Autism Interventions: New York Times, Once Again, Pushes Non Evidence Based Floortime And Ignores Evidence Based ABA

The New York Times is at it again ... pushing Floortime as an autism intervention ... without mentioning the lack of scientific, empirical evidence in support of its effectiveness. In A Child Psychiatrist Talks About Autism the NYT features a column by Dr. Joshua D. Sparrow which promotes Floortime as an intervention for autistic children and encourages parents of autistic children to consider Floortime as an intervention for their children. (And of course, as usual with the NYT there is no mention of the solid base of evidence in support of ABA as an autism intervention):

"One promising treatment for such children is Floortime, a developmental, individualized and relational approach.

After a careful assessment of the child’s unique profile, therapists and parents using the Floortime approach work together to help the child learn to handle sensory stimulation while gradually interacting in more complex and rewarding ways. The goal is to help these children engage in meaningful relationships, expanding their capacity for communication, understanding and complex, abstract thought. One of the keys is to find the child’s motivation, and to use it as fuel for this work. Another is to make the work rewarding by making it fun and pleasurable for child, parent and therapist. But it is hard and time-consuming work, and families of children with autism spectrum disorders deserve all the support we can possibly give them. Experience has shown that children with autism who are given the support they need are able to expand their abilities to relate, to learn and to communicate, especially with their loved ones.

...


For more on autism spectrum disorders and Floortime, see the International Council on Learning and Developmental Disorders Web site.


Among the many helpful and hopeful books on autism spectrum disorders are those by the late child psychiatrist Stanley Greenspan and the psychologist Serena Weider, including “Engaging Autism: Using the Floortime Approach to Help Children Relate, Communicate and Think,” and a new one to be published in April by the pediatrician Ricki Robinson, called “Autism Solutions: How to Create a Healthy and Meaningful Life for Your Child.”

The NYT presents this latest Floortime promotional vehicle without mentioning the limited evidence in support of its effectiveness as reviewed by the AAP and the Association for Science in Autism Treatment.

The picture above is from the AAP Publications Retired and Reaffirmed policy page and indicates that in September 2010 the American Academy of Pediatrics Reaffirmed the Clinical Report: Management of Children with Autism Spectrum Disorders. Pediatrics 2007. The 2007 Report described the lack of empirical, scientifc evidence in support of the efficacy of DIR/Floortime as an intervention for autism spectrum disorders:

"The DIR approach focuses on (1) “floor-time” play sessions and other strategies that are purported to enhance relationships and emotional and social interactions to facilitate emotional and cognitive growth and development and (2) therapies to remediate “biologically based processing capacities,” such as auditory processing and language, motor planning and sequencing, sensory modulation, and visual-spatial processing. Published evidence of the efficacy of the DIR model is limited to an unblinded review of case records (with significant methodologic flaws, including inadequate documentation of the intervention, comparison to a suboptimal control group, and lack of documentation of treatment integrity and how outcomes were assessed by informal procedures55 ) and a descriptive follow-up study of a small subset (8%) of the original group of patients.59" 

(page 1165)

The following information is currently found on the ASAT web site and indicates that Floortime is plausible but essentially untested.

Association for Science in Autism Treatment


Developmentally-based Individual-difference Relationship-based intervention (DIR)/Floor Time


...

Research Summary: DIR is widely considered to be a plausible intervention approach (i.e., one that could be effective), but it has not been evaluated in peer-reviewed studies with strong experimental designs (National Research Council, 2001). An uncontrolled study reported favorable outcomes (Solomon et al., 2007).

Recommendations: An important area for future research is to evaluate DIR in studies with strong experimental designs. Professionals should present DIR as untested and encourage families who are considering this intervention to evaluate it carefully.

It isn't clear to me why the NYT pushes Floortime, a non evidence based autism intevention, and ignores ABA,  the most evidence based intervention for autism, as reviewed for several decades by authorities from the US Surgeon General, to state agencies in Maine, New York and California to the Association for Science in Autism Treatment to the American Academy of Pediatrics. I have to assume that the personal biases and prejudices of senior health editors at the New York Times lie behind this persistent attempt to promote non evidence based autism interventions and ignore or put a negative spin on ABA.  I can think of no other reason, rational or not, for the NYT's  misguided autism intervention reporting.

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Autism and the Media: Anti-ABA Activist Michelle Dawson Is Back In The CBC Spotlight Denouncing ABA

To my knowledge no one has ever accused anti-ABA activist Michelle Dawson of shying away from the spotlight  and  Michelle Dawson is back where she has been so often ... in the CBC spotlight. Once again she is peddling, in the name of science, ethics and "autistic people",  her anti-ABA rhetoric.  Ms Dawson repeats previous sermons in which she preaches  that provision of ABA interventions for autistic children lacks scientific support and is unethical. She offers nothing to back up her opinions. The CBC offers little help in that regard beyond pointing out that Ms Dawson is autistic, is a researcher and is, allegedly, an autism"expert". 

Borrowing a page from the heated rhetoric of the vaccine autism wars Ms Dawson asserts that ignorant, ill informed  parents are being duped by lobbyists and ...  in an interesting twist ... governments ... into thinking their autistic children must have ABA.  The CBC article Expert raps Quebec autism treatment makes no direct reference to the numerous reviews, from the US Surgeon General to the American Academy of Pediatrics,  that have examined hundreds of studies over decades of research and concluded that ABA is the most evidence backed effective intervention for helping autistic children overcome many of the deficits associated with autistic disorders:

"Autism expert Michelle Dawson says the Quebec government is wasting its money by funding "Applied Behavioural Analysis", known as ABA — a program she calls ineffective.

ABA is designed to reinforce behaviour through repetition. Dawson, who has autism, says she has evidence that the approach doesn't deliver what it promises.

The program doesn't optimize the overall wellbeing of people with autism, said Dawson, who researches the neurodevelopment disorder at the University of Montreal.

"In ABA you have the problem that these parents have been told by everybody, including by governments, if your child doesn't get this intervention, they're to some degree down the drain," she said.

ABA is one of the few treatments the Quebec government will finance.

"It doesn't have anything to do with science or ethics, or when you look at the well being of autistic people. It's just really effective lobbying by some people, including people who have pretty extensive conflicts of interest, or even they just are true believers, they have very strong beliefs in certain approaches, or very strong beliefs about autistic people that aren't necessarily grounded in science or ethics," Dawson said."

The CBC should  do more homework on the subject before, yet again, giving Michelle Dawson a platform to promote the same tired  anti-ABA beliefs that launched her into national fame in Canada. If it's journalists are too busy to read some of the many reviews, from the US Surgeon General to the MADSEC Autism review  to the American Academy of Pediatrics which have endorsed ABA as the most effective evidence backed intervention for autistic children  they could at least check with some of the actual autism experts and health authorities that she demeans before again giving her the CBC pulpit to promote her beliefs.  

