A recent study in the U.S. has sparked significant debate regarding the notion that severe autism can be “reversed,” contradicting the misleading headlines circulated on social media that proclaim it a “miracle.” The findings are based on a case report involving two young girls, which experts have deemed anecdotal and reliant on “questionable” methods. They argue that the results only indicate that the girls learned new behaviors that may have masked or reduced some symptoms, rather than indicating a true reversal of their condition.

Social media platforms have seen a flurry of posts claiming, “Autism can be reversed, scientists discover,” and, “’Miracle’ trial claims severe autism can be reversed.” One post on X garnered over 28,000 views, showcasing the significant impact of such headlines.

The study was published in the Journal of Personalized Medicine as part of a special issue focused on treating potential environmental contributors to autism. It followed the development of non-identical twin girls diagnosed with severe autism around 20 months of age. However, it is essential to note that this was a case study rather than a clinical trial, limiting its generalizability and scientific rigor.

The authors reported a range of interventions employed by clinicians and the girls’ parents, which included dietary changes, speech therapy, and applied behavior analysis. They noted improvements in some behavioral categories as assessed by the Autism Treatment Evaluation Checklist (ATEC), a tool used to evaluate the effectiveness of autism treatments. However, experts contend that inferring autism can be reversed from these findings is misleading. A reduction in symptoms within one category does not equate to a complete reversal of the condition or the autism diagnosis itself. Additionally, using only two individuals in the study is insufficient to draw any broad conclusions.

Experts also pointed out inconsistencies in the study’s methodology and raised questions about its conclusions. Jonathan Green, a professor of child and adolescent psychiatry from the University of Manchester, explained, “The study takes a biomedical approach which looks at the impact of factors such as nutrition and environment on autism.” He further stated, “There are some questionable things in the study’s introduction about how much autism is due to the environment and how much is heritable.”

The report indicated that the girls were assessed using the Autism Diagnostic Observation Schedule (ADOS), a standardized test for autism spectrum disorder, but it did not disclose their actual scores. One of these assessments occurred during the COVID-19 pandemic, which Green noted could have led to unreliable results due to the unusual circumstances. “It does mean you can’t score the ADOS up very well,” he remarked. “You can get some, you know, unusual effects, basically because the kid is looking at people with masks on. They can react in slightly unusual ways.”

According to the study, the girls showed substantial improvements, with ATEC scores decreasing from 76 to 32 for one twin and from 43 to 4 for the other. However, Luke Beardon, a senior lecturer in autism at Sheffield Hallam University, emphasized that the ATEC checklist is subjective and only measures changes in behavior, not a decrease in autism itself. “For example, one of the questions it asks is, does a child play with toys appropriately?” he explained. “If at a behavioral level you say, ‘Okay, well, this child is utilising these toys, not in a way they were intended for the mainstream population, and we’re going to behaviourally teach them how to play with them,’ and they change their behavior, that doesn’t make them any less autistic. You’ve just taught them to behave in a different way.”

Several experts drafted a letter to the Daily Telegraph critiquing the study. They stated that extensive intervention in early life could lead to changes impacting how children score on behavioral or diagnostic tests. However, they reiterated that this anecdotal case study cannot demonstrate whether “autism can be reversed.” They described the study as methodologically weak and insufficiently rigorous in data collection and follow-up, noting, “An anecdote from parents noticing some changes in their two children does not constitute scientific evidence.”

Research has shown that autism presentations can evolve over time, with symptoms often becoming less severe as individuals age. A 2020 study found that nearly 30% of participants exhibited a decrease in autism symptoms from ages three to six. Nevertheless, the notion that autism disappears entirely and that someone is no longer autistic contradicts our understanding of the condition.

Christopher D’Adamo, an assistant professor at the University of Maryland School of Medicine and a co-author of the case study, highlighted that other studies have indicated certain interventions can improve autism symptoms. He stated that their paper adhered to reporting guidelines for case reports. D’Adamo added, “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.”

Despite the arguments presented by the authors, Tim Nicholls, assistant director of policy, research, and strategy at the National Autistic Society, expressed confusion over the media coverage of the study. He stated, “This is a case study of a single set of twins using interventions that are themselves questionable. There are absolutely no conclusions at all that can be drawn from this, and to suggest otherwise is just irresponsible journalism.”

While the case study may have reported some behavioral improvements, it fails to substantiate the claim that autism can be “reversed.” The study’s limitations and the complexity of autism underscore the need for cautious interpretation of such findings.