Autism-pedia / Therapies and treatments / Therapies and treatmentsbrianspringer.com
Therapies and treatments

Therapies and treatments

An overview of what is offered as treatment for autism, written for the adult asking what was done to them or what is offered to their relative: how to read intervention research, behavioral therapy, unproven treatments, talking therapies, psychiatric medication, the developmental and naturalistic approaches, speech, language and occupational therapy, social skills training, and psychedelics and cannabis. Each section links to a full entry.

A tour of what is offered as treatment for autism. How to tell a strong study from a weak one, behavioral therapy, treatments that do not work, talking therapies, psychiatric medicines, the early childhood programs, speech and occupational therapy, social skills classes, and cannabis and psychedelics. Each part links to a longer page.

Last reviewed 12 October 2026 · one person's reading of the research · 56 sources

How to read intervention research Established

Most treatment research in autism is about children, and much of it is not randomized. Project AIM, an updated systematic review and meta-analysis of non-drug interventions for autistic children under 8, pooled 289 reports of 252 studies covering 13,304 participants and 3,291 measured outcomes.1 When its authors restricted the contributing effects to randomized trials, the picture narrowed: behavioral interventions still showed a moderate effect on social-emotional or challenging-behavior outcomes (Hedges' g = 0.58, 95% confidence interval 0.11 to 1.06), while developmental and naturalistic developmental behavioral interventions showed small effects on social communication, adaptive behavior, language and play (g = 0.16 to 0.35). The authors report that adverse events were "poorly monitored, but possibly common".1 What a treatment looks like it does depends on which studies you count, and the studies that did not randomize people flatter it.

What a trial is compared with sets the size of its result. Most trials of talking therapy for autistic adults compare the therapy with a waiting list or with usual care, and a waiting list is not a treatment: a 2026 meta-analysis of 35 studies of interventions for autistic adults, 1,631 people in all, found a small to moderate benefit for mental-health outcomes across the 16 studies that measured them, against those comparisons.2 Outcomes in routine services look smaller again. In English national health records for 8,761 autistic adults who completed a course of psychological therapy, autistic people were less likely than matched non-autistic people to improve reliably (56.1% against 61.7%) and more likely to get reliably worse (9.2% against 7.2%).3

Who is selling it matters as much as what it found. In one audit of a single year of autism intervention research in eight applied behavior analysis journals, 119 studies and 450 authors, 78% of authors had a clinical or consultancy interest in the treatment, and 93% of the statements claiming no conflict were false.4 That is not an argument about whether a treatment works. It is the reason to check who ran the study before reading what it found.

Who benefits, and from what. A meta-regression of 1,911 effect sizes from 202 independent samples found that a child's language and cognitive scores at entry did not significantly predict how much they improved, by outcome area, across intervention types.5 An average effect hides who it came from, so "the studies show" is not the same as "this will work for you".

What was measured, and what nobody measured. Outcomes are often rated by the person delivering the treatment or by a parent rather than by the autistic person, and follow-up is often short. Harms are the thinnest part of the record: in one network meta-analysis of 71 randomized trials, only 9 reported how many people had an adverse event.6 When autistic adults are asked to rate intervention goals, they put safety, well-being, adult support and reducing harmful behavior above reducing autistic traits such as stimming and eye contact, and the studies that asked agree on that.7

Absence is a finding too. "No trial has tested this in autistic people" is a claim, and it goes stale, which is why this pedia dates such claims and gives the month they were last checked.

Most treatment research in autism is about children. Much of it does not put people into groups by chance. A big review called Project AIM looked at 252 studies of non-drug treatments for autistic children under 8, covering 13,304 people. When its authors counted only the studies that put children into groups by chance, the effects got smaller.1 The authors also said that side effects were "poorly monitored, but possibly common".1

What a treatment is compared with matters too. Most studies of talking therapy for autistic adults compare it with a waiting list or with usual care. A waiting list is not a treatment. A 2026 review of 35 studies found a small to moderate gain against those comparisons.2 Real services look less bright. In English health records for 8,761 autistic adults, autistic people were a little less likely to improve and a little more likely to get worse than other adults.3

It also matters who ran the study. In eight journals about one therapy, applied behavior analysis, most authors earned money from giving that therapy. Of the studies that said their authors had no conflict, 93 in 100 were wrong.4

Big averages can hide who improved. In one analysis of 1,911 results, a child's language and thinking scores at the start did not predict how much they got better.5 And side effects are the thinnest part of the record: in one review of 71 trials, only 9 said how many people had one.6 When autistic adults are asked what treatments should aim for, they put safety, well-being and support above changing autistic traits like stimming.7

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Established

A method section: how to judge a study of a treatment, and why each thing changes what its result means. It carries no claim about whether any particular treatment works.