The CBC  might also want to read  Dr. Edward K. Morris's published article about  Dr. Morton Ann Gernsbacher, an occasional co-author with Ms. Dawson and her mentor Dr. Laurent Mottron,  and a  comrade in arms in their struggle to prevent autistic children from receiving the benefits of ABA treatment: A Case Study in the Misrepresentation of Applied Behavior Analysis in Autism: The Gernsbacher Lectures:   

"This article presents a case study in the misrepresentation of applied behavior analysis for autism based on Morton Ann Gernsbacher’s presentation of a lecture titled ‘‘The Science of Autism: Beyond the Myths and Misconceptions.’’ Her misrepresentations involve the characterization of applied behavior analysis, descriptions of practice guidelines, reviews of the treatment literature, presentations of the clinical trials research, and conclusions about those trials (e.g., children’s improvements are due to development, not applied behavior analysis). The article also reviews applied behavior analysis’ professional endorsements and research support, and addresses issues in professional conduct. It ends by noting the deleterious effects that misrepresenting any research on autism (e.g., biological, developmental, behavioral) have on our understanding and treating it in a transdisciplinary context.

Professor Morris pulled no punches in his critique of Dr. Gernsbacher's public misrepresentations of ABA and the effect of those misrepresentations:

Sentiment against applied behavior analysis is not, of course, necessarily anti science. No matter what Gernsbacher’s sentiments may be, her achievements are anything but anti science.What stunned me, then, was how she reached her conclusions: She inaccurately represented research reviews, wrongly characterized applied behavior-analytic interventions, misleadingly appealed to history, inaccurately conveyed research designs, selectively omitted research results, and incorrectly interpreted intervention outcomes. Although misrepresentations often only a minor nuisance in science, they can have harmful consequences, which I believe hers did (and do), both locally and more broadly.

The local consequences included misinforming KU’s community members about ABA-EIBI; hundreds of KU students about a science of behavior and its application; current and prospective ABS majors about course of study at KU (and careers); and KU staff, faculty, and administrators about scholarship in a department renowned for its research in applied behavior analysis. The broader consequences include Gernsbacher’s probable influence on behavioral, social, and cognitive scientists who teach, conduct research, and provide services in autism; funding agencies and foundations who set priorities and allocate resources for autism research and applications; and state and federal agencies that set standards for autism services and funding. She has standing and stature in most, if not all, of these venues: in APS, of course, but also in the American Association for the Advancement of Science (AAAS), where she is a psychology section member at large, and in the National Science Foundation (NSF), where she is on the Advisory Committee for the Social, Behavioral, and Economic Sciences. Although Gernsbacher surely gained these highly respected positions by conducting first-rate science, the hallmarks of her science were largely absent in this section of her lecture.

In the article conclusion Dr. Morris, after a detailed review of the evidence in support of the effectiveness of ABA as an autism intervention, and after a detailed review of Dr. Gernsbacher's representations of ABA, explains why he wrote the article:

"Mainly, though, I wrote it for the families of children with autism and, ultimately, for those children who need and deserve evidence-based treatments, of which ABA-EIBI so far has the best support. Unfortunately, many parents are dissuaded from using it by misinformed, misguided, or misleading advocates of other approaches. As a result, they often use these approaches until they see their children’s poor progress. When they begin using ABA-EIBI to good effect, they speak of their great regret and guilt for not having used it earlier, when their children had the most to gain and the most time to make those gains. The opportunity cost of not using ABA-EIBI, or any equally effective intervention, is that their children will be delayed in achieving their full potential or never achieve it at all. As a result, their children will need more supportive services and institutionalization later into their lives and perhaps for the rest of their lives at significant personal and social costs to them, and financial costs to us all. This is a crime."

I have been unable to find a public reply by Dr. Morton Ann Gernsbacher to the Morris article, published in early 2009.  Dr. Morris had sent a copy of the article to Dr. Gernsbacher in 2008 shortly before she again presented lectures in which Dr. Morris states she continued to misrepresent ABA.  If Dr. Gernsbacher,  Michelle Dawson, or any of their followers, know of any public replies by Dr. Gernsbacher to the Morris criticisms I ask you to forward them to me.  In the meantime, hopefully, someone will bring the article to the attention of the CBC before it, once again, gives Michelle Dawson a platform to spread her anti-ABA ideology.  Until then the CBC may wish to avoid Michelle Dawson's anti-ABA rhetoric and read at least the following excerpt from the American Academy of Pediatrics 2007 publication, Management of Children with Autism Spectrum Disorders:

"The effectiveness of ABA-based intervention in ASDs has been well documented through 5 decades of research by using single-subject methodology21,25,27,28 and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings.29–40 Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.31–4"

    

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Autism, ABA and Conor's Autism Medications (None)

The Internet criticism of ABA as an autism intervention comes largely from a rejection of evidence based medicine, ideological based rigidity and lack of any real experience with ABA. To the anti-behaviorists no ABA supportive studies are acceptable unless they are double blind controlled studies conducted over the life time of autistic persons. Obviously it would be unethical to provide a placebo intervention to an autistic child as an intervention over a lengthy period of time.

The various studies described by the American Academy of Pediatrics, the US Surgeon General, state agencies in New York, California and Maine, the Association for Science in Autism Treatment, the Center for Autism and Related Disorders, the May Institute and the thousands of health care and education professionals who actually work with and help autistic children will be ignored by the anti-ABA ideologues. There is no need to mention of course that the direct observations of autistic children by their own parents who live with their children, care for them, help them and observe them 24/7 are of no weight whatsoever to the ideologues for whom NO information supportive of ABA could ever be acceptable.

Some of the anti-ABA rhetoric originates with adult persons with various autism spectrum disorders who themselves have had no actual involvement with ABA. The further removed from the realities of ABA and the need for an effective intervention that helps autistic children the greater the chance that the irrational anti-ABA ideology will take root. The criticisms themselves are largely non-evidence based and ignore the many positive contributions that ABA has made to the lives of autistic children including my severely autistic son Conor.

Conor has learned various skills, reduced self injurious behavior, increased communication skills, attended a neighborhood school and functioned well. On the sidebar of this blog are pictures of Conor holding his perfect attendance certificate from grade 6 during which time he received ABA instruction at school. This year colds and a flu prevented him from perfect attendance but his desire to attend school did not diminish. He loves school ABA and all. Why would Conor jump up each day eager to attend school where he receives ABA intervention if it was so abusive?

I post many picture sets of Conor on this blog site over the past 3 years. These portray him as what he is -- a very happy, personable and lovable boy. ABA has not turned him "robotic" or robbed him of his personality. There is nothing at all abusive about ABA for autistic children, certainly not for Conor, despite the absurd rhetoric of the anti-behaviorists.

