Treatment Age: The Earlier the Better
It has been well documented that children with ASD benefit the most in the early years. Early intervention is critical to ensure the maximum progress. This is not to say that older children do not benefit from treatment; they do, however as children get older the developmental gaps become wider and more difficult to catch up. Thus, it is recommended that intervention be done as early as possible.
It has been well documented that children with ASD benefit the most in the early years. Early intervention is critical to ensure the maximum progress. This is not to say that older children do not benefit from treatment; they do, however as children get older the developmental gaps become wider and more difficult to catch up. Thus, it is recommended that intervention be done as early as possible.
Treatment Intensity
Children with autism face the formidable challenge of not only trying to catch up the developmental gaps that already exist but also they need to keep up their learning pace with their peers to ensure that the gaps do not widen. For example, a child who has a 2-year delay in language may only learn one year of language in a year. However, the two-year delay still exists because the child is older and his peers have acquired another year of knowledge. In order to actually catch up, the student needs to learn more than one year of language in a year. If the student caught up 1.5 years of language every year, it would then take him or her 4 years to finally catch up with peers.
This then presents a real challenge. Given the multitude of deficits that are often present with autism, it is critical that all areas are taught intensively and systematically. Spending one hour a week on one of the deficit areas that is 2 years behind is unlikely to yield the results we may wish for. Research has consistently shown that a high volume of hours is ideal to maximize a child’s learning progress.
Children with autism face the formidable challenge of not only trying to catch up the developmental gaps that already exist but also they need to keep up their learning pace with their peers to ensure that the gaps do not widen. For example, a child who has a 2-year delay in language may only learn one year of language in a year. However, the two-year delay still exists because the child is older and his peers have acquired another year of knowledge. In order to actually catch up, the student needs to learn more than one year of language in a year. If the student caught up 1.5 years of language every year, it would then take him or her 4 years to finally catch up with peers.
This then presents a real challenge. Given the multitude of deficits that are often present with autism, it is critical that all areas are taught intensively and systematically. Spending one hour a week on one of the deficit areas that is 2 years behind is unlikely to yield the results we may wish for. Research has consistently shown that a high volume of hours is ideal to maximize a child’s learning progress.
Effective Treatment
ABA is considered by many experts to be the most effective evidence-based therapeutic approach developed to date for children with autism. Research [1], [2], [3], [4], [5] has shown that intervention and educational programming based on the principles and practices of ABA can produce significant improvements in these children. The structured teaching of functional skills, through ABA, presently has the largest body of published research supporting its effectiveness.
A 2007 clinical report of the American Academy of Pediatrics concluded that the benefit of ABA-based interventions, "has been well documented" and that "children who receive early intensive ABA 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.
In fact, ABA is currently the only autism therapy recommended for long-term benefit by the United States Surgeon General.
As a treatment for autism, Chapter Three of the Surgeon General’s report on Mental Health, 1999, states, “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior.” What other therapy option can boast all of that?”
It is well known that ABA is labour intensive and requires skilled professionals for its implementation. As such at first glance it may appear to be expensive but studies have shown [6], [7], that it costs much less than the significant cost of supporting semi-and very dependent adults with autism over their lifetimes.
ABA is considered by many experts to be the most effective evidence-based therapeutic approach developed to date for children with autism. Research [1], [2], [3], [4], [5] has shown that intervention and educational programming based on the principles and practices of ABA can produce significant improvements in these children. The structured teaching of functional skills, through ABA, presently has the largest body of published research supporting its effectiveness.
A 2007 clinical report of the American Academy of Pediatrics concluded that the benefit of ABA-based interventions, "has been well documented" and that "children who receive early intensive ABA 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.
In fact, ABA is currently the only autism therapy recommended for long-term benefit by the United States Surgeon General.
As a treatment for autism, Chapter Three of the Surgeon General’s report on Mental Health, 1999, states, “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior.” What other therapy option can boast all of that?”
It is well known that ABA is labour intensive and requires skilled professionals for its implementation. As such at first glance it may appear to be expensive but studies have shown [6], [7], that it costs much less than the significant cost of supporting semi-and very dependent adults with autism over their lifetimes.
Treatment Quality
It is critical to ensure that the treatment a child receives is of a high quality. There is tremendous variability in the quality of services. Providers may claim to provide ABA services without the proper qualification, training or quality control.
