Lisa Jo Rudy Does A Bettelheim, Demeans ABA Parents While Pushing Her New Autism Book

Lisa Jo Rudy and I seldom, if ever, agreed on autism issues while she was the host of the About Autism web page. Lisa Jo has a high functioning autistic son and leans towards a Neurodiversity perspective on most autistm issues while my son is severely autistic and I have NEVER been accused of buying into Neurodiversity ideology. I did, at one time,  actually praise Lisa Jo Rudy though for her courteous approach to me and others with whom she disagreed on autism issues:

"About.com Autism by Lisa Jo Rudy is a corporate blog written by a parent who shares a neurodiversity perspective but tries honestly to present all sides of autism issues objectively and with impeccable courtesy."

Now that Lisa is no longer the host of the About.com Autism page though she appears to be taking a new approach to discussing autism issues. She has done a  Full Bettleheim in order to promote her new book "Get Out, Explore, and Have Fun: How Families of Children With Autism or Asperger Syndrome Can Get the Most Out of Community Activities."

In promoting her new autism book Lisa Jo demeans parents who employ evidence based ABA therapy to help their autistic children by actually stating that their resort to ABA therapy for their children is more about dumping their kids with the therapists and freeing themselves up to go shopping than in helping their autistic children. In a Wicked Local Cape Cod article linked by Autism Speaks "In the News" section the following segment appears:

“Rudy said although the most common form of autism therapy is Applied Behavior Analysis (ABA) she opted for another method.“The ABA recommendation is for 40 hours a week and it’s more about handing your child over to a therapist while you go to the grocery store,” she said. 

Rudy discovered the Greenspan Floortime Approach, developed by the late Stanley Greenspan, which focuses on parent and child interaction.”

Bettleheim's refrigerator mom's theory essentially blamed lack of parent child interaction for causing children to become autistic.  The theory was in fact a fantasy with no evidence in support but it was widely accepted by the psychiatric/psychological professionals for many years and caused great harm to both autistic children and their parents.  Although Bettleheim's fantasies have long been discredited it appears Lisa Jo is still reading his books when she suggests that parents seek ABA therapy not because it is the most evidence based effective intervention for autism but because, according to Lisa, it frees the parents up to go shopping.  Lisa of course prefers the 

Greenspan Floortime Approach because, according to her, it focuses on parent child interaction.

How Lisa Jo knows anything about ABA as someone who didn't "opt for" ABA for her child has always puzzled me.  What is most interesting though, apart from her new willingness to demean ABA oriented autism parents while promoting her book is her failure to mention the different evidence bases for the effectiveness of the two approaches as autism interventions.

Many credible authorities have recommended ABA as the most evidence based effective intervention for autistic children including the office of the US Surgeon General and the Association for Science in Autism Treatment.  The American Pediatric Association issued the following statements about ABA and Floortime therapies in December 2007 noting the abundant evidence over several decades in support of ABA as an autism intervention and the scarcity of quality evidence in support of Floortime and similar relationship/developmental models:

ABA

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.

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

Floortime

"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"

American Academy of Pediatrics, Management of Children with Autism Spectrum Disorders, Published online October, 29, 2007, Reaffirmed by the APA, September 2010.  

Lisa Jo Rudy has chosen to depart from a previously courteous, objective approach to discussing autism issues, unfortunately for autistic children whose parents abandon ABA efforts based on Ms Rudy's personal prejudices.  Most parents demeaned by such comments will not take them too seriously because the Bettelheim cold mother's fantasy has been widely exposed as nonsense (outside of France anyway).  The autistic children  of parents who look to Ms. Rudy for guidance though may not be as fortunate.

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Medicare Coverage of ABA Treatment for Autism Is Important Because ...

Please watch Medicare's Orphans which details the fight for inclusion of health care treatment for autism disorders in Medicare in Canada and specifically the fight for medicare coverage of ABA. The medicare coverage of  ABA treatment for autism disorders is important because:

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 (underlining added-HLD)

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


The AAP 2007 report  Management of Children with Autism Spectrum Disorders was reaffirmed  by the AAP in September 2010:

AAP Publications Retired and Reaffirmed

REAFFIRMED

Clinical Report: Dealing With the Parent Whose Judgment Is Impaired by
Alcohol or Drugs: Legal and Ethical Considerations. Pediatrics. 2004;
114(3):869 – 873. Reaffirmed September 2010

Clinical Report: Identification and Evaluation of Children With Autism
Spectrum Disorders. Pediatrics. 2007;120(5):1183–1215. Reaffirmed
September 2010

Clinical Report: Management of Children With Autism Spectrum Disorders. Pediatrics. 2007:120(5):1162–1182. Reaffirmed September 2010

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Autism Research: Which "Autism" Is Being Studied?

