Wednesday, November 07, 2007

Autism, ABA and the Importance of Accurate Data

If parents seeking treatment for their autistic children are interested in getting past ideological rhetoric and ill informed opinions about ABA, applied behavior analysis, they would be wise to consider information available from sources like Alan Harchik chief operating officer of May Institute, a US national nonprofit organization that provides educational, rehabilitative, and behavioral healthcare services to individuals with autism and other developmental disabilities, brain injury, mental illness, and behavioral healthcare needs.

One of the great strengths and distinguishing features of ABA is the data keeping. In Autism studies need accurate flow of data Mr. Harchik stresses the importance of collecting accurate information about academic performance and problem behaviors; one of the distinguishing characteristics of using applied behavior analysis when working with children with autism and other developmental disabilities. This behavioral data provides an actual measure of a child's progress, can be shared with members of a child's interdisciplinary team, and allows for thoughtful, informed decisions about possible changes in procedures and treatments. In this article Mr. Harchik offers some practical suggestions on how to ensure the accuracy of this important information.


Joseph said...

What is needed is more rigorous research. The most rigorous study to date, the only one that was randomized, the one that was supposed to address criticism on ABA research quality, was largely unsuccessful.

The only evidence that argues for the effectiveness of ABA is either Level-II or lower quality evidence.

Another thing that's needed is adult outcome studies, which are conspicuously absent.

Autism Reality NB said...

There have been hundreds of studies over 5 decades of such studies all showing lasting gains in all areas. That is the opinion of the American Academy of Pediatrics, the US Surgeon Generals office, the Association for Science in Autism Treatment, the Maine Administrators of Disabilities (MADSEC) and state agencies in NY and California. A recent program in Nova Scotia reports substantial language gains after one year.

You, and the Neurodiversity movement, adopt a standard for research which essentially rejects modern evidence based approaches to health care treatments.

You do so not out of concern for more rigorous standards but simply because of an ideological opposition to ABA.

Autistic children have made gains, from ABA, the evidence of that fact is incontrovertible. You argue because you are innately, emotionally opposed to ABA, because of ideology.

Even Dr. Gresham who has in fact argued for the type of study which you propose, which is ethcially impossible today, given the amount of evidence demonstrating the efficacy of ABA, acknowledged in the Auton trial that ABA is the gold standard treatment for autism and that parents should not, as you would have them do, wait a generation for a generational study to be performed.

The truth is that no study can possibly satisfy you or the Neurodiverstiy movement about the benefits of ABA because you are not open minded enough to be convinced. You are entrenched in your opposition to ABA.

Joseph said...

Like I said, such a study exists. When you have high quality evidence vs. low quality evidence, high quality evidence wins. It doesn't matter how much more of the lower quality evidence you have. Of course, it would be better to have more of the high quality evidence to confirm.

Ideological considerations are secondary when there's a clearly an unresolved scientific issue at hand.

Further unresolved is the issue of adult outcomes. What good would it do to have some short-term gains if the adult outcomes are, hypothetically, worse or the same as they normally are?

Your suggestion that ABA effectiveness should not be scrutinized or confirmed with higher quality evidence is anti-scientific and, of course, will be ignored by any scientifically minded person. There's nothing to prevent anybody from discussing the scientific body of evidence of anything, nor should there be.

You claim that I can't be convinced by evidence. If you could point me to a situation where evidence of the highest quality (like a replicated double-blind trial) has demonstrated the effectiveness of something, and which I refuse to believe in, you will have made a point. The fact is that I am convinced by good evidence. In this case, the better evidence points away from effectiveness. You are too closed minded to accept the higher quality evidence I think.

Evidently, if high quality evidence existed demonstrating the effectiveness of ABA, the criticisms I've put forth could not be made. So it's more a matter of what the facts are, rather than ideological preferences.

Autism Reality NB said...


I have never said NOR suggested that ABA should not be scrutinized or criticized. ABA has been scrutinized and studied for decades. It is the only autism intervention that has been so scrutinized and it has stood up to scrutiny.

You obsessively rely on the replicated double-blind control study as the ONLY evidence you will accept. Your position is inconsistent with modern evidence based approaches to health care, including autism treatment. While that is the highest quality form of treatment there are other quality study methods as reviewed by the American Academy of Pediatrics, the NY, Maine and California agencies, the US Surgeon General and the Association for Science in Autism Treatment.

It is because of the great weight of evidence over five decades of the effectiveness of ABA in treating autism that it would be unethical to conduct the type of double blind study you are insisting on. It would be unethical to provide treatment to children for a prolonged period of time knowing that one of the methods involved in a study is already supported by the weight of so much evidence. That positon was published several years ago in the Autralian Medical Association journal.

Your position is ideological because you are not being objective in rejecting scientific evidence accepted by so many responsible agencies, professionals and academics expert in autism.

Your position is ideological because you reject all this evidence not out of scientific objectivity but because you subscribe to a belief system which holds that autism should not be treated to begin with. You do not want autistic children to be treated. And that ideology permits you to engage in endless arguments in which you purport to be defending the highest standards in scientific research.

When you ignore hundreds of studies over five decades demonstrating the efficacy of ABA in treating autism, and when you ignore the thousands of expert professional and responsible agencies which endorse the science behind those studies you are simply betraying your ideological beliefs that autism should not be treated.

Your perspective is the sad reality of the Neurodiversity movement, a movement which seeks to deprive autistic children of the ONLY evidence based effective treatment for autism.