Professional and well-qualified treatment therapists should receive ongoing extensive training and supervision by experts in the field. The program should be as good as the person who designs the curriculum and the people that implement it.
It is critical to ensure that the treatment a child receives is of a high quality. There is tremendous variability in the quality of services. Providers may claim to provide ABA services without the proper qualification, training or quality control.
Professional and well-qualified treatment therapists should receive ongoing extensive training and supervision by experts in the field. The program should be as good as the person who designs the curriculum and the people that implement it.
Reference:
[1] Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children, O. Ivar Lovaas (UCLA), Journal of Consulting and Clinical Psychology, Vol. 55, No. 1, pp. 3-9.
[2] Long-term outcome for children with autism who received early intensive behavioral treatment, JJ McEachin, O. Ivar Lovaas, Tristram Smith, American Journal of Mental Retardation, vol. 97, pp. 359-72, 1993
[3] Age and IQ at intake as predictors of placement for young children with autism: a four- to six-year follow-up, Harris SL, Handleman JS, J Autism Dev Disord 2000 Apr; 30(2):137-42 [Study of 27 children in intensive behavioral intervention program shows higher IQ and lower age at start correlate well with later placement in regular education classes.]
[4] Intensive Behavioral Treatment for Children With Autism: Four-Year Outcome and Predictors, Glen O. Sallows and Tamlynn D. Graupner, American Journal on Mental Retardation: Vol. 110, No. 6, pp. 417–438, 2005 [...after 4 years of treatment...48% of all [24] children showed rapid learning, achieved average post-treatment scores, and at age 7, were succeeding in regular education classrooms]
[5] Behavior Analytic and Eclectic Treatment of Autism, Jane Howard, Coleen Sparkman, Howard Cohen, Gina Green, Harold Stanislaw, Research in Developmental Disabilities, 26, 359-383 (2005) [Intensive behavioral therapy produced substantially larger improvements than intensive "eclectic" intervention [which] produced negative mean change scores in multiple skill domains.]
[6] Cost-Effectiviness of Expanding Intensive Behavioural Intervention to All Autistic Children in Ontario. Sanober S.Motiwala .et. al. Department of Health Policy, Management and Evaluation University of Toronro, ON Vol. 1 no 2, 2006.
[7] Cost Benefit Estimates of Early Intensive Behavioural Intervention for Children with Autism, Jacobson, J.W. et. Al. General model and single state case. Behavioural interventions, Vol. 13, 201-206, 1998.
[1] Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children, O. Ivar Lovaas (UCLA), Journal of Consulting and Clinical Psychology, Vol. 55, No. 1, pp. 3-9.
[2] Long-term outcome for children with autism who received early intensive behavioral treatment, JJ McEachin, O. Ivar Lovaas, Tristram Smith, American Journal of Mental Retardation, vol. 97, pp. 359-72, 1993
[3] Age and IQ at intake as predictors of placement for young children with autism: a four- to six-year follow-up, Harris SL, Handleman JS, J Autism Dev Disord 2000 Apr; 30(2):137-42 [Study of 27 children in intensive behavioral intervention program shows higher IQ and lower age at start correlate well with later placement in regular education classes.]
[4] Intensive Behavioral Treatment for Children With Autism: Four-Year Outcome and Predictors, Glen O. Sallows and Tamlynn D. Graupner, American Journal on Mental Retardation: Vol. 110, No. 6, pp. 417–438, 2005 [...after 4 years of treatment...48% of all [24] children showed rapid learning, achieved average post-treatment scores, and at age 7, were succeeding in regular education classrooms]
[5] Behavior Analytic and Eclectic Treatment of Autism, Jane Howard, Coleen Sparkman, Howard Cohen, Gina Green, Harold Stanislaw, Research in Developmental Disabilities, 26, 359-383 (2005) [Intensive behavioral therapy produced substantially larger improvements than intensive "eclectic" intervention [which] produced negative mean change scores in multiple skill domains.]
[6] Cost-Effectiviness of Expanding Intensive Behavioural Intervention to All Autistic Children in Ontario. Sanober S.Motiwala .et. al. Department of Health Policy, Management and Evaluation University of Toronro, ON Vol. 1 no 2, 2006.
[7] Cost Benefit Estimates of Early Intensive Behavioural Intervention for Children with Autism, Jacobson, J.W. et. Al. General model and single state case. Behavioural interventions, Vol. 13, 201-206, 1998.
