There are no evaluations of this sort of treatment, and despite the very encouraging claims parents should be very cautious before spending their money in this way. Certainly some children do seem to relate well to animals and exposure of this kind can be helpful as part of a wider therapeutic/educational programme. However, swimming with dolphins cannot cure autism even though that experience may be very helpful. I have also had experience of some children who have become very frightened in such circumstances, and for whom the experience has not been a good one at all. On one or two occasions, too, I have known of children who have attacked the animals involved. One patient of mine, for example, was sent back home after trying to bite the dolphin.

Unfortunately it is not possible to give answers to questions about ways of dealing with specific behavioural problems without knowing much more about the individual concerned. Obstinate behaviour, for example, could be due to the fact that the child is being requested to take part in activities that are inappropriate given his or her level of skills or intelligence or general interests. It could be due to the fact that he or she is very set in their ways, in which case attempting to reduce ritualistic behaviours might be an appropriate way to proceed. The crucial issue is to find out why the child is responding in this way and to attempt to deal with the underlying factors causing this behaviour.

It is not possible to give a conclusive answer to this question, as twins with autism can be very similar or very different. They may get along together very well, or they may fight constantly. Whether intervention is carried out together or separately would depend on very many factors. However, on the whole, interventions that suit the whole family and take into account the needs of all concerned tend to work better than interventions focused on an individual child.

As with all the other questions posed making firm recommendations about how an individual with autism should be treated, or where they should be placed, is not possible since appropriate advice will depend very much on that particular individual’s profile of skills and difficulties. It is also very important to take into account an individual likes and dislikes as well as personality. Some individuals would hate living in an isolated farming community, others could be very distressed living in a small apartment in a city. However most individuals with autism do seem to like their own personal space, and freedom to get away from other people if the need arises. Thus, residential settings that can offer a reasonable amount of space do seem to work more effectively than centres in which movement is much more restricted, and people cannot easily be by themselves. Nevertheless this does not necessarily mean living in isolation. Access to as wide a range of “normal” activities as possible is clearly important for the majority of individuals with autism and the best environments seem to be those that offer as much integration as possible with the local community (access to work and to leisure facilities etc) whilst at the same time offering individuals with autism the space and privacy they may need.

Many people come to me with the case of their child, saying "S/he is 5 years old and is autistic, what must I do?" and I answer "I don't know", in the sense that it is impossible to give information that fits every case. There is no one treatment that is right for everyone, the important thing is to follow an individualised educational programme, appropriate for that particular person.
Dr. Remschmidt, the Chairman, adds: no one method exists, although the effectiveness of cognitive-behavioural based educational treatments has been proven in recent research, no data exists to demonstrate the effectiveness of other methods. This points to the need to research a valid treatment.

It is difficult to talk about a child with autism “being cured”. Autism is a congenital disorder (children are typically born with it). Their disability means that their interaction with the social world is very different from the experiences of typically developing children. Our brains develop, to some extent, as a repository of these experiences. It is, therefore, very unlikely that one could “undo” this development. Reports of “cures” of children with autism are typically not corroborated, and they usually refer to individuals who have made a great deal of progress. And yet, these individuals continue to have many significant challenges in life. However, having said that “cures” are unlikely in autism does not mean that individuals with this condition cannot make great progress. In fact, the vast majority of serious treatments aim at maximising the potential of the child and making him or her more competent in their daily lives. And indeed, over many years, we have seen many individuals making wonderful progress, whereas others are less fortunate. At the Yale Child Study Center we have accompanied many individuals with autism who have completed advanced degrees, and some of them can, and do work independently and live independently. With this in mind, no treatment has shown results consistent with cure, if by that one means that a child previously with autism ceased to have problems in social and communication functioning as a result of a given treatment, becoming indistinguishable from typically developing children.

It is difficult for me to know what you mean by severe autism, but I can take a guess. Individuals who are very socially isolated and unmotivated, that have little communicative ability (and language), are likely to also display a significant level of intellectual disability, at least in the verbal domain. Some individuals may have severe challenges (in social interaction, language and communication, behavioural stereotypies, etc.) and have rather higher non-verbal intelligence. Although the rule, if one may generalise, is that the more mentally retarded is an individual, the more likely that the person does not talk, that he/she may have some medical findings (e.g., the presence of seizures), and that he/she may display stereotypies such as repetitive motor movements and extreme rigidities (e.g., resisting the slightest changes in their environment).