Guidelines of the Italian National Institute of Health on “The treatment of autism spectrum disorders in children and adolescents”: limits and implications

Linee guida dell’Istituto Superiore di Sanità su “Il trattamento dei disturbi dello spettro autistico nei bambini e negli adolescenti”: limiti e implicazioni

M. Zappella1, M.O. Bertelli2

1 Neuropsichiatra infantile e specialista in malattie nervose e mentali; Direttore scientifico della rivista “Autismo e Disturbi dello Sviluppo”; 2 Psichiatra; Direttore scientifico CREA (Centro di Ricerca ed Evoluzione AMG), Firenze


The fact that the National System for the Guidelines (GL) of the Italian National Institute for Health (ISS) has decided to dedicate the first document of the national research programme on mental health in childhood and adolescence to the treatment of Autism Spectrum Disorders (ASD) is certainly praiseworthy. In fact, relational developmental disorders are, along with intellectual developmental disorders, an area in which the range of therapeutic possibilities is particularly wide, and the cultural, sociopolitical and economical implications are exceptionally strong.


However, these GL include statements that are not supported by reliable evidence and omit key scientific references, thereby running the risk of not achieving the aim for which they were written, namely to represent a point of “reference for professionals” and “more generally for all citizens”.


The almost exclusive recourse to scientific evidence has led the GL to recommend only cognitive-behavioural interventions. Other approaches followed in daily clinical practice for many years may have been penalized by their higher complexity in outcome evaluation. Person-centred outcome measures, such as quality of life, and the life-span approach have not been appropriately considered. Other limits in the development of sections on epidemiology, aetiology and evolution reduce the importance of most recent acquisitions on the nature and the prognoses of autism and ASD.

Scarica il PDF