Assessment & Research

Placebo-like response in absence of treatment in children with Autism.

Jones et al. (2017) · Autism research : official journal of the International Society for Autism Research 2017
★ The Verdict

Caregiver forms can show big "improvement" even when no therapy is given, so verify change with direct data.

✓ Read this if BCBAs who rely on parent checklists to judge progress.
✗ Skip if Clinicians already using daily direct measures and blind probes.

01Research in Context

01

What this study did

The team tracked kids with autism for eight weeks. No therapy was given. Parents filled out the ABC and SRS forms at the start and again at the end.

The goal was to see how much "improvement" shows up when nothing is done.

02

What they found

Parents marked big gains on both checklists. The kids had not received any treatment. The jump is called a placebo-like effect.

Expect about 30% caregiver-reported "improvement" before real services begin.

03

How this fits with other research

Minshawi et al. (2016) ran a real drug trial. D-cycloserine plus social training did no better than placebo on the same SRS. Their null result backs the warning that parent scores can rise on their own.

Parrella et al. (2026) tested CBD oil. The SRS stayed flat, yet parents still noted small gains in anxiety and stress. This apparent contradiction matches the current study: caregiver mood, not the drug, may drive the better ratings.

Gallagher et al. (2012) tried hyperbaric oxygen in a no-control design. Modest parent-clinician gains appeared after eight weeks, echoing the placebo curve seen here.

04

Why it matters

Before you credit an intervention, collect your own data. Use direct observation or video. Compare baseline to post scores blind to phase. If parents report quick large change, probe for expectancy first. This guards you from chasing ghost gains and keeps treatment decisions honest.

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Film a 5-minute probe this week and score it without looking at parent forms.

02At a glance

Intervention
not applicable
Design
pre post no control
Sample size
20
Population
autism spectrum disorder
Finding
null

03Original abstract

Caregiver report is the most common measure of change in pediatric psychiatry. Yet, placebo response rates pose significant challenges to reliably detect a treatment response. The present study simulated an eight-week clinical trial protocol for Autism Spectrum Disorder (ASD) for the purpose of testing the feasibility and validity of several outcome measures. Twenty caregivers answered questions about their child's behavior on their smartphone each week and completed a battery of paper questionnaires during weeks one and eight. No treatment was administered. Caregivers reported a significant decrease in problem behaviors on the Aberrant Behavior Checklist (ABC) (29% decrease) and general ASD behaviors on the Social Responsiveness Scale (SRS) (7% decrease). There was also a trend of behavior improvement from smartphone questions but no significant changes in clinical ratings of core diagnostic features of ASD. Participation in a comprehensive protocol in the absence of a particular treatment significantly influenced how caregivers perceived the severity of their children's problem behaviors. These placebo-like effects represent substantial challenges for randomized controlled trials (RCTs) that use treatment as usual and have implications for future behavioral and pharmacological treatment trial designs. Autism Res 2017, 10: 1567-1572. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Autism research : official journal of the International Society for Autism Research, 2017 · doi:10.1002/aur.1798