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ABA and Early Intervention
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The amount of sacrifice a family must give is almost unimaginable to those who have never seen a working, intensive program.  The commitment should not be made lightly and should be made by families having researched a variety of therapies.  Intensive ABA programs have proven success but all are not the same. 

 

Simply calling an ABA program “ABA” does not put it in the same category as those programs which have demonstrated best outcomes for children with autism.

 

According to M.J. Guralnick in Behavioral intervention for young children with autism: A manual for parents and professionals (1996b), among others, successful early intervention programs should entail the following six components

  1. They should emphasize skill development through positive reinforcement
  2. Each should begin with an assessment of the child’s current functioning level in regards of skills and deficits
  3. Therapy should cover all skill areas
  4. Utilize data in decision-making and measurement of individual performance
  5. Require parent-training
  6. Be directed and supervised by those with a minimum of a Master’s degree in behavior analysis and extensive hands-on experience in providing ABA to children.
 

Research has also shown that intervention for children with autism and other developmental disabilities has the greatest success when it is implemented for 25-40 hours per week (U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General's Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.). 

 

According to Lovaas, in the landmark study titled, “Behavioral treatment and normal intellectual and educational functioning in autistic children” (1987), published in Journal of Consulting and Clinical Psychology, “Parents worked as part of the treatment team throughout the intervention; they were extensively trained in the treatment procedures so that treatment could take place for almost all waking hours.”  Up to 47% of the children in his study reached levels within normal functioning after 2 or more years of therapy.

 

 

Replications of Long-Term Outcome Evaluations

Dunlap, G., Robbins, F.R., Dollman, C., & Plienis, A.J. (1988). Early intervention for young children with autism: A regional training approach. Huntington, WV: Marshall University.

Fenske, E.C., Zalenski, S., Krantz, P.J., & McClannahan, L.E. (1985). Age at intervention and treatment outcome for autistic children in a comprehensive intervention program. Analysis and Intervention in Developmental Disabilities, 5, 49-58.

Harris, S.L. (1986). Parents as teachers: A four to seven year follow up of parents of children with autism. Child & Family Behavior Therapy, 8, 39-47.

Harris, S., Handleman, J., Gordon, R., Kristoff, B., & Fuentes, F. (1991). Changes in cognitive and language functioning of preschool children with autism. Journal of Autism and Developmental Disorders, 21, 281-290.

Harris, S.L., & Handleman, J.S. (2000). Age and IQ at intake as predictors of placement for young children with autism: a four- to six-year follow-up. Journal of Autism and Developmental Disorders, 30, 137-142.

Perry, R., Cohen, I., & DeCarlo, R. (1995). Case study: Deterioration, autism, and recovery in two siblings. Journal of the American Academy of Child and Adolescent Psychiatry. 34, 232-237.

Sheinkopf, S., & Siegel, B. (1998). Home-based behavioral treatment for young autistic children. Journal of Autism and Developmental Disorders. 23, 15-23.

Smith T., Eikeseth, S., Klevstrand, M., & Lovaas, O.I. (1997). Intensive behavioral treatment for preschoolers with severe mental retardation and pervasive developmental disorder. American Journal of Mental Retardation. 102, 238-249.

Smith, T., Groen, A.D., & Wynn, J.W. (2000). Randomized trial of intensive early intervention for children with pervasive developmental disorder. American Journal on Mental Retardation.105, 269-285.

Strain, P.S., Hoyson, M.H., & Jamieson, B.J. (1985). Normally developing preschoolers as intervention agents for autistic-like children: Effects on class deportment and social interactions. Journal of the Division for Early Childhood. 9, 105-115.

Helpful Readings About Behavior Therapy and Autism

American Academy Of Pediatrics (2001). Policy Statement: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children (RE060018) Pediatrics, 107, 1221-1226. http://www.aap.org/policy/re060018.html

Aram, D.M., Ekelman, B.L., & Nation, J.E. (1984). Preschoolers with language disorders: 10 years later. Journal of Speech and Hearing Research, 27, 232-244.

