An Important Autism Resource: Interventions for Autism Spectrum Disorders STATE OF THE EVIDENCE October 2009

I encourage anyone interested in autism disorders, particularly parents of children newly diagnosed with an autism disorder, to read Interventions for Autism Spectrum Disorders STATE OF THE EVIDENCE October 2009.  It is a thorough,  comprehensive review, as the title indicates, of the State of the Evidence relating to autism interventions published by the  State of Maine Departments of Health and Human Services and  Department of Education. 

Unlike many reviews of autism interventions it provides a detailed assessment and "grading"  of the  evidence in support of the various autism interventions.  STATE OF THE EVIDENCE in many ways is an update and further refinement of another effort by our good neighbors in Maine  the  excellent Report of the MADSEC Autism Task Force (2000).  

I have always believed that an evidence based approach to assessing the efficiency of autism interventions is of fundamental importance to finding the best ways to help my son Conor grow and overcome to the fullest possible extent the deficits that accompany his severe autistic disorder.  The MADSEC report pointed clearly to ABA as the most evidence based autism intervention.  While Conor never had the opportunity to benefit from Intensive Early Behavior Intervention he has benefited from ABA. 

I do not ask any other parent to take my word on what benefits ABA might or might not be able to bring to their child with autism.  I do encourage them to read credible sources about autism interventions. In the past the MADSEC Autism Task Force was the best report that I read providing a clear, well organized summary and assessment of the evidence in support of autism interventions.  The STATE OF THE EVIDENCE is an important new resource that follows the same helpful pattern.

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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.

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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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Kaufman To Sell Son-Rise In Scotland

Scotland on Sunday reports that Raun Kaufman is off to Scotland to sell parents of autistic children on his Son-Rise program. The article quotes several voices urging caution with respect to Son-Rise and Mr. Kaufman's claim including Dr Richard Mills, director of independent charity Research Autism:

"Anecdotal reports of recovery are not evidence. There have been no independently conducted, peer-reviewed scientific trials of the Son-Rise method so we cannot recommend it to parents."


The MADSEC Autism Task Force Report (2000 Rev.) described Son-Rise as:


page 6:

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

page 54:

Discussion

There have been no peer-reviewed, published studies of The Son-Rise Program’s effectiveness or outcome statistics. Son Rise: The Miracle Continues chronicles the experiences of Barry and Samahria Lyte Kaufman as they created a program to meet the needs of their young son, diagnosed with autism and an IQ under 30. According the Kaufman (1997), their son currently has a near genius IQ, and no traces of his original condition.

Conclusions

There have been no studies of the Son-Rise Program’s effectiveness. Researchers should consider investigation using research protocols. Professionals considering Son-Rise should portray the method as without scientific evaluation of any kind, and should disclose this status to key decision makers influencing the child’s intervention.

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Autism Society Canada Rejects Evidence Based Approach To Autism Treatment And Fails Autistic Children

Recent statements by current Autism Society Canada President Kathleen Provost to a Montreal Gazette reporter have me asking again what the ASC actually does to help autistic Canadians? When the ASC can not even tell the Canadian public in a forthright manner what numerous American state and professional agencies have told us for years about the evidence basis supporting the effectiveness of Applied Behavior Analysis in treating autism it becomes difficult to understand the ASC's raison d'être.

For parents of autistic children there are few things more important than trying to help their autistic children overcome, to the fullest extent possible, the deficits and challenges that accompany their autistic disorders - self injurious behavior, dangerous behavior such as wandering into traffic or getting lost, lack of communication and language abilities and intellectual deficits. These are all serious challenges facing many autistic Canadians. But they do not receive accurate information about the state of autism treatment from the ASC.

Autism Society Canada Statements on Autism Treatment

The Autism Society Canada has made incomplete, inaccurate and even misleading statements about the effectiveness of autism treatments. It does so by rejecting an evidence based approach to treating autism. It states that there are many approaches to treating autism without informing the public forthrightly that only Applied Behavior Analysis is supported by a large body of evidence supporting its effectiveness.

In More than one approach to autism the Autism Society Canada has failed, once again, to help Canadians evaluate the evidence supporting ABA as an autism intervention and, as the article title illustrates, helps mislead Canadians into thinking that all autism interventions are created equal. That no single autism intervention is better than any other. Nothing could be further from the truth. In that article Kathleen Provost, ASC President, is reported and quoted as follows:

Kathleen Provost of Autism Society Canada noted a lack of consensus among experts about the best ways of dealing with the condition.

