudinal questionnaire and interview study. It reported that “Issues relating to school attendance were examined, including parents' decision-making processes regarding concurrent school attendance, issues of compatibility between home and school, and issues arising for those families who discontinued school attendance in order to run a full-time intervention at home. Rather than using the Program exclusively and intensively, it was found that many families used the recommended intervention techniques part-time in the home whilst continuing their child's school attendance, and found the two learning contexts to be compatible with each other.”
  • The study by Williams and Wishart (2003) included a total of 57 children, aged 2-12, from 56 families. It was a longitudinal study with questionnaires to all participants attending initial Son Rise training in UK with 3 questionnaires: after the training (Q1) at 6 months (Q2) and 12 months (Q3) later (63% response rate at Q1). Questions concerned: implementation of the intervention; effects on the family, including drawbacks, benefits, stress, levels of happiness, and financial effects; and perceived efficacy of the intervention.
  • The study by Williams (2006) …. reported on a different aspect (implementation of the intervention) of the same study. Data was gathered on: characteristics of children and families using the programme, intervention intensity, involvement of volunteers, ongoing training, concurrent school attendance, concurrent intervention use, and perceived treatment fidelity. 64% of parents reported intensity of up to 20 hours/ week and 58% of parents worked for up to10 hours personally in the intervention – significantly fewer hours than they had initially hoped for. The majority of children (80%) continued to attend school on either a full- or part-time basis, and 59% of children were involved in other interventions at the same time.

We have also identified one study of the Picture Exchange Communication System which the authors claimed to be based on the principles of the Son-Rise Program (Zink et al, epub) but we have not included this in our analysis as we do not think that this provides an accurate evaluation of the Son-Rise Program.

Status Research

There are a number of limitations to the studies published to date. For example

The study by Houghton et al (2013)

  • Had a small number of participants (12 in total, with only 6 participants receiving the Son-Rise program).
  • Used an active treatment which lasted only 5 days while the control group did not receive the same number of hours of intervention.
  • Relied on delivery of the Program by Son-Rise therapists (rather than by the parents of the children) and took place at the Autism Treatment Center of America (rather than in the homes of the parents of the children).
  • Selected the experimental group children and the control group children from family members of autistic children who had already completed a Son-Rise Program parent-training course
  • Used a controlled group but the participants were not randomised and the participants and therapists were not blinded to the intervention being provided.
  • Did not measure the long term effects of the Program including any impact on the emotional well being of the children or the impact on the whole family

The study by Thompson C. K.  Jenkins T. (2016)       

  • Used a basic pre-post test design in which participants were compared to each other after the intervention took place
  • Relied on parents’ subjective assessments of their child’s progress rather than more objective measurements administered by an independent evaluator
  • Did not used standard assessment measures of the children’s cognition, communication, and other abilities before or after the Program was delivered.
  • Did not provide an independent assessment of how well the parents kept to the Program or how many hours of the Program they actually delivered
  • Did not measure the long term effects of the Program including any impact on the emotional well being of the children or the impact on the whole family

For a comprehensive list of potential flaws in research studies, please see ‘Why some autism research studies are flawed

Future Research

Summary of Existing Research

There is almost no research (one very small controlled study) to suggest that the Son-Rise Program is an effective intervention for autistic children and young people.

This lack of evidence does not prove or disprove the effectiveness of the Son-Rise program for autistic children. It may simply show that no research has been conducted to date.

We believe that some elements of the approach (such as the emphasis on following the child’s own interests, joint attention and reciprocal interaction with parents) may be beneficial to some autistic children and young people.

There are numerous positive anecdotal reports from people who have used the Son-Rise program for autistic children.

Recommendations for Future Research

Future research should

  • be considerably more robust in terms of numbers and methodology used
  • compare the Son-Rise program with other educational interventions which are commonly used to help autistic children and young people
  • investigate whether the program is likely to be more effective for specific groups on the autism spectrum (such as female children or children with a verbal IQ of less than 70 or children from a minority ethnic group)
  • investigate which, if any, of the components of the program are more effective  than the others (such as following the child’s lead versus a distraction free environment)
  • investigate whether the program is more effective when delivered by parents or therapists or both
  • investigate whether the program provides any long term benefits in real world settings (such as in the children’s own home)
  • investigate treatment fidelity (how closely the therapists did what they were supposed to do)
  • investigate the effects on family life and the emotional development of the children

Studies and Trials

This section provides details of scientific studies into the effectiveness of the Son-Rise program as an intervention for autistic children which have been published in English-language, peer-reviewed journals.

If you know of any other publications we should list on this page please email info@informationautism.org

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Related Studies and Trials


Other Reading

This section provides details of other publications on this topic.

You can find more publications on this topic in our publications database.

If you know of any other publications we should list on this page please email info@informationautism.org

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Related Other Reading


Personal Accounts

This section provides personal accounts of the Son-Rise program for autistic people.

Personal accounts can be useful sources of information about the intervention but are not as scientifically valid or reliable as research trials. This may be especially true where the accounts are published by an organisation which might gain a financial advantage from the take-up of the intervention.

Please note that the views expressed in these personal accounts do not necessarily represent our views. 


There are numerous positive anecdotal reports from people who used the Son-Rise program for autistic children. The anecdotal reports come from a range of people, including professionals and carers.

The Autism Treatment Center of America website and Growing Minds website contain a number of personal accounts of using the Son-Rise program.

Other published accounts include

  • Adams, A. (1993) Coaxed away from a shut – away existence. The Independent 28th September 1993
  • Gaunt, M. and Howard Taylor G. (1997) QED: Challenging Children: I want my little boy back. This BBC television programme followed the Broadrick family to the Options Institute to see the help they got for the son.
  • Roberts, Y. (1996) John’s Story. Daily Express 13th April 1996
  • Shakeshaft, L. (1998) They said our son was autistic and that was that. Daily Mail February 10th 1998.

Additional Information

According to Ron Kaufman

'The foundation of the program rests upon this idea: the children show us the way in, and then we show them the way out. In this way, we establish a mutual connection and relationship, which is the platform for all education and growth. Then, we can teach our children everything we want them to learn with exponentially greater success, speed, and ease' (Raun Kaufman, 2005.)

The Options Institute states that there are five underlying principles behind the “Son-Rise program for children with autism.

  • The importance of a loving and accepting attitude
  • The gift of a special child
  • The parents are the child's best resource
  • The question of hope and false hope
  • The child as teacher

Related Additional Information


Updated
16 Jun 2022
Last Review
01 Oct 2016
Next Review
01 Mar 2023