Neuron, Cover Page, 23 June, 2011 Volume 70, Issue 6

The abstract for the study Disrupted Neural Synchronization in Toddlers with Autism,  reported in the current issue of Neuron, indicates that autism is tied to disrupted cortical synchronization, weak "functional connectivity" across two hemispheres of the brain:

" we show that disrupted synchronization is evident in the spontaneous cortical activity of naturally sleeping toddlers with autism, but not in toddlers with language delay or typical development. Toddlers with autism exhibited significantly weaker interhemispheric synchronization (i.e., weak “functional connectivity” across the two hemispheres) in putative language areas. The strength of synchronization was positively correlated with verbal ability and negatively correlated with autism severity, and it enabled identification of the majority of autistic toddlers (72%) with high accuracy (84%). Disrupted cortical synchronization, therefore, appears to be a notable characteristic of autism neurophysiology that is evident at very early stages of autism development."

The abstract does not explain what is meant by "autism" for the purpose of the reported study. The DSM-IV does not list "autism" as a specific diagnostic label or category. It does list autistic disorder. Common usage refers to all of the Pervasive Developmental Disorders, including Asperger's Disorder as variations of "autism". It is very common for very high functioning persons with Asperger's Disorder to tell the world about their experiences as autistic persons. Some such as Ari Ne'eman, a very intelligent, articulate individual with the social skills to participate in IACC and government meetings, likes to declare to the world,  that "WE", referring to persons with "autism",  do not want to be cured of their autism.  The DSM-5 will expressly merge the various "autism" disorders into one Autism Spectrum Disorder. 

It is not clear to me what is meant by the term "autism" in this abstract study.  Is it Autistic Disorder in the DSM-IV? Is it the PDD's in the DSM-IV all of which are now referred to as autism in common usage? Is it the Autism Spectrum Disorder of the DSM-5? Does the term autism as used in this study exclude persons with autism who are also intellectually disabled as the DSM-5 definition appears to do?

If anyone has read the full study report could they indicate how autism is being used in this study? Do the subject toddlers have Autistic Disorder in the DSM-IV, all of the PDD's of the DSM-IV, or Autism Spectrum Disorder from the DSM-5? Were potential subjects with "autism" and intellectual disability excluded?

The media coverage (1, 2, 3, 4) of this study also refers generically to "autism" without indicating which autism is being studied, a piece of information that I would think is fundamentally important to understanding the study's conclusions.

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Autism Research After the DSM5? At Least Grinker Will Be Happy

Will the DSM5 render meaningless all autism research to date? Will the DSM5 make it impossible to determine whether autism disorders are increasing or whether they are triggered or caused by environmental factors? The odds are good, given the difficulties in answering these questions resulting from the expansion of "autism" disorders in the DSM-IV and DSM-IV-TR to include Asperger's, that our understanding of autism prevalence and causation will be hampered substantially, and perhaps totally undermined, by yet another revision of the autism diagnostic categories in the DSM-5.  Even our understanding of what autism is will likely change, again, as a result of the DSM-5 revisions.  The intellectual disabilities that characterized the vast majority (Yeargin-Allsopp) of persons with classic autism will now be totally  replaced by the "socially quirky" model of autism.

Autism is now recognized globally with a World Autism Awareness Day each April 2.  While the day is used for autism fund raising, and celebrating the color blue,  it does little to actually raise awareness about the nature of autism, the numbers of persons with autism disorders, or the causes or treatment of autism.  Amongst the leading factors that contribute to our inability to qualitatively improve our understanding of autism disorders is the changing diagnostic definition of autism, increased social awareness and according to some at least, the widescale availability of autism treatments and education accommodations prompting diagnostic substitution by professionals, often prompted by parents.

Roy Richard Grinker is one of the best known advocates of the "don't worry, be happy" autism is not really increasing school of thought.  A 2007 copyright summary of Grinker's  book Unstrange Minds tells us all what was really happening with autism increases ...  in Grinker's opinion:

"Unstrange Minds shows how the shift in how we view and count autism is part of a set of broader shifts taking place in societies throughout the world. The growth of child psychiatry, the decline of psychoanalysis, the internet, the rise of international advocacy organizations, greater public sensitivity to children's educational problems, and changes in public policies have together changed the way autism is diagnosed and defined.