"What we have the most researcher and information on is behaviour therapy," Provost said.

The society does not endorse any method.

"Some of it is new and we don't have enough information," Provost said. "We leave it up to the parents to make decisions."

There is no unanimity amongst "experts" about the best ways of dealing with autism, or any other issue, in any other field, for that matter. Most noticeable in opposing ABA as an autism intervention is the Montreal neuroscience community which dominates the Canadian Institutes for Health Research. (Anti-ABA advocate, Dr Laurent Mottron, of the Psychiatry Department of the Hopital Riviere-Des-Prairies was a key note speaker at the CIHR's November 2007 Autism Symposium which itself had to be rescheduled to ensure that known ABA advocates would be excluded from representing any of the provincial autism "communities"). There is, however, a clear consensus amongst experts about the best ways of dealing with autism and that consensus clearly points to ABA as the most effective evidence based intervention for dealing with autism.

Evidence Based-Medicine

To properly understand that consensus it is important to understand a point not often mentioned by the Autism Society Canada, or the CIHR for that matter, the concept of evidence based-medicine:

"Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. By individual clinical expertise we mean the proficiency and judgement that individual clinicians acquire through clinical experience and clinical practice. Increased expertise is reflected in many ways, but especially in more effective and efficient diagnosis and in the more thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisi ons about their care. By best available external clinical evidence we mean clinically relevant research, often from the basic sciences of medicine, but especially from patient centred clinical research into the accuracy and precision of diagnostic tests (including the clinical examination), the power of prognostic markers, and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. External clinical evidence both invalidates previously accepted diagnostic tests and treatments and replaces them with new ones that are more powerful, more accurate, more efficacious, and safer.

Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicabl e to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients."

Center for Evidence-Based Medicine (CEBM) and the British Medical Journal, 13th January 1996 (BMJ 1996; 312: 71-2)

The CEBM also refers readers to the Wikipedia entry on Evidence Based-Medicine:

Evidence-based medicine (EBM) aims to apply evidence gained from the scientific method to certain parts of medical practice. It seeks to assess the quality of evidence[1] relevant to the risks and benefits of treatments (including lack of treatment). According to the Centre for Evidence-Based Medicine, "Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients."[2]

EBM recognizes that many aspects of medical care depend on individual factors such as quality and value-of-life judgments, which are only partially subject to scientific methods. EBM, however, seeks to clarify those parts of medical practice that are in principle subject to scientific methods and to apply these methods to ensure the best prediction of outcomes in medical treatment, even as debate about which outcomes are desirable continues.

Practicing evidence-based medicine requires clinical expertise, but also expertise in retrieving, interpreting, and applying the results of scientific studies and in communicating the risks and benefits of different courses of action to patients.

....

Qualification of evidence

Evidence-based medicine categorizes different types of clinical evidence and ranks them according to the strength of their freedom from the various biases that beset medical research. For example, the strongest evidence for therapeutic interventions is provided by systematic review of randomized, double-blind, placebo-controlled trials involving a homogeneous patient population and medical condition. In contrast, patient testimonials, case reports, and even expert opinion have little value as proof because of the placebo effect, the biases inherent in observation and reporting of cases, difficulties in ascertaining who is an expert, and more.

Systems to stratify evidence by quality have been developed, such as this one by the U.S. Preventive Services Task Force for ranking evidence about the effectiveness of treatments or screening:

* Level I: Evidence obtained from at least one properly designed randomized controlled trial.
* Level II-1: Evidence obtained from well-designed controlled trials without randomization.
* Level II-2: Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.
* Level II-3: Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.
* Level III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.

The UK National Health Service uses a similar system with categories labeled A, B, C, and D. The above Levels are only appropriate for treatment or interventions; different types of research are required for assessing diagnostic accuracy or natural history and prognosis, and hence different "levels" are required. For example, the Oxford Centre for Evidence-based Medicine suggests levels of evidence (LOE) according to the study designs and critical appraisal of prevention, diagnosis, prognosis, therapy, and harm studies:[9]

* Level A: Consistent Randomised Controlled Clinical Trial, cohort study, all or none (see note below),clinical decision rule validated in different populations.
* Level B: Consistent Retrospective Cohort, Exploratory Cohort, Ecological Study, Outcomes Research, case-control study; or extrapolations from level A studies.
* Level C: Case-series study or extrapolations from level B studies.
* Level D: Expert opinion without explicit critical appraisal, or based on physiology, bench research or first principles.