Baer, D.M. (1991). Tacting "to a fault." Journal of Applied Behavior Analysis, 24, 429-431.

Becker, W.C., (1971). Parents are teachers. Champaign, IL: Research Press.

Berger, K. (1967). The most common words used in conversation. Journal of Communication Disorders, 1, 201-214.

Bryson, S., & Smith, I. (1998). Epidemiology of autism: Prevalence, associated characteristics, and implications for research and service delivery. Mental Retardation and Developmental Disabilities Research Reviews, 4, 97-103.

Carr, E.G., Levin, L., McConnachie, G., Carlson, ].I., Kemp, D.C., & Smith, C.E. (1994). Communication-bused interventions for problem behavior. A user's guide for producing positive change. Baltimore: Paul H. Brookes Publishing Company.

Catania A.C. (1984) Learning. Englewood Cliffs: Prentice-Hall.

Chakrabarit, S., & Fonbonne, E. (2001). Pervasive developmental disorders in preschool children. Journal of the American Medical Association, 24, 3093-3099.

Committee on Children With Disabilities (2001). Technical Report: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children. Pediatrics, 107, e85. http://www.pediatrics.org/cgi/content/full/107/5/e85

Dyer, K. & Larsson, E. V. (1997). Developing functional communication skills: Alternatives to aberrant behavior. In E. Cipani & N. N. Singh (Eds.), Practical approaches to the treatment of severe behavior problems. Sycamore, IL: Sycamore.

Eikeseth, S. (1999). Intensive School-based Behavioral Treatment for Four to Seven Year Old Children with Autism: A One Year Follow-up. Paper presented at the first internet conference on autism: http://www.autism99.org/flash/papers_front.htm.

Eikeseth, S., & Lovaas, O.I. (1992). The autistic label and its potentially detrimental effect on the child’s treatment. Journal of Behavior Therapy and Experimental Psychiatry. 23, 151-157.

Filipek, P.A., et. al. (1999). The screening and diagnosis of autistic spectrum disorders. Journal of Autism and Developmental Disorders, 29, 439-484.

Fowler, S. A. (1982). Transition from preschool to kindergarten for children with special needs. In K. E. Allen & E. M. Goetz (Eds.), Early childhood education: Special problems, special solutions. Rockville, MD: Aspen.

Freeman, B.J., Rahbar, B., Ritvo, E.R., Bice, T.L., Yokota, A., & Ritvo, R. (1991). The stability of cognitive and behavioral parameters in autism: A 12-year prospective study. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 479-482.

Goldstein, H. (1993). Structuring environmental input to facilitate generalized language learning by children with mental retardation. In A.P. Kaiser & D.B. Gray (Eds.), Enhancing children’s communication: Research foundations for intervention. Communication and language intervention series, Vol. 2 (pp.317-334). Baltimore, MD: Paul H. Brookes Publishing.

Guess, D., Sailor, W., & Baer, D.M. (1976). Functional speech and language training for the severely handicapped. Lawrence, KS: H & H Enterprises.

Hamilton, L.M. (2000). Facing Autism: Giving Parents Reasons for Hope and Guidance for Help. Colorado Springs, CO: WaterBrook Press.

Harris, S.L. & Handleman, J.S. (1994). Preschool education programs for children with autism. Austin, TX: PRO-ED.

Harris, S.L. & Weiss, M.J. (1998). Right from the start: Behavioral interventions for young children with autism. Bethesda, MD: Woodbine House.

Horner, R. H. Dunlap, G. & Koegel, R. L., (Eds.). (1988). Generalization and maintenance: Life-style changes in applied settings. Baltimore, MD: Brooks.

Howlin, P. & Moore, A. (1997). Diagnosis in autism: A survey of over 1200 patients in the UK. Autism, 1, 135-162.

Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 181-197.

Koegel, L., Koegel, R., &. Dunlap, G. (Eds.) (1996), Positive behavioral change. Baltimore, MD: Paul H. Brookes Publishing Company.

