Positively Autistic on CBC News
November 2, 2008 by Kristina Chew, PhD
Filed under Health
The claim that vaccines can be linked to autism suggests that a child became autistic and was somehow “damaged” by a vaccine. According to such a view, not only is autism something that happened to a child; it is something bad that happened—-a recent CBC News special feature, Positively Autistic, says that “since the early 90’s, an autistic rights movement has sprung up, challenging the official view of autism and working to change how the world sees autism.” Interviewed are: Amanda Baggs, Estée Klar-Wolfond of The Autism Acceptance Project, Michael Moon, Michelle Dawson, Dr. Laurent Motron, and Ari Ne’eman and Scott Robertson of the Autisitc Self-Advocacy Network. One comment from a mother :
This news story gave me a real jolt -it is by far, the best story I have ever seen on autism in the media and it was bang-on. Perhaps because it was individuals with autism who spoke for themselves. I have 2 non-verbal children with autism and I am certain of their potential even though they are considered to have an intellectual disability (a diagnosis criteria established by the neuro-typical). There is a beauty, a uniqueness in them. As far as humanity goes, they are gems. My only fear as a parent is that perhaps, my intentions however, good, may be at times be misguided. I want them to “fit in” so that they will not fear the world and because I want them to connect with others – “no man is an island.” However, for this to be accomplished we all have to change the way we view humanity and cherish the differences rather than try to have everyone fit a mold that really doesn’t exist anyway. I feel that those that spoke on your story have spoken to me for my kids and have given me insight, perspective, and guidance. Thank you so much for airing this.
Seeing autism as a “disorder” or a “difference” can affect, and alter, how one thinks about “curing” (and “crusading against“) autism—go here to see the video.
Laurentius
You communicate very well. You are fortunate.
You do not share my son’s life challenges and you do not speak for him. I do. I am his father. While I do not seek treatment for you I do seek treatment, ABA treatment for my son, just like hundreds of thousands of caring parents across North America. If a safe, more effective treatment became available, a true cure, I would want that for my son, just like hundreds of thousands of parents of autistic children across North America.
No one to my knowledge seeks to treat or cure autistic adults who do not seek such treatment.
It is unfortunate that high functioning autistic adults like Michelle Dawson aggressively lobby against the efforts of parents who are seeking effective ABA treatment for their own children.
And fortunate, too, that they do, and that we can try to have a conversation about it.
The problem is that you do not confine yourself to speaking for your son alone, what you do is falsely characterise those adults like me as seeking to curtail the rights of children to appropriate interventions, the key word here is appropriate.
I think it is very dangerous to advocate one kind of intervention and one kind only, and to seek to have that imposed upon all autistic children, in effect if ABA became the sole mandatory, or sole funded intervention, you would trespassing on other parents choices as well.
In reality (this can be verified by reading my work), what I do is report accurately from primary sources. Mr Doherty opposes this, and calls this reprehensible. I provide accurate, sourced, verifiable information. Mr Doherty opposes this and calls this reprehensible. I take the risk of testing my ideas through publication in peer-reviewed journals. Mr Doherty opposes this and calls this reprehensible.
I am not a lobbyist or anything close, though of course Mr Doherty is free to be dishonest about this, as he is dishonest about so many things. Mr Doherty is free to dishonestly and gratuitously accuse me of being aggressive also–he is free to lie about me as he pleases, as he does so frequently. This is a reflection on the values and standards and ethics, including professional ethics, of Mr Doherty and of the autism advocates he represents.
In Quebec, as in the rest of Canada, autism advocates have demanded ABA-based interventions by writing off all autistics who have not received this specific treatment starting early in life. That is, they have written off most autistics in Canada.
This writing-off has happened at the level of human rights laws in various provinces, as well as at the level of Canada’s highest law, the Charter of Rights and Freedoms. See the Auton and Wynberg trial decisions, for example, which are fully supported by Mr Doherty and other autism advocacy leaders in Canada.
This writing off has also happened in parliament and in provincial legislatures, with the full support of autism advocates. A member (judge) of the Canadian Human Rights Tribunal, Michel Doucet, has in a major, well-known document written off autistics this way.
