In medicine, claiming the ability to perform “miracles” can understandably raise some hackles. Generally, medical professionals prefer to leave the supposed miracle-working to the likes of Dr. Oz and stick with empirically supported interventions, thank you very much. But “miracles” is exactly the word Kent, UK parents Mark and Annie Montague use to describe what they have experienced while attempting to socialize their severely autistic twin sons, Samuel and Jacob. A recent BBC feature documented how the family has found an apparent solution to their intense struggles with the twins’ non-responsive and often destructive behavior—including running away from home multiple times—in a form of social skills intervention called the Son-Rise program. Since they began participating in the immersive program—Mark and Annie went so far as to construct isolated indoor environments in which the boys could undergo their therapy—Samuel and Jacob have begun making eye contact, communicating effectively, and being less destructive.
With autism rates on the rise and in the news, the Montagues’ case may seem like a sign of hope for other families going through similar trials. However, before we begin proclaiming that a miracle cure has been found—or even that autism requires a cure in the first place—we should first examine the Son-Rise program with a healthy dose of scientific skepticism.
What is the Son-Rise program?
The Son-Rise program isn’t new – in fact, it dates back to the mid-‘70s, when Barry Neil Kaufman published his book Son-Rise, which documented he and his wife Samantha’s self-directed methods of treating their autistic son, Raun. In a nutshell, the program prescribes parents and/or therapists joining the autistic child in an isolated, low-stimulation playroom and, rather than coercively teaching the child socially typical behaviors, mimicking and joining in the child’s natural behaviors. This fosters trust and allows the adults to gradually and gently introduce new skills and encourage social interaction. In effect, the child is in control of his or her own therapy.
Does it work?
Anecdotally, the Son-Rise program has undoubtedly been a godsend to many families. The Montagues are one example. The Kaufmans would obviously seem to be another, but they are plagued by some controversy. Although they make seemingly fantastic claims about the extent of Raun’s recovery (they “transformed Raun from a mute, withdrawn child with an I.Q. of less than 30, into a highly verbal, socially interactive boy with a near-genius I.Q.,” according to Barry Neil Kaufman’s website), at least one researcher has questioned whether or not Raun—now a Brown University-educated author and lecturer—was ever autistic in the first place.
The reality is that what little scientific study has taken place seeking to measure the Son-Rise program’s efficacy has been inconclusive at best. One of the only peer-reviewed articles to date focused solely on the Son-Rise program documented positive developments for the children studied, but warned that the sample sizes used were not representative enough to be generalizable to the autistic population as a whole. Another study found that “the programme [sic] is not always implemented as it is typically described in the literature,” making it difficult to assess whether the benefits families have experienced can be fully attributed to the program itself.
Ultimately, the current scientific consensus remains clear: autism is a lifelong condition, and few social skills interventions, the Son-Rise program included, have been conclusively proven to mitigate symptoms, much less be considered a “cure.” That could change with further study, but for now, let’s hold off on the “miracle” talk.
What does it mean for my patients?
While it’s understandable if the lack of empirical backup stops you short of recommending that your patients adopt the Son-Rise program wholesale, there are elements of it that could apply to almost every family with autistic kids. First, it encourages, if not mandates, parents to be heavily involved in their kids’ therapy and their lives in general. While that isn’t the answer for every family—some need more robust support and intervention from medical professionals than others—it’s a positive goal to aspire to.
Furthermore, the key principle underlying the Son-Rise program is that autistic children should be met on their terms rather than being pressured to operate by others’. Whether the mirroring techniques used in the program constitute a foolproof form of therapy or not, applying that principle more generally helps erase stigmas and encourages autistic kids to feel more comfortable in their own skin.