Koegel, R. L., Rincover, A, & Egel, A. L., (1982). Educating and understanding autistic children. San Diego, CA, College-Hill Press.

Koegel, R.L. & Koegel, L.K. (1995). Teaching children with autism: Strategies for initiating positive interactions and improving learning opportunities. Baltimore: Paul H. Brookes.

Koegel, R.L., Schreibman, L., Good, A., Cerniglia, L., Murphy, C., & Koegel, L. (1989). How to teach pivotal behaviors to children with autism: A training manual. Santa Barbara: University of California.

Kozloff, M.A. (1973). Reaching the autistic child: A parent-training program. Champaign, IL: Research Press.

Krantz, P.J., MacDuff, G.S., Wadstrom, O., & McClannahan, L.E. (1991). Using video with developmentally disabled learners. In Practical guide to using video in the behavioral sciences, ed. P.W. Dowrick. New York: John Wiley & Sons.

Kymissis, E., & Poulson, C.L. (1990). The history of imitation in learning theory: The language acquisition process. Journal of the Experimental Analysis of Behavior, 54, 113-127.

Larsson, E.V., Luce, S.C., Anderson, S.R., & Christian, W.P., (1992). Autism, In M.D. Levine, W.B. Carey, & A.C. Crocker (Eds.): Developmental-Behavioral Pediatrics. Philadelphia: W.B. Saunders.

Lord, C., & Schopler, E. (1989). The role of age at assessment, developmental level, and test in the stability of intelligence scores in young autistic children. Journal of Autism and Developmental Disorders. 19, 483-499.

Lord, C., Rutter, M., & LeCouteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659-685.

Lovaas, O.I., Ackerman, A., Alexander, D., Firestone, P., Perkins, M., Young, D.B., Carr, E.G., & Newsom, C. (1981). Teaching Developmentally Disabled Children: The Me Book. Baltimore, MD: University Park Press.

Lovaas, O.I. (1977). The autistic child: Language development through behavior modification. New York: Irvington.

Lovaas, O.I. (1993). The development of a treatment-research project for developmentally disabled and autistic children. Journal of Applied Behavior Analysis. 26, 617-630.

Lovaas, O. I., Koegel, R. L., & Schreibman, L. (1979). Stimulus overselectivity in autism: A review of research. Psychological Bulletin, 86, 1236-1254.

Lovaas, O.I., & Newsome, C.D. (1976). Behavior modification with psychotic children. In H. Leitenberg (Ed.), Handbook of behavior modification and behavior therapy. Englewood Cliffs: Prentice Hall.

Lovaas, O.I., & Smith, T. (1988). Intensive behavioral treatment for young autistic children. In B.B. Lahey & A.E. Kazdin (Eds.), Advances in clinical child psychology (Vol. 11, pp. 285-324). New York: Plenum.

Lovaas, O.I., & Smith, T. (1989). A comprehensive behavioral theory of autistic children: Paradigm for research and treatment. Journal of Behavior Therapy and Experimental Psychiatry, 20, 17-29.

Luce, S. C., Christian, W. P., Anderson, S. R., Troy, P. J., & Larsson, E. V., (1991). Development of a continuum of services for children and adults with autism and other severe behavior disorders. Research in Developmental Disabilities, 13, 9-25.

Maine Administrators of Services for Children with Disabilities (2000). Report of the MADSEC Autism Task Force, Revised Edition.. Kennebec Centre, RR 2 Box 1856, Manchester, ME 04351, http://www.madsec.org/madsec/ATFReport.doc

Martin, G., & Pear, J. (1988), Behavior modification: What it is and how to do it. Englewood Cliffs: Prentice Hall.

Mason, S.A., & Iwata, B. A. (1990). Artifactual effects of sensory-integrative therapy on self-injurious behavior. Journal of Applied Behavior Analysis. 23, 361-370.