Evidence Based-Medicine and Autism Interventions

Autism has been plagued by a host of "alternative" treatments and interventions including some as whacky as "swimming with dolphins"; the notion that somehow swimming in close proximity to these intelligent but still wild and powerful sea creatures somehow has therapeutic value for autistic children. Facilitated communication in which a therapist aids non-verbal autistic children in communicating through a variety of assisted communication technologies has caused actual harm as seen very recently in Oakland County Michigan where a family was torn apart when the parents of autistic children were wrongully charged with abuse based on a therapists Facilitated Communication interpretations of the autistic daughter's responses. The interpretations were exposed as nonsense at trial when the same process elicited answers such as these to questions posed to the daughter:

Q: What color is your sweater?

A: JIBHJIH

Q: What are you holding in your hand right now?

A: I AM 14


In Children with autism deserve evidence-based intervention, The evidence for behavioural therapy, MJA 2003; 178 (9): 424-425, Jennifer J Couper and Amanda J Sampson, reviewed some of the evidence in support of the efficacy of behavioral interventions for autism. The authors stressed the importance of an evidence based approach to autism interventions:

While ineffective therapies may be harmless, they waste parents' money and the child's valuable therapy time. Furthermore, the delay in implementing effective treatment may compromise the child's outcome.

Couper and Sampson reviewed the evidence at that time (2003) in relation to behavioral treatment for autism:

the early intervention that has been subjected to the most rigorous assessment is behavioural intervention. There is now definite evidence that behavioural intervention improves cognitive, communication, adaptive and social skills in young children with autism. In 1987, Lovaas showed apparent recovery, persisting into adolescence, in nine of 19 young children who received an intensive home-based intervention based on applied behavioural analysis, a scientific method of reinforcing adaptive and reducing maladaptive behaviours.5,6 Subsequent studies also showed that behavioural intervention caused significant, albeit somewhat lesser, gains.7-11 This has modified the orthodox view that autism is always a severe, lifelong disability. Criticisms of the adequacy of the design and power of these studies are being addressed by the multisite Lovaas replication Early Autism Project. The first US site has released data (Wisconsin Early Autism Project).12 Again, after three to four years of intensive applied behavioural analysis intervention, about half the preschool children with autism acquired near-normal functioning in language, performance IQ and adaptability. Ninety-two per cent of intervention children acquired some language. Control children who received special education showed no gains in IQ or adaptability.12

Why is intensive applied behavioural analysis intervention more effective than special education for children with autism? This can not be simply explained by the intensity of these programs (30–40 hours per week). Children in a school-based Scandinavian study who received behavioural intervention gained an average of 25 language IQ points in the first year of the intervention, with improvements in performance IQ, communication and adaptability. On all scores, they surpassed control children who received special education according to best practice for autism, and the same intensity, duration and supervision of therapy.13

Autism Treatment Consensus - God Bless America

Contrary to Kathleen Provost's, and the ASC's, statements, there IS a consensus on the best way to "deal with" autism. That consensus has been clearly articulated in a number of reviews of autism treatment effectiveness by responsible, respected American authorities. Thankfully the internet ensures that Canadian parents are not dependent on a sham Autism Symposium, the self interested dictates of some members of the Montreal neuroscience community, or the misleading statements of timid ASC representatives. We can read for ourselves what more credible authorities have concluded.

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

No other intervention reviewed by the AAP approached ABA in the quantity or the quality of evidence in support of its effectiveness as an ABA intervention.

New York State Department of Health - Clinical Practice Guidelines - Report of the Recommendations Autism/Pervasive Developmental Disorders 2005 (rev ed)

Intervention Methods

Intensive Behavioral and Educational Intervention Programs

Summary Conclusions

Intensive behavioral and educational intervention programs involve systematic use of behavioral teaching techniques and intervention procedures, intensive direct instruction by the therapist, and extensive parent training and support.

* Articles screened for this topic: The literature search found 232 articles that reported using behavioral and educational approaches in children with autism as well as 68 articles from a comprehensive review article on single-subject design studies.

* Articles meeting criteria for evidence: 5

Several studies done by independent groups of researchers have evaluated the use of intensive behavioral intervention programs for young children with autism. The four studies that met criteria for evidence about efficacy all compared groups of young children with autism who received either an intensive behavioral intervention, a comparison intervention, or no intervention. In all four of the studies reviewed, groups that received the intensive behavioral intervention showed significant functional improvements compared to the control groups.