Conor is now 13 1/2 years old and stands 5' 11''. In the past year and a half he has undergone the adolescent "change of life" with rapid growth spurts and all the other changes that can be so disruptive of young personalities in the teen years. While there are some challenging behaviors at times there is nothing out of the ordinary. Despite his growing size, strength and disruptive adolescent changes he is still a very well behaved, gentle young man. We have not felt the need to provide Conor with ANY medications at any time to manage his behavior.

Although he used to bite himself with some frequency, and still does on occasion, such self harmful behavior is rare. He does not return home at the end of a day at school and engage in self injury as a way of coping psychologically as one prominent anti-ABA activist testified that she would do at the end of the work day. The ideologues can blame ABA intervention for Conor's near elimination of self injurious behavior or they can pretend that my direct observations about the impact of ABA in reducing such behavior are of no weight. No need to guess which way the anti-behaviorists would lean on that choice.

Conor has received NONE of the medications prescribed for many autistic children. The anti-ABA ideologues can also blame ABA for that result but they won't. They don't really want to look at the issue objectively. They do not want to look at the whole picture including the benefits ABA has brought to my son or other autistic children.

If you are the parent of a newly diagnosed autistic child consult your attending health care professionals about the best way to help your child. Make any treatment or intervention decisions with their input but do not be turned off of ABA as a possible intervention to help your child by the anti-ABA rhetoric that permeates some Internet autism hubs. Most of such rhetoric emanates from people with no direct involvement in helping autistic children. Most of such rhetoric emanates from people with no actual experience with ABA. Most of such rhetoric emanates from people, whether they fancy themselves researchers or not, who just don't know what they are talking about when they are talking about ABA. Do not be misled by the misbehavior of the anti-behaviorists.

In the meantime I am looking forward to another day with my wonderful son who has benefited greatly from his ABA intervention. Conor will probably also enjoy the day ... without the need to injure himself so that he can "cope psychologically" ... and without medication.

God damn that ABA!

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Montreal Gazette Speaks Up For Autistic Children

With few exceptions the mainstream media coverage of autism disorders has been abysmal. Even now many in the MSM can do little more than engage in a feeding frenzy over Oprah Winfrey's presentation of health issues including autism disorders. Seldom is concern for how to actually help autistic children or adults reflected in the popular press. Seldom are straightforward facts such as the long proven efficacy of ABA in helping autistic children overcome, in whole or in part, their autistic deficits been mentioned in the MSM. Yesterday the Montreal Gazette spoke up for autistic children and did it well.

In Autistic children deserve better the Gazette argued that the Quebec government of Liberal Premier Jean Charest should amend a piece of legislation, Bill 21, dealing with changes to various legislative rules in the field of mental health and human relations by permitting psychologists specially trained in autism to diagnose and treat persons with autism. Here in New Brunswick psychologists already diagnose and treat autism disorders. In making this argument the Gazette also pointed out that The American Academy of Pediatrics states that "the intensive treatment, known as Applied Behavioral Analysis, is now of "well-documented" effectiveness as a medical treatment" a point seldom made by the mainstream media.

The Montreal Gazette has spoken up, with wisdom and clarity, on behalf of autistic children in Quebec. Hopefully the learned autism journalists at Canada's CBC can take time out from their love affair with Michelle Dawson, Dr. Laurent Mottron and the anti-autism treatment Neurodiversity movement and do the same.

autism

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Michelle Dawson's False Claims Allegations? Where's the Evidence?

Jonathan Mitchell of Autism's Gadfly has run afoul, like so many others have, of Michelle Dawson.

On the discussion board Misbehaviour of Behaviourists Ms Dawson has accused Jonathan of making false statements about her. Apparently Jonathan made a statement about Ms Dawson's communications with the IACC, the Interagency Autism Coordinating Committee that might not have been correct; or at least not literally correct. Ms Dawson takes Jonathan to task over the issue at the Misbehaviour of Behaviourists. Then, out of left field, Ms Dawson also accuses me of making false claims about her as well:

Michelle Dawson	8995
03-06-2009 08:31 PM ET (US)

Edited by author 03-06-2009 08:32 PM

Still in the "pants-on-fire" dept., for what Mr Mitchell wrote on his blog, see /m8990. What Mr Mitchell has claimed on his blog is false. He made it up.

If Mr Mitchell did not make anything up, as he claims, then I'm sure he can provide sources to support his claim that I was "writing letters trying to influence the direction of NIMH autism research" and so was Mike S.

I suggest that as with Mr Doherty, no one should believe Mr Mitchell when he makes any claims about people he disagrees with, unless Mr Mitchell can provide sources (in this case, links to all the "letters" Mike S and I have written to the NIMH) to support his views.

Some day when I have a lot of spare time, I'll try to find and list all the false claims, misrepresentations, etc., made about me and my colleagues by Mr Mitchell and Mr Doherty.

As you can see Ms Dawson did not provide any specifics, particulars, examples, information or evidence of any kind whatsoever to substantiate her out of left field allegations against me. She just decreed that I have made false claims and informed her loyal subjects that some day, when she had the time, she would bother herself with substantiating her allegations. That my friends is the work of Michelle Dawson, autism researcher and anti-ABA activist.

To my knowledge the statements that I have consistently made about Ms Dawson are that:

1) She is an anti-ABA activist ( see the title of her forum (the Misbehaviour of Behaviourists), her appearances before the Supreme Court of Canada and the Canadian Senate in opposition to ABA for Canada's autistic children and her numerous media comments opposing ABA.)

2) That her anti-ABA views are inconsistent with the views of numerous credible authorities in the United States, like the US Surgeon General, the American Academy of Pediatrics, the MADSEC (Maine) Autism Task Force, the NY State Department of Health, and the Association for Science in Autism Treatment to name the most prominent.

I stand by these statements which are factually correct. And I caution anyone against putting too much weight on any of Michelle Dawson's allegations and statements that she has made against anyone, professional, reporter, parent or autistic person who dares to disagree with her views.

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No Autism Funding Just Jibber Jabber In Harper Budget

Shelly Berman as Judge Robert Sanders on Boston Legal
"What is this jibber-jabber? I don't like jibber jabber in my courtroom"

Senator Jim Munson, who has been an unrelenting advocate on behalf of Canadians with autism disorders and their families, questioned Marjory LeBreton (Leader of the Government and Minister of State (Seniors) yesterday over the lack of funding for autism in the Harper government budget:

"Hon. Jim Munson: Honourable senators, my question is for the Leader of the Government in the Senate. Last week's federal budget talked a lot about infrastructure. My question is about another kind of infrastructure, namely, social infrastructure.

(1505)

I talked about it yesterday, as did Senator Oliver, in dealing with autism. I do not need to go over all the figures. One in 150 families is affected by autism.

Parliament has taken steps. We lobbied hard and Minister Clement listened and did some work.