Established

This part is about how to judge a study of a treatment. It does not say whether any treatment works.

ABA and behavioral therapy Established

Applied behavior analysis is the most widely used early support for autistic children in the United States, and the one health insurance most often pays for. Two 2026 syntheses by researchers in the behavior-analytic and early-intervention field report large gains, and both say the studies behind them carry a serious risk of bias because children were not assigned to groups at random.8,9 Almost all of the research is in children under 8 and over short periods. A 10-year follow-up of a community-based program found no lasting advantage once baseline IQ was controlled,10 and an analysis of 144 studies found no relationship between any measure of how much intervention a child received and how they did, undercutting the basis for recommending 20 to 40 hours a week.11 Some autistic adults who had behavioral intervention as children report lasting distress. The largest study of this used insurance records and matched 17,120 autistic young people who had an ABA record with 17,120 who did not, finding 30% higher odds of a mental health hospitalization; that is an association, not a cause, and the study found no link between how much ABA a child received and PTSD or suicidality.12 The one finding the entry labels established is about the field's own records: in the same eight ABA journals, 93% of studies had at least one author with a clinical or consultancy interest in the treatment, and 93% of the statements claiming no conflict were false.4

Full entryABA and behavioral therapy Applied behavior analysis is the most widely used early autism intervention in the United States. Where it came from, what the research does and does not show, the harms people report, and the disclosure problem in its journals.

Applied behavior analysis, or ABA, is the support most often offered to autistic children in the United States, and the one insurance most often pays for. Two reviews from 2026 report big gains, and both say the studies behind them are weak because children were not put into groups by chance.8,9 Almost all the research is in children under 8, over short times. A 10-year follow-up found no lasting advantage once the children's starting IQ was accounted for.10 One analysis of 144 studies found no link between how many hours of therapy a child got and how they did.11 Some autistic adults say the therapy as children stayed with them badly. The biggest study used insurance records: young people who had ABA were 30% more likely to go to hospital for mental health. That is a link, not a cause.12 The one settled finding is about the journals: nearly all the studies had an author who also earned money from ABA, and nearly all the statements saying they did not were false.4

Full entryABA and behavioral therapy What applied behavior analysis (ABA) is, where it came from, what the research shows, and why autistic people disagree about it.
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Established

Summarizes ABA and behavioral therapy. Widely used, mostly studied in young children, and resting on studies that did not assign children to groups at random. The entry labels the benefit evidence emerging, the harms evidence at the hypothesis-to-emerging boundary, and the conflict-of-interest findings established.

Established

This is a summary. The full page says the benefit evidence is still early, the harm evidence is at the edge of early, and only the conflict-of-interest findings are settled.

Unproven treatments and how to spot them Established

One of these treatments has killed a child: a five-year-old autistic boy died during his third chelation treatment, after the office used a form of the drug that has not been recommended for children since 1991.13 Of 53 poison-center exposures to chlorine dioxide sold as "Miracle Mineral Solution", recorded in the United States between 2000 and March 2020, about a quarter of the people exposed needed hospital care.14 Other treatments fail on benefit rather than on safety. A Cochrane review of 16 studies found no evidence that secretin works,15 a meta-analysis of six randomized trials found no effect of a gluten-free, casein-free diet on core autism symptoms while noting it might cause gastrointestinal side effects,16 and the first double-blind trial of fecal microbiota transplant, in 103 children, found no significant difference between the transplant and placebo groups on its main outcome.17 Brain stimulation has drawn a large volume of recent trials, and its own 2026 meta-analysis of 53 randomized trials rated the certainty of the evidence low to very low.18 The entry also carries the leucovorin episode of 2025 and 2026, whose claims are checked in Contested causes.

