REAC and autism: what the research has actually measured

When you are the parent of a child on the autism spectrum and hear about a new treatment, the first and the right reaction is scepticism. A great deal is promised in this field, and little of it is delivered. So let us take it slowly and look at what has actually been studied.

First: what this is not about

REAC is not aimed at the autism itself. Autism is not an illness, and none of the studies is about turning autistic children into non-autistic children.

What is being studied is the regulation of the nervous system. Many autistic children live in a body that is on high alert most of the time. Sounds, light, fabric against the skin, unpredictability — what is background for others is foreground here. That costs energy all day long, and that energy cannot be spent on anything else.

If that load eases, there is capacity to spare. That is the mechanism the studies are trying to measure.

Study 1: stress load in 46 children

Published in Advances in Neurodevelopmental Disorders (2023). 46 children with autism spectrum disorder, average age just under 10, went through one NPO followed by 18 treatments.

The measure was the ATEC — Autism Treatment Evaluation Checklist — which is completed by parents and covers four areas: language and communication, sociability, sensory and cognitive awareness, and health and behaviour.

Result: improvement in 69.6% to 89.1% of participants depending on the subscale, all with p < 0.005. The total score moved from the 7th to the 5th percentile.

Study 2: everyday functioning in 27 children and adolescents

Journal of Personalized Medicine (2023). 27 participants aged between 3 and 17, the same course of treatment, but a different measure: PEDI-CAT.

The difference is worth dwelling on. PEDI-CAT does not measure symptoms — it measures what the child can do in everyday life: look after themselves, get around, understand and take part in social situations, take responsibility for their own actions. For a family, that is often what matters.

Result: significant progress in all four areas (p < 0.05).

Study 3: the newest protocol, 39 children

Journal of Clinical Medicine (2025). 39 children aged between 4 and 13 went through a further-developed protocol, BWO Neurodevelopment-Autism: 18 treatments of around eight minutes each, given three to four times a day over one to two weeks.

The total ATEC score fell from 67.8 to 56.3. Average improvement: 11.5 points, p < 0.0001, effect size Cohen's d_z = 0.78.

59% achieved a clinically meaningful improvement, defined as a drop of at least 8 points. Around 10% showed a temporary worsening along the way, which the authors describe as an adjustment phase.

How to read an effect size

The Cohen's d figure of 0.78 tells you something the p-value does not. A p-value only tells you whether a difference is likely to be down to chance. An effect size tells you how big the difference is.

As a rule of thumb, 0.2 counts as a small effect, 0.5 as medium and 0.8 as large. So 0.78 sits close to what is conventionally called a large effect. By comparison, many well-established psychological treatments fall in the range of 0.5 to 0.8.

What it means in practice

The parents we talk to rarely describe anything dramatic. They describe it taking five minutes instead of thirty to get out of the door. The child calming down more quickly after a meltdown. More words coming. Sleeping through the night.

That sounds small. It is not, if you are the family.

What we say to every parent

The treatment replaces nothing. Special educational support, speech and language therapy, occupational therapy, municipal support and any medication should continue exactly as before. If anything, we ask that you do not change other things during the same period — partly because it is rarely wise, and partly because otherwise there is no way of knowing what made the difference.

And we agree in advance what you would like to see change, so that afterwards we can talk about it on the basis of something concrete rather than an impression.

See how a course of treatment works →