Societies are becoming more aware of children's behavioral and learning differences at earlier and earlier ages and more comfortable with diagnosis, medication, and psychiatric labels. Under the rubric of autism we now find a multitude of emotional and cognitive problems, problems that used to be given other diagnostic labels or that were even considered within the range of the normal. Doctors now have a more heightened awareness of autism and are diagnosing it with more frequency, and public schools in the United States, which first started using the category of autism during the 1991-1992 school year, are reporting it more often, developing ways to help children with autism, and directing parents to appropriate resources. Epidemiologists are also counting it better.


As a result, the statistics on autism that we have today - 1 in 166 -- are the most accurate we've ever had."

 The 2007 summary was written more than a dozen years after the last diagnostic definition change for autism disorders in the DSM manuals.  Yet the CDC recognized rates have moved upward twice since then to 1 in 150 and most recently to 1 in 110.  I am no cultural anthropologist but with a change from 1 in 166 to 1 in 110 it seems fool hardy to simply assume that the increased rates of approximately another 50% in 4 years are accounted for solely on the basis of diagnostic and social ascertainment factors. 

It is worthy to note that the IACC has acknowledged that the almost 100% dedication of autism funding toward genetic focused research has come at the cost of needed environmentally focused research, that the current thinking is that autism arises from the interaction of genetic and environmental factors (hardly a radical concept) and that the IACC view is that the social and diagnostic changes account for only approximately 50% of the dramatic increases in reported cases of autism disorders.

It seems that, finally the feel good, autism is 100% genetic and is not really increasing view of the Grinker (and Neurodiversity) model of autism is about to be seriously challenged and hopefully researched.  But wait a minute ... along comes another autism diagnostic revision in the DSM-5. 

PREDICTION: The DSM-5 autism diagnostic revisions will once again be used to cloud and confuse our understanding of autism rates and causation.  Many concerned parents and concerned professionals will be  Out of Luck in hoping for more understanding of autism.  Roy Richard Grinker, however, and those for whom exploration of potential environmental causes of autism are a nuisance, should be happy that Grinker's 100% genetic, stable model of autism will be protected from serious research challenges for decades to come.

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Blame Game: Health Officials Blame Their Vaccine Program Failures on Autism Concerned Parents

The past 2 years have seen an onslaught of attacks on anyone who raises any questions about vaccine safety and in particular against anyone who suggests that vaccines might be implicated in causing or triggering autism disorders in some children.  Dr. Paul Offit has been the New York Times go to guy in promoting vaccine programs for almost a decade. His crusade to prevent discussion of possible autism vaccine connections was kick started with his New York Times Op-Ed "contribution" in March 2008 criticizing the results of the Hannah Poling case. 

With that opinion Dr. Offit expanded his unquestioned status as a vaccine expert to include his self appointed/self anointed status as an autism expert AND as a legal expert. The Offit Offensive began in full force in January 2009 with the New York Times' ceaseless coverage of  Offit's False Prophets and his drive to shut down discussion of vaccine safety issues.  The criticism of those who raise autism and safety issues has intensified with the ceaseless attacks on Dr. Andrew Wakefield and the unproven fraud allegation of the  BMJ (after the fact admitter of conflicts) and its adoptee  Brian Deer.

The result of the Offit Offensive? After years of attacking vaccine questioners public health authorities continue to see declines in vaccination rates and continue to blame those who question vaccine safety particularly those who are concerned about possible vaccine autism connections.  In just the most recent example in the news Minnesota doctors and health authorities are again tying declining measles vaccination rates and increased measles outbreaks to "erroneous" allegations of vaccine autism connections. 

As the parent of fully vaccinated sons I have never blamed vaccines for my younger son's autistic disorder and profound developmental delays.  I myself receive vaccines when I think them necessary or when advised by my family doctor. I believe vaccines to be important public health tools but like all of man's inventions I do not believe that they are  flawless.  Vaccines have caused injury in the past.  That is fact and it is reasonable for people to ask questions about the safety of vaccines.  The anecdotal evidence of vaccine autism connections, even acknowledging the weakness of anecdotal evidence, can not be ignored unless and until strong studies are done to convince parents that what they believe they have seen is not what really caused their children to lapse into a serious neurological disordered condition.  Failure to persuade the public is the failure of the health authorities and the persuasion strategies they have adopted to promote vaccine safety.  Decline in public confidence in vaccines is the failure of the health authorities not the public they are trying to convince.