While none of the four studies used random assignment of subjects to groups, there did not appear to be any evidence of important bias in group assignment. Within each study, the groups receiving different interventions had equivalent subject characteristics. Furthermore, all studies showed similar and consistent results.

Since intensive behavioral programs appear to be effective in young children with autism, it is recommended that principles of applied behavior analysis and behavioral intervention strategies be included as an important element of any intervention program.

It is recommended that intensive behavioral programs include a minimum of 20 hours per week of direct instruction by the therapist. The precise number of hours of behavioral intervention may vary depending on a variety of child and family characteristics. Considerations include age, severity of autistic symptoms, rate of progress, other health considerations, tolerance of the child for the intervention, and family participation. It is recommended that the number of hours be periodically reviewed and revised when necessary. Monitoring of progress may lead to a conclusion that hours need to be increased or decreased.

It is recommended that all professionals and paraprofessionals providing therapy to the child as part of an intensive behavioral program receive regular supervision from a qualified professional.

It is important that parents be included as integral members of the intervention team. It is recommended that parents be trained in behavioral techniques and be encouraged to provide additional hours of instruction to the child. It is also recommended that training of parents in behavioral methods for interacting with their child be extensive and ongoing, and that it include regular consultation with the primary therapist.

Although some of the intensive behavioral intervention programs that were effective included use of physical aversives (such as a slap on the thigh), other programs reported good outcomes without the use of any physical aversives. The panel does not recommend the use of physical aversives, especially given the small physical size and vulnerability of young children in the age group from birth to age three years.

None of the other interventions reviewed by the NYSDOH approached ABA as an evidence based effective intervention for autism.

Report of the MADSEC (Maine Administrators of Services for Children with Disabilities) Task Force Report 2000 (rev ed)



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.


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.


Mental Health: A Report of the US Surgeon General 1999

Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior. A well-designed study of a psychosocial intervention was carried out by Lovaas and colleagues (Lovaas, 1987; McEachin et al., 1993). Nineteen children with autism were treated intensively with behavior therapy for 2 years and compared with two control groups. Followup of the experimental group in first grade, in late childhood, and in adolescence found that nearly half the experimental group but almost none of the children in the matched control group were able to participate in regular schooling. Up to this point, a number of other research groups have provided at least a partial replication of the Lovaas model (see Rogers, 1998).

Consensus and Fully Informed Choices

The above are some of the leading statements by credible agencies that have reviewed the evidence bases in support of various autism interventions. No other intervention has anywhere near the same evidence in support of its efficacy as documented by these credible American agencies. Contrary to the unsubstantiated statement by Kathleen Provost there is in fact a clear consensus that ABA is the treatment of choice for autism.

If Kathleen Provost, and the Autism Society Canada, wish to exercise their information role responsibly they should make this clear to the public. Parents of newly diagnosed autistic children should be told that they might be gambling their child's precious development time, and their future development potential by forgoing ABA in favor of "feel good" unproven alternatives. In failing to do so they are failing autistic children in Canada.

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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 and Educators' Control Issues in Vernon Connecticut

It looks like an old story is playing out again in Vernon, Connecticut. ABA based instruction for autistic children, provided under contract with an outside agency, is being terminated by the local education authorities and is being brought "in house". As reported in the Journal Inquirer:


VERNON — The local school system’s decision to stop contracting with the Capitol Region Education Council to teach children with autism — and to bring the work in house — has angered parents, who say any change can harm a child with an autistic disorder.

.....

For more than a decade, CREC has taught children with autism at the Center Road School. The organization uses the Applied Behavior Analysis instructional method, which has the approval of the U.S. Surgeon General.

In fact the US Surgeon General is not the only agency to endorse ABA as an effective evidence backed instructional method for autistic children. State agencies in New York and California, the MADSEC Autism Task Force Report from Maine and the 2007 report of the American Academy of Pediatrics have all endorsed ABA as the most evidence based effective intervention for autistic children. As summarized in the 2007 AAP Report 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.31–40

So why would a successful program be discontinued and the education of autistic children brought "in house"? Control is often the real motivation for such decisions by alleged "educators" who often know little about autism, and generally know much less than the concerned parents who live 24/7 with the realities of autism. Here in New Brunswick, Canada, much progress has been made in providing autistic students, including my son Conor, with a real education. Autism specific training has begun to be provided to Teacher Aides that work with autistic children and Conor is currently receiving instruction from a UNB Autism Intervention Program trained TA under programs and supervision by autism trained resource teachers. But it was not always the case and even today senior "educators" still resist the commitment by our current government to provide UNB Autism training, which includes ABA based instruction methods, to teacher aides and resource teachers.

