A look at “Novel therapeutics in autism spectrum disorder” by Sara Daniella Kevelson, Rana Elmaghraby, Fenil Patel, Hallie Brown, Michelle Gorenstein, Jennifer Bain, Zachary Michael Grinspan, Ernie Pedapati, Jeremy Veenstra-VanderWeele and Pankhuree Vandana (2026)
Every few months a headline promises an autism breakthrough: a hormone spray, a brain-stimulating headset, a friendly robot. So what’s genuinely promising, and what’s still more fairy tale than field-tested? This sweeping review by a team of US clinicians and researchers takes a tour through five areas of research.
What they found
Talking and behavioural therapies are still considered the first port of call, and they’re changing. There’s a shift away from rigid, old-school ABA towards more naturalistic, child-led approaches, plus a growing (if still small) evidence base for adapted CBT, DBT and mindfulness for anxiety, depression and suicidal thoughts. Groups built around shared interests, from LEGO to tabletop role-playing games, are showing early promise for genuine connection rather than “fixing” social skills.
Medication has been slow going. No new medicines have been approved for autism in the US since 2006, and nothing is approved for autism itself, only for related difficulties such as irritability. Some much-hyped candidates have disappointed in larger trials. A 290-child study of oxytocin nasal spray found no difference from placebo, and a meta-analysis of bumetanide trials found no lasting benefit. Placebo responses in autism trials run as high as 20–30%, which makes it hard to tell what works.
Digital tools (apps, robots, virtual reality) show modest, focused benefits, but tech glitches affect up to 30% of sessions, and robots can cost over $15,000.
Brain stimulation such as TMS has a role for depression in autistic people, using the same protocols as for anyone else. Using it to change autistic traits remains experimental.
Gene-based therapies are progressing for specific genetic conditions linked to autism, such as Fragile X and Rett syndrome, but are in their earliest days.
The common thread is that autism is so varied that averages hide individuals. What helps one person may do nothing for the next.
A grain of glitter ✨
This is a thorough and generally even-handed review. It acknowledges criticism of ABA from autistic people, explains its choice of language, and repeatedly flags small samples and missing control groups.
But it’s still a narrative review, so the authors chose the studies. It’s also very US-centred, with frequent reference to FDA approvals and American insurance codes. Much of the medical research still aims at “core symptoms”, which sits awkwardly with a neurodiversity-affirming view that autistic traits aren’t something to be treated away. The genuinely useful targets for many autistic people (anxiety, depression, trauma, sleep) get less space than the shiny frontiers.
A curious footnote: the authors declare they used AI tools, including Claude, to help with the literature review and data extraction. That’s refreshingly transparent, but it’s one more reason to read the conclusions with an appraising eye.
Why this matters
If you’re autistic, or supporting someone who is, it’s easy to feel pressure to chase every new development. This review is a calm reminder that most “breakthroughs” are still in the testing stable. Right now, the strongest evidence is for support that’s adapted to you: therapy that fits how your brain works, and help with the things that actually make life harder.
The unicorn’s verdict: exciting horizons, but don’t trade in your trusty steed just yet.