While portrayed as being a front line crusader for the safety of children by vaccination Dr. Paul Offit is not in fact on the front lines.  It is parents who are on the front  lines fighting for their children's well being and health day in an day out. Calling them ignorant or irrational won't win their hearts and minds.  Blaming them for the decline in vaccination rates in some areas will not win the day for vaccine programs. Solid, credible studies free of pharmaceutical company influence by credible, trusted research authorities will. 

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Utah Study Misrepresents Autism Disorders, Report Includes Only Top 10% Highest Functioning Autistic Study Subjects

Wow, talk about your blatant misrepresentation of autism disorders.  A Utah study has followed the lives of 400 persons with autism since the 1980's in an effort to understand their quality of life as adults.  Except that well ... the study only reported on the top 40, or top 10% highest functioning members of the study group:

"Last year’s study – written by researchers at the U., Carmen B. Pingree Center for Children with Autism in Salt Lake City, McGill University in Canada, Los Angeles Medical School and Yale University School of Medicine – offered a rare glimpse into the lives of adults with autism, an understudied population. But it was limited in scope to 41 of the higher functioning participants from the original 1980s study."

Apart from ignoring those autistic subjects who were lower functioning the study only mentions that 20 of the subjects are now dead.  20 seems to me to be a fairly signficant number and a full study of the causes of their deaths as they relate to their autism disorders might be a subject worth elaborating on.  Of course those 20 might have been lower functioning persons with actual, honest to goodness Autistic Disorder and Intellectual Disability not the "good" autistics featured in movies and major media interviews.

Sadly there is nothing unique about the Utah based study.  When it comes to the autism "spectrum" academics often join hands with the mainstream media, and with Hollywood,  to portray the so called spectrum as composed entirely of higher functioning persons with autism.

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Lost in The Shadows of Autism Research: Does Exclusion of Low Functioning Autistic Subjects Limit Study Results?

Shadows distract autistic kids is the title of an article in the Times of India which reportedly shows that while people can look at the shadow of an object and often figure out what the object is, shadows interfere with how autistic children recognize objects.  The study however involved only high functioning autistic children.  Low functioning autistic children were, once again, excluded.

Notwithstanding the involvement of only High Functioning Autistic subjects the article states with reference to autism generally:

"These new findings shed light on the sensory abnormalities that accompany and possibly even help cause autism, the researchers said ... in autistic children, the presence of shadows — either matching or not matching the objects — interfered with recognition, making them take a little less than 350 milliseconds on average to do either. Instead, they reacted faster when there were no shadows present, recognizing objects in roughly 310 milliseconds. A possible explanation is that in autism, shadows go from being simple features worth a glance to extra details they hyper-focus on, potentially eating up their attention." 

Is it possible to draw conclusions about the entire autism spectrum based on studies which exclude low functioning autistic subjects? Personally, I am doubtful.

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Autism Disorders and Intellectual Disability: Claim that 75-80% of Persons with Autistic Disorder are Intellectually Disabled is Based on Credible Authorities

UPDATE: Alan Griswold is in very deep denial. I have now provided 3 credible sources to support the 75-80% range of persons with Autistic Disorder as also being Intellectually disabled - the ICD, the CPA and the CDC and Mr. Griswold can only repeat  his opposition to an association between Autistic Disorder and Intellectual Disability.  Of course accepting this information would require Mr. Griswold to reject his contribution to the world's discussion of autism disorders, his book Autistic Symphony which rejects autism as a medical disorder:  

"Autistic Symphony offers a unique look at the fascinating subject of autism. Challenging the psychiatric and scientific perspectives that focus exclusively on disabilities and impairments, Autistic Symphony celebrates the challenges and rewards experienced by every autistic individual, and argues that far from being a medical monster, autism is one of our culture's greatest strengths."

 
As I mentioned in my previous post Alan Griswold of Autistic Aphorisms is one of those comfortable with speculation that Jesus Christ may have been autistic but is not comfortable with the fact that many persons with Autistic Disorder are Intellectually Disabled.  Mr. Griswold and Astrid at at  Astrid's Journal disagree with my numerical references and wrongly describe them as self constructed.

My claim is not that 75-80% of all persons with an Autism Spectrum Disorder are also Intellectually Disabled as Astrid in particular seems to think. My assertion is that credible authorities have stated that 75-80% of persons with Autistic Disorder are intellectually disabled.  I stand by that assertion and, once again, for those who actually read before reacting, offer the sources:

1. Canadian Psychological Association    Autism Brief to the Standing Senate Committee on Social Affairs, Science and Technology November 9, 2006.