Will the government consider taking a further step to create a division for autism within the Public Health Agency of Canada so that this condition can be looked at, receive the attention it deserves, and families can receive the help they so desperately need? I am looking for that national leadership focus.

Hon. Marjory LeBreton (Leader of the Government and Minister of State (Seniors)): I am well aware of the honourable senator's hard work on the subject of autism.

As the honourable senator knows, when Minister Clement was Minister of Health he set up a research chair to study ways to move this issue forward. Autism is one of many conditions that falls within the purview of provincial departments of health and, of course, health care is delivered by the provinces.

With regard to the budget, a great deal of money has been set aside at universities for research in science and technology. It is hoped that indirectly, through the money that has been provided to universities, to the science community and to the health system, in addition to all the money that the government transfers to the provinces for health care, the treatment of autism will move forward quickly in the near or immediate future.

With the budget and the actions that the government has taken, in our consultations in various areas, we have tried to reach out to the good suggestions that are there, including the worthy ones of the honourable senator.

I am sure that Minister Aglukkaq � who is from the North, I am happy to say � and her officials, will have reviewed the files that Minister Clement was working on in terms of autism. I cannot say definitively what they are but I will find out."

Debates of the Senate (Hansard) 2nd Session, 40th Parliament,
Volume 146, Issue 7 Thursday, February 5, 2009

The reply by the Honourable Marjory LeBreton betrays no actual knowledge of autism or the evidence based effective autism intervention, ABA, that so many autistic Canadian children require to help them overcome their deficits and live fuller lives. In case someon on Ms LeBreton's staff Stumbles Upon or otherwise inadvertently reads this blog site I offer the following information from the American Academy of Pediatrics, also found on the upper right hand corner of this blog site:

The effectiveness of ABA-based intervention in ASDs has been well documented through 5 decades of research by using single-subject methodology21,25,27,28 and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings.29–40 Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.31–4

American Academy of Pediatrics, Management of Children with Autism Spectrum Disorders

I also bring to the attention of the Honourable Ms LeBreton that many autistic Canadian adults are living in reprehensible residential care facilities if they are lucky and are not simply living on the ward of a general hospital as has occurred here in New Brunswick. Some are actually exported to the United States to receive residential based treatment not available here in New Brunswick and other parts of the country.

Please Ms LeBreton, stop posturing with nonsense about autism research dollars. Canadian research for autism is not generally directed at finding cures or treatment for autism. At least some of it goes to researchers more interested in promoting feel good "autism is beautiful" nonsense.

If Ms LeBreton has a conscience, and any integrity, I ask her to please stop with the "jibber jabber" (parents advocating for autistic family members have heard it for years) and start talking about funding ABA services for autistic children and decent residential care and treatment facilities for autistic adults wherever they happen to live in Canada.

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Vaccine-Autism War: Media Offensive Marginalizes Parents and Ignores Dr. Bernadine Healy

It was only one week ago, on January 13, 2009 that the New York Times published its puff piece promoting Dr. Paul Offit and his pro-vaccine agenda. The NYT praised Offit and vaccines and portrayed parents who assert a causal connection between vaccines and autism disorders as over-emotional, crazed, even dangerous. The article appeared the day before the IACC's clandestine reversal of its previous decision to authorize funding of possible environmental causes of autism, including possible vaccine-autism connections.

The NYT article was followed up on January 16, 2009 by a Newseek.com interview of Alison Singer a former senior officer with Autism Speaks, who resigned from that organization the evening before the vote to reverse. The reversal vote was not specified on the agenda and other public representatives on the IACC received no prior notice. In the Newsweek article Ms Singer portrays parents who question the role of vaccines, and the various toxic substances they contain, as "a small number of people with very loud voices".

On January 19 and 20 the NYT continues the effort to portray parents as over-emotional and untrustworthy sources of information and anecdotal evidence in Trying Anything and Everything for Autism. In this article the NYT presents "behavioral intervention" as the only scientifically validated intervention for autism while portraying parents as desperate for trying alternative, unsubstantiated interventions.

The point of the article though is not to inform parents of autistic children, or the public, about a helpful intervention for autism. If that were the case the NYT article would have expressly referenced the specific "behavioral intervention" that is scientifically validated as effective in treating but not curing autism - Applied Behavioral Analysis. If the article was intended to inform the public it would have given a detailed description of ABA programs, how they work, the detailed record keeping involved and the very considerable and specific evidence in support of ABA as an autism intervention as summarized in the 2007 American Academy of Pediatrics review Management of Children With Autism Spectrum Disorders :


Applied behavior analysis (ABA) is the process of applying interventions that are based on the principles of learning derived from experimental psychology research to systematically change behavior and to demonstrate that the interventions used are responsible for the observable improvement in behavior. ABA methods are used to increase and maintain desirable adaptive behaviors, reduce interfering maladaptive behaviors or narrow the conditions under which they occur, teach new skills, and generalize behaviors to new environments or situations. ABA focuses on the reliable measurement and objective evaluation of observable behavior within relevant settings including the home, school, and community. The effectiveness of ABA-based intervention inASDs has been well documented through 5 decades of research by using single-subject methodology21,25,27,28 and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings.29–40 Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.31–40

The aim of this latest NYT article, however, was not to inform the public about the well documented, evidence based, benefits of ABA as an intervention for autism. As the title makes clear, the theme of the article is that parents are desperate. The clear implication is that the opinions of desperate parents should not be given much, if any, weight in public discussions about complex, important, issues surrounding autism - issues like the role of vaccines and vaccine ingredients as potential triggers of autism disorders.

In the January 13 article the NYT praised Dr. Paul Offit, a leading critic of those who question the autism related safety of vaccines. Newsweek.com interviewed Alison Singer also a critic of the rabble rousing parents who presume to question the practice of injecting children with mercury and other toxic substances.

The second NYT article of January 19-20 quotes Dr. Michael Fitzpatrick, author of “Defeating Autism: A Damaging Delusion”. "Coincidentally" the two NYT articles (and the Newsweek.com interview) bookend the secretive decision of the IACC to reverse its decision of only weeks earlier to authorize funding for research of the very issues that concern the delusional, desperate, loud parents marginalized in these shameful excuses for journalism.

No mention is made in these three articles of:

1) The IACC decision of December 2008 to authorize funding of research into potential environmental, including potential vaccine, causes or triggers of autism.

2) The clandestine IACC decision of January 14, 2009 to reverse its December decision to authorize environmental and vaccine factors related to autism.

3) The views of Dr. Bernadine Healy, former head of the NIH and the American Red Cross, who has stated that there are real issues concerning vaccines and autism disorder that have not been researched fully and should be researched.

The above facts do not necessarily show any conspiratorial involvement by the NYT, or Newsweek, to help public health authorities involved with the clandestine move to suppress research of possible environmental and vaccine contributors to autism disorders. But at the very minimum it shows that the authors and editors of these media institutions are dupes of the authorities who did move secretively to prevent such research from moving forward.