Full entryUnproven treatments and how to spot them The treatments sold for autism that research has disproved or left unproven, from secretin and chelation to special diets, brain stimulation and leucovorin, and the warning signs that mark them out.

Some treatments sold for autism have hurt people. A five-year-old autistic boy died during a treatment called chelation, when the office used the wrong form of the drug.13 A bleach product sold as "Miracle Mineral Solution" poisoned 53 people in the United States between 2000 and March 2020, and about a quarter needed hospital care.14 Other treatments simply do not work. A review of 16 studies found no sign that secretin helps.15 A review of six trials found that a gluten-free, casein-free diet does not change core autism traits, and might upset the stomach.16 The first good test of a gut-bacteria treatment, in 103 children, found no difference from a pretend treatment.17 Brain stimulation is studied a lot, and its own review of 53 trials said the proof is weak.18

Full entryUnproven treatments and how to spot them Some treatments sold for autism do not work or are unproven, and some can hurt. This is what the research shows, and how to spot a bad treatment.
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Established

Summarizes Unproven treatments and how to spot them. Chelation and bleach are documented as harmful, one from a fatal case report and one from poison-center records. The rest are disproved or left unproven rather than proven harmless.

Established

This is a summary. Some of these treatments are known to harm. The others are disproved or unproven.

Talking therapies adapted for autistic adults Emerging

On average, the therapies that have been studied help autistic adults a little: a 2026 meta-analysis of 35 studies, 1,631 people in all, found a small to moderate benefit for mental-health outcomes across the 16 studies that measured them.2 The treatments on offer are narrow, because most reuse an existing cognitive behavioral therapy or mindfulness protocol, and only about 14% of the outcome measures used have been validated with autistic people.29 A 2025 network meta-analysis of 67 randomized trials, whose participants ranged from children to adults and averaged about 18 years old, ranked mindfulness-based programs highest for anxiety, cognitive behavioral therapy for depression and physical activity for quality of life, though its rankings estimate which treatment is likely among the best rather than proving it beats the others.19 One therapy has been tested specifically in suicidal autistic adults, and it is the strongest adult evidence in the field: in a Dutch trial of 123 adults, dialectical behavior therapy reduced suicidal thoughts and suicide attempts more than usual care by the end of treatment, though both differences had faded to chance by 12 months.20 Trauma treatment is the biggest gap: a 2026 review, searching the literature to 2022, found only four studies of PTSD treatment in autistic people, three of them about a single person, and no randomized trial of trauma-focused therapy in autistic adults was found as of October 2026.21 The commonest barrier autistic adults report is the therapist, most often a lack of knowledge about autism.22

Full entryTalking therapies adapted for autistic adults What the pooled evidence says about therapies for autistic adults, how the treatments that have been tested compare, why trauma treatment is barely studied in this group, and what adaptations the studies describe.

Talking therapy helps autistic adults a little, on average. A 2026 review of 35 studies found a small to moderate gain.2 Most programs reuse the same two kinds of therapy instead of making new ones, and few of the ways they check progress were designed for autistic people.29 A review of 67 trials found that mindfulness helped most with worry, and CBT most with low mood. That review mixed children and adults together.19 One therapy has been tested in suicidal autistic adults, and it is the best adult evidence there is: in a Dutch trial of 123 adults, it lowered suicidal thoughts more than usual care at first, but the difference had gone by a year.20 Trauma treatment is the biggest gap. A 2026 review found only four studies of PTSD treatment in autistic people, and no one has properly tested a trauma therapy in autistic adults.21 The problem autistic adults mention most is the therapist knowing too little about autism.22

Full entryTalking therapies adapted for autistic adults Some therapies help autistic adults, but the studies are often small. Trauma treatment has barely been tested in autistic adults.
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Emerging

Summarizes Talking therapies adapted for autistic adults. One pooled estimate and a set of mostly small trials, most of them compared with a waiting list or with usual care.

Emerging

This is a summary. One pooled result and many small studies, most compared with a waiting list.