In that brief the CPA refers to 2 separate categories "Autism" and Asperger's":

"Cognitive impairment is present in about 80% of persons diagnosed with Autism and
general intellectual functioning is most often below average. Persons diagnosed with
Asperger’s Disorder have average to above average intellectual functioning.


...

In sum, persons with ASD present with a wide range of impairments in cognition, language and
behaviour which present in some common but reliably distinct ways between Autism and
Asperger’s disorders."

2. Center for Disease Control Counting Autism 

CDC’s most recent data show that between one in 80 and one in 240 children with an average of one in 110 have an ASD. This is a prevalence of about one percent of children. These results reflect data collected by CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network in multiple communities throughout the U.S. in 2006.

Estimates are based on health and education records from participating communities, which includes eight percent of the U.S. population of eight year olds. All children in the studies were eight years old because previous research has shown that most children with an ASD have been identified by this age for services.


...


Cognitive Functioning (from the pdf version)

2004
 
From 37.9% (Arizona) to 63% (Alabama) (overall average: 43.8 %) of the children identified with an ASD also had an intellectual disability (an IQ ≤70, at the sites that had test results on intellectual ability for at least 75% of the children identified).

2006
 
From 29.3% (Colorado) to 51.2% (South Carolina) (overall average: 41.0 %) of the children identified with an ASD also had an intellectual disability (an IQ ≤70, at the sites that had test reults on intellectual ability for at least 75% of the children identified)

The CDC figures of 41-44% for all persons on the Autism Spectrum having an intellectual disability are consistent with the 80% figure for those with Autism EXCLUDING Aspergers cited by the CPA. These figures and sources are my authorities for the upper end of the 75-80% range of persons with Autistic Disorder having an Intellectual Disability.  That is not a self constructed figure.

The lower end of the range I cite is the figure based on older sources like the 1992 ICD diagnostic criteria for Autism:

3.The ICD-10 Classification of Mental and Behavioural DisordersWorld Health Organization, Geneva, 1992


F84.0 Childhood Autism


A pervasive developmental disorder defined by the presence of abnormal and/or impaired development that is manifest before the age of 3 years, and by the characteristic type of abnormal functioning in all three areas of social interaction, communication, and restricted, repetitive behaviour. The disorder occurs in boys three to four times more often than in girls.


...


All levels of IQ can occur in association with autism, but there is significant mental retardation in some three-quarters of cases.


F84.1 Atypical Autism


A pervasive developmental disorder that differs from autism in terms either of age of onset or of failure to fulfil all three sets of diagnostic criteria. Thus, abnormal and/or impaired development becomes manifest for the first time only after age 3 years; and/or there are insufficient demonstrable abnormalities in one or two of the three areas of psychopathology required for the diagnosis of autism (namely, reciprocal social interactions, communication, and restrictive, stereotyped, repetitive behaviour) in spite of characteristic abnormalities in the other area(s). Atypical autism arises most often in profoundly retarded individuals whose very low level of functioning provides little scope for exhibition of the specific deviant behaviours required for the diagnosis of autism; it also occurs in individuals with a severe specific developmental disorder of receptive language. Atypical autism thus constitutes a meaningfully separate condition from autism.


Includes:
* atypical childhood psychosis
* mental retardation with autistic features

These three authorities are the primary sources for my assertion that 75% (3/4 in the ICD) to 80% (CPA, CDC) of persons with Autistic Disorder also have intellectual disability.  Those are not self constructed figures as claimed by Alan and Astrid.  They are figures provided by credible authorities.

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Parents Stand by Son with Aspergers Convicted of Conspiring to Murder Them

The Independent UK reports that the parents of Christopher Monks, a 25 year old man with Aspergers Disorder who plotted with an internet friend to kill them stood by their son on sentencing and asked the court to show leniency.

The internet "friend" returned to the Skarnes home after visiting earlier in the day and attacked the parents who fended him off when he attempted to attack the father in his bedroom with a large kitchen knife.

""The pair were convicted despite the fact that Monks’s father, also Christopher, and his wife Elizabeth have fully supported their son, who was adopted at the age of 10 months. They argued that his condition meant he was unable to separate fantasy from reality and that he had never intended to have them murdered.

.......

Sentencing the pair at Preston Crown Court, Mr Justice McCombe said he felt for Monks’s parents. “No court could fail to be moved by the unstinting love they have for their son,” he said. “In their own words in a letter sent to me they say ‘Whatever sentence is passed, we will serve it with him’.”