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Michelle Dawson, ABA and Autism in 2009

I read recently still more anti-ABA commentary from Ms Michelle Dawson, a long time crusader against government provision of Applied Behavioral Analysis for autistic children. Together with her colleague, Dr. Laurent Mottron, she has appeared as an "autistic" before the Supreme Court of Canada and before a Canadian Senate committee examining funding of autism treatment to oppose government funding of ABA treatments for autistic children.

Ms Dawson also comments frequently on the internet, and in the mainstream media, to speak on behalf of "autistics" and to advocate against ABA for autistic children in Canada. Ms Dawson takes great pleasure in explaining how the professionals who contribute to the American Academy of Pediatrics, the MADSEC (Maine) Autism Task Force, the New York State Department of Health, the Association for Science in Autism Treatment, and any of the professionals who actually work with autistic children, including heaven forbid, low functioning autistic children, are wrong about ABA and its effectiveness in helping autistic children make substantial, sustained gains as summarized in 2007 by the AAP:

Applied Behavior Analysis

Applied behavior analysis (ABA) is the process of applying interventions that are based on the principles of learning derived from experimental psychology research to systematically change behavior and to demonstrate that the interventions used are responsible for the observable improvement in behavior. ABA methods are used to increase and maintain desirable adaptive behaviors, reduce interfering maladaptive behaviors or narrow the conditions under which they occur, teach new skills, and generalize behaviors to new environments or situations.

ABA focuses on the reliable measurement and objective evaluation of observable behavior within relevant settings including the home, school, and community. The effectiveness of ABA-based intervention in ASDs has been well documented through 5 decades of research by using single-subject methodology21,25,27,28 and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings.29–40 Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.31–40

Given the well documented record of sustained gains reported for autistic children using ABA, as reported by such credible agencies, it is difficult to understand the opposition by Michelle Dawson and her colleague and supporter Dr. Laurent Mottron. The writings of neither of these two staunch opponents of ABA disclose any first hand involvement with ABA.

Nor is it clear whether they have any direct contact with severely impaired autistic persons, you know, the ones who do NOT appear before legal, political and media entities on a regular basis, the people, like my son who require 24 hour supervision, the ones living in institutional care, THOSE "autistics", the ones whose existence Dr. Mottron and Ms Dawson rarely, if ever, mention. Dr. Mottron publishes several papers a year in learned publications about autistic savants and persons with Aspergers and High Functioning Autism. (With 2009 literally around the corner look for more papers from Dr. Mottron on autistic savants and the charcteristcs of superior autistic intelligence). Dr. Mottron is OK with Canadian tax dollars going to support his "research" into savant intelligence but opposes funding of ABA interventions for autistic children even those with limited communications, the "autistics" who do not appear in his frequently published papers.

Michelle Dawson, in addition to being a researcher working with Dr. Mottron, and assisting his investigations of high functioning autism, is also herself an "autistic". Affidavits filed by Dr. Mottron and Ms Dawson, then a postal worker, in support of her appearance as an intervenor before the Supreme Court of Canada describe her as an autistic person or autistic individual. She also states that she was diagnosed with "autism". Her specific autism spectrum disorder, or pervasive developmental disorder, is not expressly mentioned in either affidavit.

In her affidavit Ms Dawson, despite a slim affidavit record of her own "autism", challenged the legitimacy of the parents and professionals who appeared in the proceedings:


20.

In addition, no autistic individuals testified or participated in the process. Yet there are autistic individuals who could have coherently and cogently explained the realities of autism, with both its benefits and weaknesses to the courts.


21.

The courts were only left with the perspective of parents and the state in what became an argument over who was responsible to assume the costs of dealing with the disability;


22.

I believe that the perspective I could bring to this Court would be of assistance to the Court and allow it to have a fuller understanding of the issues before it;


23.

I know of no association or group seeking to intervene in these proceedings who could bring the true perspective of autistic individuals;


24.

While several groups and associations exist to promote the rights of autistic individuals, in my experience, they are usually dominated by parents and professionals, and very seldom have any input from autistic individuals, even when the autistics seek to participate in these organizations.


Ms Dawson intervened in Auton, according to her solemnly declared affidavit, because she offered the true perspective of autistic individuals. She made this solemn declaration without stating her specific autism spectrum disorder, elaborating on why she herself was not diagnosed until she was an adult in 1993-4, or discussing any differences that might exist between "autistics" who can appear before the Supreme Court and those who struggle with basic language. Nor did she explain in her affidavit how she could speak on behalf of those autistic children and adults who, unlike her, cannot speak at any significant level.

A few years ago I had the pleasure of two very brief telephone conversations with Ms Dawson. She contacted me because I was at that time the President of the Autism Society New Brunswick and she was interested in obtaining a copy of a document prepared for the ASNB by a Universite de Moncton law professor pertaining to autism and the Canadian constitution. I was surprised later, when learning of her intervention in the Auton case in the Supreme Court of Canada, that she purported to speak on behalf of so many other autistic persons; given her obvious abilities contrasted with the severe challenges faced by so many autistic persons, including my son.

On reflection I also remembered our brief conversations and the fact that despite taking on this self appointed representational role on behalf of "autistics", including my son, she had never asked me, during those conversations any questions about autistic people in New Brunswick or the health, education or living conditions of persons with autism spectrum disorders in New Brunswick. She disclosed no obvious interest in informing herself, while talking to the then President of ASNB about conditions faced by autistic persons in New Brunswick. (Nor did Ms Dawson ask whether we had any persons with an Autism Spectrum Disorder serving on our Board of Directors)

Of course Ms Dawson's failure to ask me any such questions now makes perfect sense having read her affidavit. As a mere parent of an autistic child I had no information that would be of any value to Ms Dawson who after all is an "autistic". Despite the responsibilities that nature, our society and our laws bestow upon parents to care for and nurture our children, we are not qualified to represent our autistic children's interests in Ms Dawson's view. Despite living with them, caring for them, loving them and sacrificing for our children, despite seeing their challenges and struggles up close and helping them overcome those challenges we can not possibly offer the perspective that Ms Dawson, a total stranger with no commitment to them or responsibility for their well being, can offer because she is after all an "autistic".

My son is severely "autistic". His diagnosis is autistic disorder, assessed with profound developmental delays. He can not speak for himself in ordinary daily interaction let alone before the Supreme Court of Canada. The information I just presented is supported by professional assessments and is more information than Michelle Dawson supplied in her leave to intervene affidavit in Auton. Michelle Dawson, whatever her diagnosis, has nothing in common with my son and does not, and never did, bring his "perspective" to courts, legislative bodies or in her media appearances.

