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Treatment-Guided Research Initiative (TGRI)
For decades, science has viewed autism as a neurological disorder that occurs during the prenatal stage effectively causing functional brain damage.1 Recently, the scientific community has shifted away from viewing autism as simply a brain disorder, but instead as a medical disorder that affects the entire body.2 The accounts of individuals with ASD experiencing seizures, sleeping disorders, hormonal imbalances, gastrointestinal complications, infections, and allergies has “lead many scientists to call for a national policy initiative in which biomedical and behavioral sciences are integrated so that synergy between them results in more effective approaches to ASD and related disorders.”1 The goal of the Treatment-Guided Research Initiative (TGRI) is to turn treatment experience into science, instead of waiting for science to eventually result in treatments.3
By bringing research and treatment together science can potentially eliminate the medical factors, such as gastrointestinal dysfunction and sleep disorders, which can interfere with behavioral therapies. For example, individuals on the autism spectrum experiencing painful gastrointestinal problems are likely not going to be receptive to ABA therapies.4 By focusing on, and eliminating, these biomedical factors, we can strengthen the impact of behavioral and educational approaches.
Another function of the TGRI is to change the way science conducts research on autism. Science must not lump individuals with autism together, but focus on the individual to discover what treatments benefits certain subgroups, and why those treatments provide positive results for that particular subgroup.4 The current system of conducting a clinical trial by grouping random individuals with varying forms of autism spectrum disorder does not yield beneficial results for the entire population of individuals with ASD. Some treatments are designed to target specific defects that may not occur in every person with ASD. TGRI goes hand in hand with a single-subject research design (SSRD), in which a single individual is monitored and different treatment methods can be evaluated.1 Due to the diversity of the ASD population SSRD methodology can lay a foundation for treating individuals on the autism spectrum with similar biomedical conditions.
Many parents have reported positive changes in social behavior, communicative behavior, and academic performance as a result of alleviating specific physical symptoms of ASD. For additional information please visit the links below:
- Integrating Behavioral and Biomedical Approaches: A Marriage Made in Heaven by Edward Carr, Ph. D., and Martha Herbert, M.D., Ph.D.
- Treatment-Guided Research: Helping People Now with Humility, Respect and Boldness by Martha R. Herbert, M.D., Ph.D.
- The Future of Applied Behavior Analysis in Autism Spectrum Disorders by Edward G. Carr, Ph. D, BCBA, Doreen Granpeesheh, Ph.D., BCBA, and Lee Grossman, BA
- Functional Medicine: The Way to Treat Autism Now by Jeffery Bland, Ph.D.
- Priority Setting in Health Research: Tradeoffs and Consequences by Kenneth Olden, Ph.D., SC.D., LH.D., and Rosemarie Ramos, Ph.D., M.P.H.