But he added both men continued to present a “significant” risk of harm to the public. “I recognise that Mr and Mrs Monks find this difficult to accept but the court has a duty to protect the public and ensure that they are not released into the community until that risk is eliminated.”"

The article illustrates just how much many parents of children with Autism Spectrum Disorders love their children no matter how severe the challenges they present.

autism

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CDC Autism News Update 2015: Diagnostic Definition Changes, Increased Awareness Behind Recent Autism Surge

January 1, 2015 CDC Autism News Update

In a New Years day  media briefing the CDC has explained that its latest autism prevalence data, released two days before Christmas this year, and  showing a sharp rise in ASD, short for Autism Social Difference,  diagnoses, from 1 in 75 in 2012 to the current estimate of  1 in 50, is probably due to diagnostic definition changes and increased awareness.

New CDC Director Arnie Newman, who is himself "on the spectrum" with an  ASD diagnosis of Asperger Social Difference, says that some tiny, insignificant part of the increase could theoretically be due to environmental factors.  Dr. Newman also noted we are all fortunate to be living in the Acceptance Era when offensive terms like "Disorder" and "Disability" have been replaced by the enlightened  concept of "Difference". 

In what it repeatedly emphasized was a totally unrelated development the CDC also  finally released its  Sixth National Report on Human Exposure to Environmental Chemicals. The report is the most comprehensive assessment to date of the exposure of the U.S. population to chemicals in our environment. CDC has measured 2120 chemicals in people's blood or urine—750 of which have never before been measured in the U.S. population.

We now know  that there are lots of environmental chemicals in our bodies said Dr.  Newman but we should not assume that they cause any harm. Dr. Newman stated in closing that the CDC long term study plan projections for the year 2025 include the possibility of examining the effects, if any,  of such chemicals on the developing neurological systems of fetuses and young children.  Such a study is definitely, or at least probably, on our list of possible future research priorities said Dr. Newman.  

autism

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Misleading Autism Treatment Statements at About.com Autism

Lisa Jo Rudy at About.com Autism, for reasons unknown to me has made misleading statements about the evidence in support of the efficacy of various autism treatments. Coming on the heels of the recent Deborah Fein study showing that 10-20% of subject children with autism recovered from their autism with Intensive Early Behavioral Intervention ... ABA ... it is surprising to see About.com Autism apparently react to that study with the assertion that all autism therapies are created equal. Ms Rudy and About.com Autism appear to have turned their backs on evidence based assessments of autism treatments.

Ms Rudy stated in Can All Positive, Intensive Therapies Help Kids with Autism?:

As a result, there's no good way to know whether a child who received Floortime would have done better with RDI or ABA. Certainly, evidence shows that most children with autism improve to varying degrees with intensive therapy, no matter what its name.

Apart from the recent Fein study demonstrating full recovery as set out above other studies and reviews of those studies have unequivocally indicated that only ABA enjoys a solid evidence basis in support of its effectiveness:

The MADSEC (Maine) Autism Task Force assessed the evidence basis in support of various autism interventions as of 2000 and found that only one, ABA, met the highest standard:

"Based upon a thorough examination of numerous methodologies considered as interventions for children with autism, the MADSEC Autism Task Force has characterized the interventions reviewed as follows:

• Substantiated as effective based upon the scope and quality of research:
Applied behavior analysis.

In addition, applied behavior analysis’ evaluative procedures are effective not only with behaviorally-based interventions, but also for the systematic evaluation of the efficacy of any intervention intended to affect individual learning and behavior. ABA’s emphasis on functional assessment and positive behavioral support will help meet heightened standards of IDEA ‘97. Its emphasis on measurable goals and reliable data collection will substantiate the child’s progress in the event of due process.

In describing the evidence backed benefits of ABA the MADSEC Report noted that:

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 benefiting individuals with autism known today. Early interventionists should leverage early autism diagnosis with

The American Academy of Pediatrics Management of Children with Autism Spectrum Disorders (2007) report described the level of evidence of ABA effectiveness in a manner that no other treatment mentioned in the report even remotely approximated:

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

To these reviews of studies supporting ABA effectiveness in treating autism can be added the US Surgeon General and the NY State Department of Health. Now the Fein study on autism recovery would add to the information basis of such reports.

We are decades past the point where About.com Autism can claim that all autism interventions are created equal as long as they are positive and done early and intensively. There is no evidence to support the About.com position. The About.com Autism position is in essence a rejection of an evidence based approach to assessing autism interventions.

autism

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