Michelle Dawson will continue in 2009 to tell the world that the AAP, the US Surgeon General, the New York State Department of Health, the MADSEC (Maine) Autism Task Force, the Association for Science in Autism Treatment, Dr. Mickey Keenan of the University of Ulster, Dr. Doreen Granpeesheh of the Center for Autism and Related Disorders, Dr. Alan Harchik of the May Institute, Dr. Paul McDonnell, Professor Emeritus (Psychology), Dr. Ivar Lovaas, and literally thousands of other health care professionals and researchers are all wrong about the effectiveness of ABA in helping autistic children make sustained substantial gains in intellectual and social skills.

Meanwhile in 2009, Michelle Dawson and Dr. Mottron will undoubtedly continue to receive Canadian tax dollars for their research into, and publish papers about, autistic savants, Aspergers and high functioning autism. Curiously omitted from their scholarly works will be the severely autistic, those with cognitive deficits, those who injure themselves and others and live lives of dependency and solitude after the parents and others who actually care for them are gone.

If past is prologue Ms Dawson will still not ask about those "autistics" much less fortunate than her, like my son, or other autistic persons in New Brunswick, or elsewhere. Ms Dawson will continue in 2009 to ignore the existence of intellectually impaired, communication challenged, severely autistic persons on whose behalf she purports to speak. And she and Dr. Mottron will continue to oppose government funding of ABA for autistic children.

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Autism and ABA Abuse of Autistic Children - A Case Study, Part 3

Conor had a long weekend again, because of teacher interviews/teacher association council days at the end of last week. Such extended breaks from school are difficult for Conor who apparently has been deceived by nefarious ABA trickery into thinking that he actually enjoys the ABA based instruction he receives in school. Hence, the perfect attendance he achieved last year as Middle School.

Conor has, with ABA instruction, developed some reading skills but they are not yet on a level where he can understand the writings of Michelle Dawson (admittedly as a lawyer with 24 years experience I also have trouble reading, understanding and finding the evidentiary basis of Ms Dawson's essays and opinions).

Without her objective input, (Ms Dawson's own opinions do not appear to be contaminated by any direct involvement with, or first hand knowledge, of ABA, or respect for the opinions of the hundreds of medical and education professionals and researchers who endorse ABA as an effective intervention for children with autistic disorders), Conor does not understand that his human rights, as an autistic person, are being violated by exposure to ABA abuse.

Although Ms Dawson, diagnosed as "autistic", by someone, as an adult, does not indicate that she herself was ever abused by exposure to ABA that does not, in itself, mean that she does not know what she is talking about does it? Does it?

Surely her lack of respect for the opinions of health care professionals who actually work with autistic children, including severely affected autistic children, providing ABA treatment to help reduce self injurious behavior and increase cognitive, communication and social skills (AAP, MADSEC, US Surgeon General) does not mean that Ms Dawson does not know what she is talking about does it?

Michelle Dawson has said that the human rights of autistic persons like my son Conor are denied by exposure to ABA. His autistic essence as she would define it is being trampled and he is effectively being abused. After all Michelle Dawson says so.

Conor's perfect attendance record at middle school where he receives daily ABA instruction must be proof that he is abused, his autistic essence trampled, his human rights as an autistic person trampled right? Well if you are still not convinced that ABA advocates, especially parents, are violating our children's human rights, as pronounced by Michelle Dawson, then please see also:

Autism and ABA Abuse of Autistic Children - A Case Study, Part 1

Autism and ABA Abuse of Autistic Children - A Case Study, Part 2

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Time To Resume The Struggle, Canada Still Needs A Real National Autism Strategy

The general election in Canada has come and gone. And Canada's National Autism Crisis remains.

Prime Minister Stephen Harper had no qualms about spending hundreds of millions of dollars on an unnecessary election. But still he can not even spend five cents on actually helping autistic children and adults in Canada. Prime Minister Stephen Harper has done nothing to help autistic children receive evidence based treatment in Canada. Nothing of substance will be done to help autistic children in Canada while Stephen Harper is Prime Minister.

There were many people who fought hard to raise the profile of autism and Canada's autism crisis during this election. I am not offering any names because I do not want to offend anyone by accidental omission. From BC to Nova Scotia the fight was waged for a real National Autism Strategy. The ultimate objective was not achieved .... this time. But the fight will continue for a real National Autism Strategy.

We know that autistic children across Canada deserve the opportunity for a better life. They deserve to receive Applied Behavioral Analysis and any other evidence based treatment that might be developed in future. They need treatment now. They do not need sham National Autism Symposiums which exclude parent advocates and provide watered down versions of what more credible American agencies like the American Academy of Pediatrics, the New York State Department of Health, the MADSEC Autism Task Force and the Office of the US Surgeon General have been telling us for many years.

We have to continue the fight for a National Autism Strategy. We have to reboot, recalibrate, recharge and resume the struggle and we have to start right now!

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New York Times' Slanted Article On DIR/Floortime and Autism

The New York Times has published in its print and online editions a lengthy piece by Melissa Fay Greene promoting DIR/Floortime. The article acknowledges to some extent the value of ABA as an autism intervention but implies that ABA is outdated and that DIR/Floortime is a new modern improved form of autism intervention. The usual cliches about ABA being rote learning are trotted out along with the positive buzzwords used to promote DIR/Floortime "relationship", "respectful of the child". The article indicates that experts do not endorse any one method.

What the article does not do is mention the fact that there is no empirical evidence to support the effectiveness of DIR/Floortime as an autism intervention. The MADSEC Autism Task Force Report (2000 rev. ed.) described DIR Flootime as without scientific evaluation of any kind.

MADSEC Autism Task Force Report, page 6:

• Without scientific evaluation of any kind:
Greenspan’s DIR/”Floor Time,” Son-Rise.


MADSEC Autism Task Force Report, page 43:

Discussion

There have been no peer-reviewed, published studies of Greenspan’s DIR/Floor Time’s
effectiveness for children with autism.

Conclusions

There have been no peer-reviewed, published studies of Greenspan’s DIR/Floor Time’s
effectiveness for children with autism. Researchers should consider investigation using research protocols. Professionals considering Greenspan’s Floor Time should portray the method as without peer-reviewed scientific evaluation, and should disclose this status to key decision makers influencing the child’s intervention.

