It is sad to see that in Ireland today that old, failed logic and tired clichés like "one size does not fit all" are being trotted out by the governing Fianna Fail party to
deny Applied Behavior Analysis (ABA) services to autistic children in Ireland:
Fianna Fáil's Peter Power appealed to the Opposition not to assume that those opposing the motion were 'anti-children', saying nobody was absolutely right, or absolutely wrong.There was derisive laughter from the gallery when Fianna Fáil's Margaret Conlon, a former teacher, referred to children with special needs demonstrating their abilities 'when they play their tin whistles as a group'.Concluding the debate for the Government, Minister Micheál Martin said the Government did not believe 'one size fits all', because autism is a continuum, and said the idea of a wide range of teaching methods was not a ridiculous suggestion.These rationalizations were trotted out a decade ago in New Brunswick and other jurisdictions in Canada and the United States in an effort to deny proven effective ABA services for autistic children desperately in need of such help. These rationalizations are used to provide cover for a refusal to provide effective help for autistic children, not because of genuine concern that other methods might be more appropriate, but because of the cost implications of providing effective ABA intervention.
The reality is that stubborn insistence on refusing the only widely endorsed, evidence based, effective intervention for autistic children is motivated by nothing more than miserliness. The concern of those who resort to such obviously weak excuses has nothing to do with ensuring that each autistic child receives the best intervention possible for that child. If it were they would provide ABA for each child for whom, in their wisdom, they consider it appropriate and other interventions, whatever they might be, for the others. But they won't do that either; governing parties are often just too cheap to spend money to provide evidence based, effective ABA treatment and education for autistic children.
In New Brunswick the government of the day tried the old "one size does not fit all" approach . The debate over whether ABA should be provided by government was intense and at times very personal. But today, although improvements are badly needed, government funded ABA intervention is provided for pre schoolers and some methods and resource teachers and teacher aides are being trained to provide ABA in the school setting. My son with Autism Disorder , and in grade 6, receives ABA instruction every day at Nashwaaksis Middle School. ABA services are also provided to one extent or another in jurisdictions across Canada.
The debate in New Brunswick, and elsewhere, was moved forward by focusing on the principle that interventions should have a solid evidence basis to support their effectiveness. Without an evidence basis parents and officials are essentially gambling with the development of autistic children by wasting time on unproven and unreliable interventions. Here in New Brunswick it was the insistence on evidence based interventions that emerged from an Inter Departmental Committee review of autism specific services in 2001, which at that time were virtually non existent. It is that commitment to evidence based practices which has led to substantial improvements, and to the provision of ABA services for autistic children in New Brunswick.
One of the most helpful and influential reviews of the studies of autism intervention effectiveness was the
MADSEC ( Maine Administrators of Services for Children with Disabilities) Autism Task Force Report 1999, 2000 (rev.ed.) The MADSEC Autism Task Force was commissioned to:
perform a detailed analysis of methodologies with which to educate children with autism. This analysis will focus upon the scope and quality of scientific research which objectively substantiates, or fails to substantiate, each method’s effectiveness. Based upon the research analysis, the MADSEC Autism Task Force will make recommendations for the consideration of decision makers who are key
to the intervention of children with autism. (Mission Statement, p. 2 ) The MADSEC team reviewed the scientific literature, literally hundreds of studies, in support of various autism interventions. It concluded, as summarize in its Executive Summary at pages 5-6:
• 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.
• Shows promise, but is not yet objectively substantiated as effective for individuals with autism using controlled studies and subject to the rigors of good science:Auditory Integration Training, The Miller Method, Sensory Integration, and TEACCH.• Repeatedly subjected to the rigors of science, which leads numerous researchers to conclude the intervention is not effective, may be harmful, or may lead to unintended consequences: Facilitated Communication.• Without scientific evaluation of any kind:Greenspan’s DIR/”Floor Time,” Son-Rise.The MADSEC depiction of ABA as the only autism intervention substantiated as effective, based on the scope and quality of research in support, was not the only review of the research literature to reach such a conclusion. State agencies in New York and California and the office of the US Surgeon General had reached similar conclusions. Nor was it the last.
In
Management of Children With Autism Spectrum Disorders, October 29, 2007 the American Academy of Pediatrics stated:
Applied Behavior AnalysisApplied 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 methodology 21,25,27,28 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
Other interventions were evaluated by the AAP but no other intervention received a comparative positive assessment, not even close.
Fianna Fail is using the old beaten argument that one size does not fit all to justify refusal to provide ABA services to autistic children. In doing so they are denying those children the opportunity to realize, in the words of the AAP, "
substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior".
Fianna Fail has its counterpart here in Canada. Although most provincial jurisdictions try to provide ABA services, the level of funding, and extent of service provided, varies from province to province. Our federal government has huge surpluses but will not provide funding to the provinces to pay for more ABA intervention. The Conservative government of Prime Minister Stephen Harper and Alleged Health Minister Tony Clement refuse, on a variety of flimsy grounds, including the old "one size does not fit all cliché", to spend money to help autistic children.
For Ireland's Fianna Fail, and for Canada's Conservative Party, it appears that money means more than children .... more than autistic children anyway.
autism