According to Mr Doherty, autistics who have been written off (e.g., as unable to communicate or learn or progress in any way, as having no life or health, as diseased and defective and inferior, as less than human, as belonging in institutions, as destroying ourselves and our families and the economy, etc.) should be happy about this.
But writing off autistics this way has not been enough for autism advocates in Canada. They have taken the position that autistics do not deserve to benefit from and be protected by recognized standards of science and ethics, including professional ethics. They have imposed this position on all autistics in Canada and have enshrined it in our laws.
Autism advocates like Mr Doherty have also widely spread the information that autistic people are just naturally violent and dangerous to others.
By fully supporting the Auton trial decision, autism advocates like Mr Doherty also have taken and imposed the position that it is unethical to provide autistics with support or assistance, this being tantamount to providing support or assistance to people with AIDS when a treatment that can cure half of them is available. The claim that it is unethical to help or support autistics, rather than to eradicate autism, is central to Auton.
So, I tried to be happy about being written off, about having my friends and their children and their parents and their brothers and sisters and their grandchildren and their students written off, about it being decided under our highest law that it is unethical to help autistics rather than try to eradicate autism.
I’ve tried to be happy about being denied even very basic standards of science and ethics (including professional ethics). I’ve tried to be happy about being assumed to be violent and “aggressive” and dangerous to others, on the grounds that autism advocates say this is so, in our courts and in parliament.
Unfortunately, being happy about all this did not work out so well, no matter how I tried. Autism advocacy put me in danger.
So I starting looking for and then providing, for those who are interested, accurate, verifiable information about autism. Mr Doherty considers this to be wrong and and aggressive reprehensible.
To understand what Mr Doherty opposes, you need only look at the positions I’ve taken, all of which Mr Doherty has denounced as reprehensible.
I’ve taken the position that autistics are human beings with human rights. This was the basis for my intervention in Auton–that autistics who have not received Lovaas-type ABA (the one treatment being demanded in Auton) starting very early in life are human beings with human rights. Mr Doherty opposes this, calling this reprehensible.
I’ve taken the position that autistics deserve to benefit from and be protected by recognized standards of science and ethics. Mr Doherty opposes this, calling this reprehensible.
I’ve taken the position that services for autistics–whatever those services may be–should be asked for accurately (with respect to the existing science), ethically, and respectfully. Mr Doherty opposes this, calling this reprehensible.
This is just to alert Kristina that another of my messages on this thread has been put under moderation.
Ms Dawson accused me of defamation. She did not substantiate that allegation with reference to any specific statements that I have made.
Now she offers more diatribe, and once again, her distorted caricatures of positions I have taken over the years.
If anyone wishes to know what I have done with respect to autism advocacy in the province where I live I have been part of a group of parents who have successfully advocated for government funded evidence based treatment for autistic children at the pre-school level with services provided by personnel trained at the University of New Brunswick. That program has been recently reviewed and recommended by Dr. Eric Larsson.
I have also participated as a member of a group who advocated, successfully, for autism specific trained Teacher Aides and Resource Teachers to work with autistic school children in community schools with accommodation for learning environments for those students, including my son.
I have advocated, successfully, again with other concerned parents, for reinstatement of an autism specific tertiary care program at the Stan Cassidy rehabilitation clinic in Fredericton New Brunswick. The Stan Cassidy provides services for autistic children with severe and complex challenges such as life threatening self injurious behavior and even self starvation.
I continue to advocate, with other parents, for the development for autism specific residential care and treatment facilities.
I advocate nationally for a meaningful National Autism Strategy in Canada.
I have provided to the extent that I can, pro bono, legal services to youths with Aspergers and Autistic Disorder.
These are the activities that Ms Dawson caricatures in her rhetorical exercises here and elsewhere on the internet. She in fact makes similar remarks about anyone who disagrees with her views about autism and autistic disorders, and the services necessary to help autistic children and adults.
In the activities that I have been involved with I have visited autistic youth and adults in various facilities and witnessed first hand the real life challenges faced by many autistic persons not as blessed as Ms Dawson. I do not buy into her rhetoric and ideology. And I have worked with and communicated with persons with Aspergers and Autism who do not share her ideology either.