The American Academy of Pediatrics reviewed autism interventions in Management of Children with Autism Spectrum Disorders(2007) and stated, at page 5, with respect to RID that:

Relationship-focused early intervention models include Greenspan and Wieder’s developmental, individual-difference, relationship-based (DIR) model,55 Gutstein and Sheely’s relationship-development intervention (RDI),56 and the responsive-teaching (RT) curriculum developed by Mahoney et al.57,58 The DIR approach focuses on (1) “floor-time” play sessions and other strategies that are purported to enhance relationships and emotional and social interactions to facilitate emotional and cognitive growth and development and (2) therapies to remediate “biologically based processing capacities,” such as auditory processing and language, motor planning and sequencing, sensory modulation, and visual-spatial processing. Published evidence of the efficacy of the DIR model is limited to an unblinded review of case records (with significant methodologic flaws, including inadequate documentation of the intervention, comparison to a suboptimal control group, and lack of documentation of treatment integrity and how outcomes were assessed by informal procedures55) and a descriptive follow-up study of a small subset (8%) of the original group of patients.59

The article also fails to indicate the value of ABA as an autism intervention and the large body of evidence supporting its effectiveness:

MADSEC (2000)

Conclusions

There is a wealth of validated and peer-reviewed studies supporting the efficacy of ABA
methods to improve and sustain socially significant behaviors in every domain, in individuals
with autism. Importantly, results reported include “meaningful” outcomes such as increased
social skills, communication skills academic performance, and overall cognitive functioning.
These reflect clinically-significant quality of life improvements. While studies varied as to the
magnitude of gains, all have demonstrated long term retention of gains made.

Other major contributions of ABA to the education and treatment of individuals with autism
include:

• a large number of empirically-based systematic instruction methods that lead to the
acquisition of skills, and to the decrease/elimination of aberrant behaviors;
• a technology for systematically evaluating the efficacy of interventions intended to affect
individual learning and behavior; and
• substantial cost/benefit.

Over 30 years of rigorous research and peer review of applied behavior analysis’ effectiveness
for individuals with autism demonstrate ABA has been objectively substantiated as effective
based upon the scope and quality of science. Professionals considering applied behavior
analysis should portray the method as objectively substantiated as effective. Methods of applied behavior analysis should be considered to evaluate the effectiveness of any intervention used to help individuals with autism. Researchers should continue to vigorously investigate behavioral intervention as the most promising area of research and treatment benefitting individuals with autism known today. Early interventionists should leverage early autism diagnosis with the proven efficacy of intensive ABA for optimal outcome and long-term cost benefit.


American Academy of Pediatrics (2007)

The effectiveness of ABA-based intervention in ASDs has been well documented through 5 decades of research by using single-subject methodology21,25,27,28 and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings.29–40 Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.31–40

The New York Times is still a news source of great influence. When it is using that influence in promoting interventions for children with autism, a neurological disorder, it should do its homework and present an accurate and credible review of the professional literature. Simply offering a guest column to a promoter of an intervention lacking in empirical verification of its effectiveness does a disservice to autistic children whose decision makers, family or public, could be misled by the NYT and its weighty reputation.

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Wesley Romey Says It Is Time for Medicare for Autism

If you listened to anti-ABA advocates like Michelle Dawson and Dr. Laurent Mottron you might erroneously think that ABA oppresses autistic children. These staunch opponents of ABA for autistic children, with little or no direct experience themselves with ABA as an autism treatment, have made representations to the Supreme Court of Canada and the Canadian Senate in a continuing campaign to prevent government funding of ABA treatment for autism in Canada.

Ms. Dawson and Dr. Mottron conduct this anti-ABA campaign despite reviews by responsible, credible agencies like the American Academy of Pediatrics, the US Surgeon General, the MADSEC (Maine) Autism Task Force, and the New York State Department of Health, all of which have confirmed that ABA, based on hundreds of studies over several decades of research, is effective at realizing persistent gains in intellect, communication and socialization skills and improved positive behavior.

Michelle Dawson is an adult diagnosed autistic who often offers her perspectives on behalf of all autistic people, including her anti-ABA biases. Unlike Ms Dawson, Wesley Romey is a 13 year old autistic boy, diagnosed as a child, who has actually received ABA treatment and advocates for Medicare coverage of autism treatment, specifically ABA, as he did compellingly at a rally Saturday in Surrey, British Columbia. As reported by Surrey Now Wesley enthralled the audience with his comments:

"We want medicare for autism and we want it now!" he cried to the crowd, and was met with a standing ovation.

...

Wesley, though, was the speaker who particularly touched the crowd. Wesley shared with the audience his success with Applied Behavioral Analysis (ABA) therapy. He urged listeners to demand the government fund autism treatment, because he is proof that it works.

"I want to say this to every Canadian out there. It's not fair that every child with autism doesn't get the same chance that I did. If you don't stand up for your children, who will?"

It is time to break the self perpetuated myth that Michelle Dawson speaks for all autistic persons in her opposition to ABA treatment for autistic children. She does not have the experience, the expertise, or any legitimate moral basis, to oppose effective, evidence based, ABA treatment for autism.

It is time the federal government stopped holding sham "national autism symposiums", with keynote speakers like anti-ABA advocate Dr. Laurent Mottron, and started acknolwedging the credible agencies like the AAP, the MADSEC Autism Task Force, the New York State Department of Health and the US Surgeon General that, based on objective reviews of hundreds of studies, confirm ABA as an effective autism treatment.

It is time the federal government read the Senate report "Pay Now or Pay Later" and started taking Canada's autism crisis seriously with1 in 150 children being diagnosed with autism.

It is time that the federal government started listening to the thousands of parents of autistic children across Canada who are fighting tooth and nail to obtain ABA treatment for their autistic children while such treatment will be most effective.

It is time, it is long past time, that the federal government stop ingoring the plight of so many autistic children and their families.

It is time, it is long past time, that all autistic children in Canada in need of ABA treatment receive such treatment in timely fashion regardless of which province their parents live in.

Take it from Wesley Romey, it is time for Medicare for Autism NOW!

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Help For Your Autistic Child? Consult Credible Autism Authorities

If you are seeking help for your autistic child you should certainly consult your local professionals. If you do so you may want to make sure they are up to date and aware of some of the leading reviews of the effectiveness of various autism interventions. One thing you absolutely should NOT do is listen to anti-ABA activists. Their opposition to ABA is usually based on ideology, emotion and their own personal rejection of autism as a disorder or disability. Some credible agencies which have reviewed the scientific basis supporting the effectiveness of which hundreds of studies over several decades supporting the effectiveness of ABA as an effective autism intervention include:

American Academy of Pediatrics - Management of Children with Autism Spectrum Disorders 2007

MADSEC (Maine) Autism Task Force Report 2000 (rev ed)

US Surgeon General 1999

NY State Dept of Health 2005 (rev ed)

This is what the AAP and MADSEC reports stated:

American Academy of Pediatrics (2007):

The effectiveness of ABA-based intervention in ASDs has been well documented through 5 decades of research by using single-subject methodology21,25,27,28 and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings.29–40 Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.31–40

MADSEC Autism Task Force Report (2000):

Over the past 30 years, several thousand published research studies have documented the effectiveness of ABA across a wide range of:

• populations (children and adults with mental illness, developmental disabilities and
learning disorders)
• interventionists (parents, teachers and staff)
• settings (schools, homes, institutions, group homes, hospitals and business offices), and
• behaviors (language; social, academic, leisure and functional life skills; aggression, selfinjury,
oppositional and stereotyped behaviors)

…

The effectiveness of ABA-based interventions with persons with autism is well documented, with current research replicating already-proven methods and further developing the field.