Maurice, Catherine. (1993). Let me hear your voice: A family's triumph over autism. New York: Knopf.

Maurice, C., Green, G., & Luce, S.C. (1996). Behavioral intervention for young children with autism: A manual for parents and professionals. Austin, TX: Pro-ed.

McEachin, J., Leaf, R., Boehm, M., & Harsh, J.D. (1999). A work in progress: Behavior management strategies and a curriculum for intensive behavioral treatment of autism. New York: Different Roads to Learning.

Michael, J. (1984). Verbal behavior. Journal of the Experimental Analysis of Behavior, 17, 23-34.

Mudford, O.C., Cross, B.A., Breen, S., Cullen, C., Reeves, D., Gould, J.,& Douglas, J. (2000). Auditory integration training for children with autism: no behavioral benefits detected. American Journal of Mental Retardation, 105, 118-129.

National Research Council (2001). Educating Children with Autism, Committee on Educational Interventions for Children with Autism, Division of Behavioral and Social Sciences and Education, Washington, D.C.: National Academy Press. http://books.nap.edu/books/0309072697/html/index.html

New York State Department of Health Early Intervention Program (1999). Clinical Practice Guideline: The Guideline Technical Report, Autism/Pervasive Developmental Disorders, Assessment and Intervention for Young Children. Publication #4217. Health Education Services, P.O. Box 7126, Albany, NY 12224.

New York State Department of Health Early Intervention Program (1999). Clinical Practice Guideline: Report of the Recommendations, Autism/Pervasive Developmental Disorders, Assessment and Intervention for Young Children. Publication #4215. Health Education Services, P.O. Box 7126, Albany, NY 12224. http://www.health.state.ny.us/nysdoh/eip/menu.htm

Newsom, C. (1998). Autistic disorder. In EJ Mash & RA Barkley (Eds.), Treatment of childhood disorders (2nd ed.)(pp. 416-467). New York: Guilford Press.

Rapin, I. (1991). Autistic children: Diagnosis and clinical features. Supplement to Pediatrics, 87, 751-760.

Rimland, B. (1994). Recovery from autism is possible. Autism Research Review International, 8, 3.

Sailor, W., Anderson, J. L., Halvorsen, A. T., Doering, K., Filler, J., & Goetz, L., (1989). The comprehensive local school: Regular education for all students with disabilities. Baltimore, MD: Brooks.

Sallows, G.O., & Graupner, T.D. (1999). Replicating Lovaas’ Treatment and Findings: Preliminary Results. Paper presented at the first internet conference on autism: http://www.autism99.org/flash/papers_front.htm.

Satcher, D. (1999). Mental health: A report of the surgeon general. U.S. Public Health Service. Bethesda, MD. Available at: http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec6.html#autism

Schreibman, L. (1988). Autism. Beverly Hills, CA: Sage.

Simeonsson, R.J., Olley, J.G., & Rosenthal, S.L. (1987). Early intervention for children with autism. In M.J. Guralnick & F.C. Bennett (Eds.) The effectiveness of early intervention for at-risk and handicapped children. Orlando FL: Academic Press.

Skinner, B.F. (1957). Verbal behavior. New York: Appleton-Century-Crofts.

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Smith, T. (1993). Autism. In T.R. Giles (Ed.). Handbook of Effective Psychotherapy. New York: Plenum.

Stokes, T., & Baer, D. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10, 349-367.

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Volkmar, F., Cook, E.H., Pomeroy, J., Realmuto, G., & Tanguay, P. (1999). Practice parameters for the assessment and treatment of children, adolescents, and adults with autism and other pervasive developmental disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 38(Suppl):32S-54S.

Warren, S. F., & Rogers-Warren, A. K. (Eds.). (1985). Teaching functional language. Austin, TX: Pro-Ed.

Wetherby, B. & Striefel, S. (1978). Application of miniature linguistic system of matrix training procedures. In R.L. Schiefelbusch (Ed.), Language intervention strategies. Baltimore: University Park Press.