If anyone wishes to actually read my views, rather than her distortions of my views, they can do so at my blog site, Facing Autism in New Brunswick.
I rarely write anything related to Mr Doherty beyond responding, sometimes (not nearly all the time), when he deliberately spreads grossly false information about me. I am curious as to how far Mr Doherty will go in this direction.
I don’t go looking for Mr Doherty’s writing (I don’t read his blog unless I am directed to by others), and I don’t read extensively online. But all the same, there Mr Doherty is, all over the place, being grossly dishonest and spreading lies about me, with clear intent to destroy my reputation.
I have occasionally written about the positions Mr Doherty has publicly taken. I’ve provided full sources for this, so that Mr Doherty’s positions can be verified by those who are interested (and of course, Mr Doherty is free to post comments on my blog, whereas I gave up after having two of three comments–polite, sourced, verifiable, pertinent comments–refused by Mr Doherty).
For one example, it is easy to verify that Mr Doherty fully supports the Auton trial decision, and that he fully opposes my Auton intervention. The Auton trial decision has been publicly available for a long time now, and so has my Auton written argument. Anyone can look at the Auton trial decision to see what Mr Doherty supports, and anyone can look at my Auton intervention and see what Mr Doherty opposes.
And so on. Indeed, it is easy enough to verify that Mr Doherty opposes everything and anything I write or do, including all the research I’m involved in and just the fact that I was given the opportunity to test my ideas and contribute to research. So it is easy to establish what his position is.
Just in the comments above, you can see that when I pointed out the great contributions and accomplishments of intellectually disabled people (those who Mr Doherty calls “low-functioning”), Mr Doherty’s response was to say that this–the fact that I mentioned the achievements of intellectually disabled people–is reprehensible.
When I won a legal decision, one that just may help other disabled people (or so I’ve been told), in response, Mr Doherty made false claims about me, including that (as I’ve written elsewhere) “there was a deliberate, that is dishonest and fraudulent, concealing of information from the Tribunal on my part and possibly on the part of others.” Anyone who wants to verify this instance of defamation on Mr Doherty’s part need only read his blog post about the Tribunal decision. I am assuming Mr Doherty can locate this post himself.
I have just recently noticed that Mr Doherty appears to write misleading information about me, and some of the researchers who has collaborated with me, very often and extensively. Also it seems that he widely distributes this false, misleading information.
In doing so, he has defamed me and my collaborators, and spread grossly false information with the apparent intention to destroy the reputation of others.
Mr Doherty also supports and promotes autism advocacy organizations (like FEAT) and leaders (like Andrew Kavchak) who have defamed me extensively, and he has published defamatory comments about me on his blog, and defended this (see jypsy’s comment above, for one example).
All of this is evidence of the standards Mr Doherty want applied to autistics, of how he believes autistics should be regarded and treated, and of his own standards, values and ethics.
@Jen
Laurentius wrote:
“Michelle to me always seems obsessed with particular ideas and stances, anti ABA, and anti any other way of understanding the world beyond her particular branch of neuroscience”
Time to put an end to this brand of nonsense, way past time. For starters Jen you can take a couple of hours and read the misbehaviour of behaviourists. It takes a couple of hours and a clear open mind. If you can find an ‘anti’ ABA in there that is not closely linked to the legions of ethical questions about it’s practices and more importantly, it’s claims, I wish you luck. Try this. Eye contact. If the goal of ABA programs is ‘indistinguishability from peers’, is this ethical in light of the fact that the brass ring of indistinguishability might be a possibility for a teensy weensy fraction of the spectrum? Isn’t this false advertising, which is fraud as well as unethical? The ethics has more to do with what is known about disruption of communication by insistence on eye contact, or if you will insisting on certain things from an autistic child that are for the benefit and only for the benefit of others. There is no benefit to the child, since indistinguishability is a pipe dream.
Now take the writing off of autistics and especially adult autistics by claiming that without ABA the child will be in an institution or if adult is already in one. Is that ethical? Can ABA proponents make such a claim in good faith? We know that the claim is fundamentally dishonest because we know what the claim rests on (courtesy of Michelle), so what are they doing – more false advertising?