Psychiatric medication in autistic adults Established

Autistic adults are given psychiatric medication far more often than other adults. In UK primary care records covering 1997 to 2023, 30% of autistic adults and 14.7% of non-autistic adults had been prescribed an antidepressant in 2023.30 In US Medicaid claims for 2019, 45% of autistic young people with an intellectual disability and 22% of those without one had been prescribed an antipsychotic, against 19% and 3% in the comparison groups.31 No medication is approved to treat the core features of autism; the only approved use is an antipsychotic for irritability, and both US labels describe efficacy established in short-term trials in children aged 5 to 17.32 No placebo-controlled trial of an antipsychotic in adults selected for autism was found as of October 2026, and the closest test, in 86 non-psychotic adults with an intellectual disability, found risperidone and haloperidol did no better than placebo.33,34 Monitoring often does not happen: of 1,538 antipsychotic prescriptions in autistic youth, 847 (55%) were counted as unmonitored against the frequency the guidelines recommend.35 The common belief that autistic people are more sensitive to medication has real support for particular drugs, such as slightly more side effects from SSRIs in autistic children, but no controlled study of the general claim was found as of October 2026.36

Full entryPsychiatric medication in autistic adults Autistic adults are prescribed antidepressants far more often than other adults, and autistic young people far more often antipsychotics. Almost all the trial evidence for these drugs comes from children. What the studies show, their side effects, and the belief that autistic people are especially sensitive to medication.

Autistic adults are given psychiatric medicines far more often than other adults. One UK study looked at health records from 1997 to 2023. It found 30 in 100 autistic adults had been given an antidepressant in 2023. That was 14.7 in 100 of other adults.30 In US Medicaid records, 45 in 100 autistic young people with an intellectual disability had been given an antipsychotic. That was 19 in 100 of young people with only an intellectual disability.31 No medicine treats the main features of autism. The only approved use is an antipsychotic for irritability. The studies behind it were short, and only in children aged 5 to 17.32 Doctors often give these drugs to adults anyway. No one has tested them properly in autistic adults. No placebo-controlled trial in autistic adults was found as of October 2026. The closest test was in adults with an intellectual disability. It found the drugs worked no better than a pretend pill.33,34 Blood tests should follow these prescriptions. Often they do not happen. In one group of autistic young people, 55 in 100 prescriptions were not monitored the way guidelines recommend.35 Many autistic people say they react more strongly to medicines. That may be true for some drugs. Autistic children on antidepressants may get slightly more side effects. But no study found as of October 2026 compares autistic and non-autistic people on the same medicines.36

Full entryPsychiatric medication in autistic adults Autistic adults are given more mental-health medicine than other adults. Autistic young people are given more antipsychotics. Most of the research on these drugs was done in children. Here is what the studies show, and what they do not.
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Established

Summarizes Psychiatric medication in autistic adults. National record systems in the UK and the US, for two different drug classes, agree that autistic people are prescribed far more of these medicines. The only approved use rests on trials in children, and no adult trial was found.

Established

This is a summary. Health records in two countries agree that autistic people are given these medicines more often. The only approved use comes from studies in children, and no study has tested these medicines properly in autistic adults.

Developmental and naturalistic approaches Emerging

Naturalistic developmental behavioral interventions are the early childhood programs that combine behavioral teaching with developmental science, grouped under this name in 2015; the Early Start Denver Model, JASPER and the parent-mediated PACT are the three named most often.37 Pooled, the effects are small to moderate and shrink when the looser studies are set aside: limiting the largest early childhood meta-analysis to randomized trials left effects of 0.16 to 0.35 on social communication, adaptive behavior, language and play, with adverse events "poorly monitored, but possibly common".1 The largest independent test, a 2025 trial of 180 children in France and Belgium, found that ESDM added to treatment as usual did not improve overall development significantly more, and its authors say it "cannot be universally recommended".38 PACT's first trial improved the back-and-forth between parent and child but not autism symptom severity at 13 months; taking the trial and its six-year follow-up together, symptom severity was lower in the PACT group, measured differently from the trial's original outcome.39,40 What predicts who improves is not settled: one mega-analysis found starting younger and a higher developmental level predicted more change, while an independent meta-regression found entry language and cognition did not predict the effect of any intervention.41,5 On the question the entry's title asks, the researchers who named the family write that the approaches "represent ABA treatment", the Autistic Self Advocacy Network answered in 2021 that "'new ABA' is Still ABA", and no randomized trial found as of October 2026 compares a named naturalistic program with a named behavioral one; the trial that would is planned and has not reported.37,42,43

Full entryDevelopmental and naturalistic approaches (NDBIs) The early childhood programs grouped under this name, including the Early Start Denver Model, JASPER and PACT, combine behavioral teaching with developmental science. What the trials show, whether the programs differ from ABA, and what autistic adults say about their goals.