Documentation of the efficacy of ABA-based interventions with persons with autism emerged in the 1960s, with comprehensive evaluations beginning in the early 1970s. Hingtgen & Bryson (1972) reviewed over 400 research articles pertinent to the field of autism that were published between 1964 and 1970. They concluded that behaviorally-based interventions demonstrated the most consistent results. In a follow-up study, DeMeyer, Hingtgen & Jackson (1981) reviewed over 1,100 additional studies that appeared in the 1970s. They examined studies that included behaviorally-based interventions as well as interventions based upon a wide range of theoretical foundations. Following a comprehensive review of these studies, DeMeyer, Hingtgen & Jackson (1982) concluded “. . .the overwhelming evidence strongly suggest that the treatment of choice for maximal expansion of the autistic child’s behavioral repertoire is a systematic behavioral education program, involving as many child contact hours as possible, and using therapists (including parents) who have been trained in the behavioral techniques” (p.435).
Support of the consistent effectiveness and broad-based application of ABA methods with persons with autism is found in hundreds of additional published reports. [highlighting added HL Doherty]

Baglio, Benavidiz, Compton, et al (1996) reviewed 251 studies from 1980 to 1995 that reported on the efficacy of behaviorally-based interventions with persons with autism. Baglio, et al (1996) concluded that since 1980, research on behavioral treatment of autistic children has become increasingly sophisticated and encompassing, and that interventions based upon ABA have consistentlyresulted in positive behavioral outcomes. In their review, categories of target behaviors included aberrant behaviors (ie self injury, aggression), language (ie receptive and expressive skills, augmentative communication), daily living skills (self-care, domestic skills), community living skills (vocational, public transportation and shopping skills), academics (reading, math, spelling, written language), and social skills (reciprocal social interactions, age-appropriate social skills).

In 1987, Lovaas published his report of research conducted with 38 autistic children using methods of applied behavior analysis 40 hours per week. Treatment occurred in the home and school setting. After the first two years, some of the children in the treatment group were able to enter kindergarten with assistance of only 10 hours of discrete trial training per week, and required only minimal assistance while completing first grade. Others, those who did not progress to independent school functioning early in treatment, continued in 40 hours per week of treatment for up to 6 years. All of the children in the study were re-evaluated between the ages of six and seven by independent evaluators who were blind as to whether the child had been in the treatment or control groups. There were several significant findings:

1) In the treatment group, 47% passed “normal” first grade and scored average or above on IQ
tests. Of the control groups, only one child had a normal first grade placement and average
IQ.

2) Eight of the remaining children in the treatment group were successful in a language
disordered classroom and scored a mean IQ of 70 (range = 56-95). Of the control groups,
18 students were in a language disordered class (mean IQ = 70).

3) Two students in the treatment group were in a class for autistic or retarded children and
scored in the profound MR range. By comparison, 21 of the control students were in
autistic/MR classes, with a mean IQ of 40.

4) In contrast to the treatment group which showed significant gains in tested IQ, the control
groups’ mean IQ did not improve. The mean post-treatment IQ was 83.3 for the treatment
group, while only 53.3 for the control groups.

In 1993, McEachin, et al investigated the nine students who achieved the best
outcomes in the 1987 Lovaas study. After a thorough evaluation of adaptive functioning, IQ and personality conducted by professionals blind as to the child’s treatment status, evaluators could not distinguish treatment subjects from those who were not. Subsequent to the work of Lovaas and his associates, a number of investigators have
addressed outcomes from intensive intervention programs for children with autism. For example, the May Institute reported outcomes on 14 children with autism who received 15 - 20 hours of discrete trial training (Anderson, et al, 1987). While results were not as striking as those reported by Lovaas, significant gains were reported which exceeded those obtained in more traditional treatment paradigms. Similarly, Sheinkopf and Siegel (1998) have recently reported on interventions based upon discrete trial training which resulted in significant gains in the treated children’s’ IQ, as well as a reduction in the symptoms of autism. It should be noted that subjects in the May and Sheinkopf and Siegel studies were given a far less intense program than those of the Lovaas study, which may have implications regarding the impact of intensity on the effectiveness of treatment.

...

Conclusions
There is a wealth of validated and peer-reviewed studies supporting the efficacy of ABA
methods to improve and sustain socially significant behaviors in every domain, in individuals
with autism. Importantly, results reported include “meaningful” outcomes such as increased
social skills, communication skills academic performance, and overall cognitive functioning.
These reflect clinically-significant quality of life improvements. While studies varied as to the
magnitude of gains, all have demonstrated long term retention of gains made.

Other major contributions of ABA to the education and treatment of individuals with autism
include:

• a large number of empirically-based systematic instruction methods that lead to the
acquisition of skills, and to the decrease/elimination of aberrant behaviors;
• a technology for systematically evaluating the efficacy of interventions intended to affect
individual learning and behavior; and
• substantial cost/benefit.

Over 30 years of rigorous research and peer review of applied behavior analysis’ effectiveness for individuals with autism demonstrate ABA has been objectively substantiated as effective based upon the scope and quality of science. [highlighting added - HLD]

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Autism Treatment and Autism Advocacy in Canada: God Bless America!

Canada shares a border with the United States of America and we can not escape the influence of our giant neighbor and our American cousins. We absorb American news and popular culture every time we turn on our televisions. From American Idol to CSI Miami we get it all, every day. American political decisions, from war in Iraq to border crossing security changes, can have a dramatic impact on Canadians and we often follow their politics closely. Why is Hillary staying in? Does John McCain have the support of the Republican base? For Canada's autistic children, and their families who seek effective autism treatment for them, the United States and credible America autism authorities, have also had a huge influence. They have filled a vacuum by providing credible, well researched knowledge and information about the effectiveness of autism treatments.

The American Academy of Pediatrics, the Maine Autism Task Force, the Office of the US Surgeon General, and state authorities in New York and California, have all played critically important roles in educating Canadian parents about the scientific, evidentiary basis in support of the efficacy of autism treatments particularly ABA. The input of these US authorities has helped many Canadian parents and autism advocates counter the often lacking and misleading information provided to them by Canadian bureaucrats and the anti-ABA biases of some influential members of the Montreal scientific community.

With such credible sources providing reliable, substantiated, information parents and autism advocates in Canada have had the tools we needed to help educate public decision makers and to obtain evidence based, effective ABA intervention for our autistic children. A great deal remains to be done to provide effective help for autistic children, in Saskatchewan, Ontario, Nova Scotia, in every province and territory in Canada, but we do have the tools to help us, courtesy of our American neighbors. With the guidance they have provided, and with our own will and determination, we can succeed in our struggle to help our autistic children.

YES WE CAN!

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