Farmwife and uncountable others including our Harold insist that ‘low functioning’ autistics are really doomed, miserable in fact without this intervention and yet the results show from multiple studies that it’s the severely affected who gain least to nothing from ABA. True, they might gain nothing, no matter what you do, but using this as a reason for mandating ABA is ludicrous and that word again, dishonest. Go and look at the graphs in Sallows and Graupner.
Adn while we’re talking about mandating ABA and getting the public purse to pay for it, what happens to people who want a real speech language pathologist and/or a real occupation therapist – you know, therapists that have been trained with more than a single course in basic biology, which is what you are likely to get with a BCBA certified therapist. You should read the qualifications required of ABA therapists – not good – they get arts degrees not science degrees and that’s not bad for a therapy marketed as ‘medically necessary’.
Forget about ‘anti- ABA’. This is a lot more nuanced than Harold wants to admit to. Try going through your own ABA program and looking at it as a series of ethical questions, because that’s what it’s about – getting the best teaching there is for autistic children and it won’t be good at all, for them or for you if some very basic, very ethical questions are’nt answered, first.
I wasn’t going to get into this but I am getting damn sick and tired of ABA still being marketed as a panacea for all spectrumites and nobody doing anything at all about the defects, which are every one of them based on ethical deficiencies in the first place.
It is amusing to see Alyric write about nuance in autism discussions. Perhaps the self described “Polemicist since Grade 8″ is ready to move beyond the middle school rhetoric and name calling of his grade 8 period:
http://www.blogger.com/profile/13293946886969452901
Very few ABA advocates take the all or nothing approach that Alyric, whoever he is, attributes to us. Most of us are parents who do not trust anonymous internet bloggers (alyric) or former Canada Post workers diagnosed autistic as adults (Dawson) to make decisions for us concerning our children’s well being.
As parents our interests involve more than expanding on careers as Grade 8 polemicists. For us the stakes are much higher. We have a duty to look after our autistic children’s interests to help them to the best of our ability. In doing so most of us, and I am referring to the hundreds of thousands of parents across Canada and the United States who are fighting for funding for delivery of ABA services and for the means to make those services available in our home jurisdictions have to take a much more serious approach. We look to credible authority and our own observations of the children we love, live with, care for and help every day of our lives.
As the father of a 12 year old boy with Autistic Disorder, assessed with profound developmental delays, I know that ABA is not a panacea. It has however helped us communicate with Conor, reduce self injurious behavior, learn some mathermatics and reading skills to name but a few of his accomplishments with ABA instruction. He looks forward to school every day where he receives ABA instruction, and to the arrival of the ABA therapist that we retain for after school instruction.
Beyond our personal experience and observations of our real live children however we also can read and understand the reports of credible, responsible agencies that have described the benefits of ABA for autistic children including the US Surgeon General, the New York State Department of Health, the MASEC (Maine) Autism Task Force, the American Academy of Pediatrics and the Association for Science in Autism Treatment. (As a Canadian I say God Bless America for its leadership in this area). The conclusions of these agencies are indeed both nuanced and supported by substantial research and evidence of the effectiveness of ABA:
Some of those conclusions follow. I hope they are nuanced enough for “our” Grade 8 polemicist Alyric.
————————————
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).
The 1987 Lovaas study, with its finding about 47% of the children studied showing such significant improvements, is more limited than it might appear to be. Attempts to replicate those figures are ongoing; the early studies have not been replicated.
The Lovaas agency provided intensive ABA services for my son when he was just diagnosed. Many of our therapists had worked at the replication site in Wisconsin and talked frequently of proving the study and, at the time, a huge emphasis was put on getting Charlie to be part of the “47%” who “recovered,” somewhat with the result of not attending enough to where he himself was.
A second experience with the Lovaas agency (with the clinic based in New Jersey) was quite different, mostly because the ABA consultant emphasized flexibility and fun and starting with Charlie. (She was exceptional; not every consultant had this view.) There was no talk of the “47%” or recovery.
But a lot about teaching Charlie at where he is.