Naturalistic developmental behavioral interventions are early childhood programs. They use the same teaching methods as ABA, but in play and daily routines, following the child's lead. The Early Start Denver Model, JASPER and PACT are the three named most. Pooled together, their effects are small to moderate, and smaller when only strong studies are counted.1,37 The biggest independent trial, of 180 children in France and Belgium, found the program added little to usual care.38 PACT helped parents and children talk together, but it did not change autism traits at first.39,40 One big analysis said younger children improved more. Another independent one said a child's starting language and thinking did not predict the result.41,5 The researchers who named this group write that the programs "represent ABA treatment". An autistic advocacy group says "new ABA" is still ABA. No fair test has compared the two head to head.37,42

Full entryDevelopmental and naturalistic approaches (NDBIs) These are programs that help young autistic children by teaching through play. Three well-known ones are the Early Start Denver Model, JASPER and PACT. This page shows what the studies found, and how these programs are like, and unlike, ABA.
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Emerging

Summarizes Developmental and naturalistic approaches (NDBIs). The programs are grouped by name and share their techniques; most of their trials are developer-run, and the largest independent test found no advantage over treatment as usual. Whether they differ from ABA in anything but delivery is untested.

Emerging

This is a summary. These programs mix behavioral teaching with child development research. Most studies were run by the people who made the program. The biggest independent study found no clear extra benefit.

Psychedelics and cannabis Emerging

Almost all randomized trials of cannabis products in autism have been in children and adolescents.23 No cannabis product is approved for autism, and in the trials so far, results are mixed, placebo effects are large, and the reviews rate the evidence low to very low in certainty.23,24,25 Trials of ketamine and MDMA against placebo have been small: one crossover trial of ketamine in 21 people aged 14 to 29 found no significant effect on social withdrawal, the outcome it targeted,26 and one pilot trial of MDMA-assisted therapy randomized 12 autistic adults with marked to very severe social anxiety.27 For psilocybin, the registry searched for the full entry lists one treatment trial, an open-label study in Toronto planning to give psilocybin with psychotherapy to 20 autistic adults with depression that has not responded to other treatment.28

Full entryPsychedelics and cannabis What trials and surveys show about cannabis and CBD, ketamine, MDMA, psilocybin and LSD in autistic people, how small that evidence still is, the drug interactions that matter, and how autistic writers describe using these substances. A research summary, not medical, dosing or legal advice.

Cannabis is a plant that some medicines come from. Almost all tests of cannabis for autism have been in children.23 No cannabis product is approved for autism. The results so far are mixed, and the proof is weak.23,24,25 Tests of two other drugs, ketamine and MDMA, have been small. The ketamine test did not find the change it looked for.26,27 One study plans to test psilocybin, a drug from mushrooms, in 20 autistic adults with depression.28

Full entryPsychedelics and cannabis What scientists know about cannabis, CBD, ketamine, MDMA and psychedelic drugs in autistic people. The studies are few and small. This page does not tell anyone to use these drugs, and it is not medical or legal advice.
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Emerging

Summarizes Psychedelics and cannabis. The trials are few and small, most of them of cannabis products in children, and reviews rate the certainty of the evidence low to very low. The full entry found no product approved for autism. A research summary, not medical, dosing or legal advice.

Emerging

This is a summary. There are only a few small studies, and the reviews say the proof is weak. No product is approved for autism. This page is not advice about any drug.