The excuses over the years are usually the same. I personally began advocating several years ago for ABA instruction in our schools and a Department of Education spokesman was interviewed as part of a story in which I was featured. The spokesman downplayed ABA and said that the Department was interested in TEACCH. TEACCH has often been described as "promising" but lacking in evidence of effectiveness in teaching autistic children. As summarized in the MADSEC ( Maine Administrators of Services for Children with Disabilities) Autism Task Force Report 1999, 2000 (rev.ed.) :


• 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.

In New Brunswick the UNB Autism Intervention Training of teacher aides and resource teachers has been opposed by some senior educators who wanted to do the training ..... "in house" just as the Vernon educators want to provide the instruction of autistic children in house. In each case, the autism training here in New Brunswick, or the autism instruction in Connecticut, it is control which is the real issue, control by the educators. In the Connecticut story the alleged educators want to use non-ABA methods of instructing autistic children, despite the well studied effectiveness of ABA and despite the lack of evidence supporting the effectiveness of other autism instruction methods. One spokesman even acknowledged that one of the methods that they seek to use has NO evidence in support of its effectiveness:

Buell says the ABA method is “not going out the window” and will be used with children who do well with it.

But she said in a written statement that the school system plans to explore a variety of other instructional methods.

With one possible exception, all the methods under consideration have studies supporting their effectiveness, Buell added.

Spokesperson Buell did not elaborate, in the article anyway, about these "other instructional methods" and the studies in support of their effectiveness. Whatever they might be there is no way these other methods enjoy the scope and quality of research in support of their effectiveness, as reported by the Maine MADSEC Autism Task Force in 1999-2000, or the AAP in 2007.

It is not about "other instructional methods".

It is about control.

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Autism in Ireland - Fianna Fail Uses Old, Failed Logic, Tired Clichés, In Denying ABA Help To Autistic Children

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 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 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.

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Autism and Learning - ABA Is Being Used To Help Autistic School Children

If you read only the writings of a few hard core anti-ABA activists like Dr. Laurent Mottron and his colleague Michelle Dawson, or their followers in the Neurodiversity movement, you would think that Applied Behavior Analysis, or ABA, is an oppressive violation of the rights of autistic children. You would not know that ABA is considered by thousands of autism experts, based on hundreds of studies over more than five decades of research to be an effective method of helping autistic children make continuing gains in learning, intellect, social and communication skills. Numerous responsible and respected agencies have reached the same conclusion, including the American Academy of Pediatrics, The US Surgeon General's Office, the Association for Science in Autism Treatment, and state and provincial agencies across Canada and the United States, including the best known in Maine, New York and California.

If you are a parent of a newly diagnosed autistic child I urge you to ignore the anti-ABA activists and read the material published by the responsible agencies I have listed above. And talk to parents who actually live with autistic children day in and day out and care for them who are helping their children with ABA. Finally consult with people like those at the May Institute who actually work with autistic children. And consult with people like those at the Half Hollows Hill school. There the teachers and other staff use the most effective known method of teaching students with autism Applied Behavior Analysis.

These people are not sitting in a Montreal research facility studying ways to prove that ABA is wrong. Nor are they working only with higher functioning autistic children. They work with autistic children from across the spectrum .... and they use ABA to help them learn .... because it works. The faculty and staff at Half Hollow Hills, like the professionals at the May Institute, know that autism works, not just because of the volumes of research telling them it works, but also from the daily experience of actually working with autistic children from across the autism spectrum and helping them learn by ABA methods. An experience not shared by anti-ABA activists Mottron and Dawson.

For a reality based view of ABA as actually used in helping autistic children read the Newsday article Half Hollow Hills teachers use reinforcement-and-reward strategies to teach their STUDENTS WITH AUTISM. Do not listen to the anti-ABA activists, get the input of people who know what they are talking about and who actually help autistic children day in and day out.

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Autism Quote of the Decade - 2nd Place - MADSEC Autism Task Force Report ABA Conclusion

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.

---

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.

---

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.

...

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.

- Report of the MADSEC Autism Task Force, 2000

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