Harold wrote a whole lot, which I’m not getting into given that among the glowing reports of ABA efficacy the ones showing less than good will be missing including the only scientific study, Smith Groen Wynn 2000 and other studies such as Howlin 2007 and there are others. What was it Sir Michael Rutter said about it now? No evidence of its effectiveness? The word were rapier sharp, which is typical Rutter. Laurentius will know, since that’s his side of the pond where people seem to be quite a bit less dazzled by marketing ploys.
Harold is usually expedient where it comes to facts so I’m glad that he’s consistent, if only for demonstration purposes. This is something of a distortion.
“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.”
it turns out that only one child had scores in adaptive functioning scales in the normal range. The other 8 kids had at least one or more than one in the clinically significant range. No one surveyed the teachers of these children, so calling them ‘indistinguishable from their peers’ seems to be a marketing ploy with little evidence behind it. And that’s how it goes in ABA land, which is very much a commercial landscape.
I’m not so anti-ABA being fairly optimistic that it’s nothing like the old Lovaas (on the whole), but making it mandatory – big mistake. They’d need to fix a whole swag of things starting with basic qualifications before that would be acceptable, as well as sticking to the facts regarding efficacy and for whom it is efficacious, which is not everyone.
Indeed Michelle Dawson notwithstanding, the ABA studies do not convince on this side of the atlantic and that is nothing to do with politics, they just fail the tests of being able to infer a reasonable hypothesis from biased and non replicable studies.
I take my cues from Rita Jordan and Glenys Jones when it comes to deconstructing this stuff. (And the ever sceptical Pat Howlin of course)
All the sources Mr Doherty cites cannot make any case for ABA-based autism interventions– without heavily depending on studies using aversive procedures.
That is true even of the most recent source, the AAP report (Myers et al., 2007), where 6 of the cited papers in the paragraph Mr Doherty promotes depend to a greater or lesser degree on aversive procedures (including strong aversives like electric shock).
Indeed, the US surgeon general cited only one primary source related to ABA-based autism interventions. This reported a small-N study, not a true experimental design, where preschool autistic children were hit (Lovaas et al., 1987; McEachin et al., 1993). Recently, two behaviour analysts involved in this study specified that these very young children (as young as 19 months) were hit “hard” (Leaf & McEachin, 2008).
This study was also the only prospective controlled trial with an N of 10 or more that the NYSDOH and MADSEC could locate.
The majority of Mr Doherty’s sources also could not, in spite of ABA’s long history of being researched as an autism treatment, locate a single RCT of ABA-based autism interventions.
Even by 2007, there was only one (where the intended comparison between randomly assigned groups was actually carried out). This solitary very small-N RCT, in 47 years of research into ABA-based autism interventions, reports poor results, particularly for children with the specific diagnosis of autism (Smith, Groen & Wynn, 2000, 2001; don’t forget to read the authors’ errata).
But this is considered good enough for autistics. Why? Because autism advocates have succeeded in imposing only the lowest possible standards of science and ethics (including professional ethics) on all autistics. Mr Doherty widely promotes the view that this is a very good thing. I disagree.
Two researchers recently applied the standards of a different field to the ABA group designs in autism, and while treating this evidence as though it were much better quality than it is, still concluded (”ABI” refers to early intensive ABA-based interventions):
“Currently there is inadequate evidence that ABI has better outcomes than standard care for children with autism. Appropriately powered clinical trials with broader outcomes are required.”
(Spreckley & Boyd, 2008).
Another 2008 paper notes that:
“There have been a number of different reviews of evidence-based practices of treatments for young children with autism. Reviews which have critically evaluated the empirical evidence have not found any treatments that can be considered evidence-based.” (Reichow et al., 2008).
And another paper, which found no advantages for early ABA-based autism interventions over other autism-specialized services over 2 years (even though the ABA group received a much more intensive intervention), reported that:
“Our data support the growing consensus that no one intervention for children with ASD is universally superior to all others.” (Magiati et al., 2007).
These authors refer to the NIASA (2003) report, but it is not the only one, as noted in another peer-reviewed paper:
“However, the past five years have yielded both a ‘practical consensus’… and a formal consensus from the National Academy of Science in the USA (NRC, 2001) that no single approach is the best for all individuals or even across time for the same individual with ASD.” (Volkmar et al., 2004).