Speech, language and occupational therapy Emerging

Speech and language therapy works on speech sounds, language and social communication, and almost all of the research is in children. The best-known trial, PACT, taught parents to adjust how they responded to their child; it improved the back-and-forth between them but did not reduce autism symptom severity at 13 months, and a larger later trial delivering the approach at home and at school found no effect on its main outcome.39,44 Pooled across early childhood interventions of every kind, and counting only randomized trials, one effect survived once biased measurement was also set aside.1 Occupational therapy works on everyday activities as well as the sensory and motor skills underneath them; the professional guideline found strong to moderate evidence for goal-directed care in general but said more evidence is needed on participation in daily living.45 Sensory integration is its most contested part: the positive reviews come from occupational therapy associations or from researchers who work in it, the largest independent trial, of 138 children, found no advantage over usual care and judged it not cost-effective, and the strongest positive finding is narrow — meeting goals the therapist chooses, with no benefit on sensory processing or, in the best reviews, on behaviors of concern.46,47,48 What adults are offered is thin: a study that interviewed 18 autistic adults began from the position that there is no clear therapy pathway for autistic adults, and no study found as of October 2026 has tested an adult version of the sensory-integration trials run in children.49

Full entrySpeech, language and occupational therapy What speech and language therapy and occupational therapy did for autistic people as children, what their evidence shows, and what adults are offered now.

Speech and language therapy helps with speech sounds, language and talking with others. Almost all the research is in children. The best-known trial, PACT, helped parents and children talk together, but it did not change autism traits at first.39,44 Occupational therapy helps with everyday things like dressing, eating and school. Sensory integration is one kind of it, and the most argued over. The reviews that praise it come from its own side. The biggest independent test, of 138 children, found it worked no better than usual care.46,47,48 What adults are offered is thin. No study found as of October 2026 has tested an adult version of those sensory studies.49

Full entrySpeech, language and occupational therapy What speech and language therapy and occupational therapy are meant to do, what studies show they do, and what autistic adults are offered now.
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Emerging

Summarizes Speech, language and occupational therapy. Every research section is emerging: the trials are small, several were run by the teams that built the therapy, and the adult end of the record is sparse.

Emerging

This is a summary. All the research parts are early. The studies are small, and some were run by the teams that made the therapy. There is little help described for adults.

Social skills training Emerging

Social skills training is a group program that teaches social rules, mostly to autistic children. The best-controlled tests compare it with another social activity rather than with waiting, and there the groups converge: among 84 autistic children assigned at random to KONTAKT or to a social art group, both improved and the two groups did not differ on the main measure.53 Pooling the four studies that measured social responsiveness found no significant difference between training and control, and a meta-analysis that reported a moderate change in social responsiveness was describing change within each group over the trial rather than a difference between the groups.54 The adult trials are small and developer-run: the two randomized trials of PEERS for young adults compared it with waiting, and a meta-analysis of five adult trials reported large parent-rated effects while warning they may be inflated.52,50 Whether the training teaches masking is the question that decides it for many autistic writers, and no study found as of October 2026 has measured it; researchers argued from 2018 that the taught rules can work against authenticity and add to stigma, and the double-empathy research the critique rests on holds that the difficulty sits in the interaction rather than in the autistic person alone.51,55,56

Full entrySocial skills training What social skills training is, what the trials in children and adults show, why some autistic writers call it training to mask, and the double-empathy framework that the critique rests on.

Social skills training is a group class that teaches social rules, mostly to autistic children. The fairest studies compare it with another group activity, not with waiting. When 84 autistic children were put into a class or an art group, both improved about the same.53 A review that pooled four studies found no clear difference between the classes and the control group.54 The adult studies are small, and the program's own makers ran them.52,50 Many autistic writers call the classes a lesson in masking. No study found as of October 2026 has measured whether they increase masking. One researcher argued in 2018 that the rules taught can work against being yourself.51,55

Full entrySocial skills training Social skills training is a group class that teaches autistic people how to act around others. Here is what the studies show, and why some autistic writers call it training to hide who you are.
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Emerging

Summarizes Social skills training. The pooled effects are small to moderate, most trials compare the program with a waiting list or usual care, and the trials that use an active social group find both groups improving. No trial has measured whether it increases masking.

Emerging

This is a summary. The gains are small to moderate. Most studies compare the classes with a waiting list, not with another activity. No study has checked whether the classes teach masking.

Sources

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