Sunday, May 03, 2009

Early ABA Autism Intervention Makes Dollars and Sense

The title of this comment is a modification of the Dr. William Frea article Early autism intervention makes dollars and sense on dailybreeze.com.

I modified the title for my comment for the simple reason that in the subject article Dr. Frea is talking about the individual child benefits and societal costs savings arising from early ABA intervention. Every parent is free to choose who they wish to consult with respect to their choice, if any, of intervention for their autistic child. If anyone is wondering why they might want to consider Dr. Frea's recommendations they should know that he is chief clinical officer and co-founder of Autism Spectrum Therapies, an agency providing autism services throughout Southern California, and has served on the California State Legislative Blue Ribbon Commission on Autism. In other words he has the education, experience and expertise to know what he is talking about.

Another reason to listen to Dr. Frea is that he bases his recommendations on an evidence based approach to assessing autism interventions and their merits. An evidence based approach uses the best available scientific and empirical evidence to assess the effectiveness of a treatment or intervention. This avoids reliance on non-scientific anecdotal evidence and reliance on a near impossible standard that may never be met during the lifetime of your autistic child. It also avoids ideologically motivated anti-autism treatment rhetoric as the basis for trying to help your autistic child.

Dr. Frea reviews the results of autistic children who receive early ABA and the cost savings to society that result. He urges California policy makers to fund, or require funding of, evidence based autism therapies. In this context he summarizes nicely the current position of ABA as an autism treatment:

We all hope researchers will soon discover the cause of the autism epidemic and how to prevent it. In the meantime, we need to deal with both today's reality and tomorrow's prognosis, as these children move on through middle school, high school and transition to adulthood and careers. The best investment that we can make today is early intervention with scientifically validated ABA therapy.




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5 comments:

Marius Filip said...

ABA has the bad reputation of being long, exhausting and a financial burden to parents.

I've read the testimony of a mom who said that she did not want to put her child through ABA but he's got "a house paid in full and no debt". Also, she mentions that her child learned how to speak from a classmate (???).

I wish it were so simple.

Despite the obvious financial burden that ABA imposes on families, the DTT techniques can be applied by lots of parents without formal training who can dedicate more time to their children, such as stay at home moms.

While this does not necessarily lead to full recovery, it may constitute a very valuable supplement to the ABA training obtained from qualified professionals.

Hence, from my point of view, the rejection of ABA is even less justified - even from a financial standpoint.

Anonymous said...

Unfortunately as more kids are disgnosed really low quality ABA and unethical service providers are starting to flood the market. Districts and parents experience this and are then turned off from ABA. This is happening quite a bit and it is just a shame because high quality ABA programming can help tremendously, but there are so many in the industry now claiming to be "experts" and charging huge amounts of money for nothing but horrible "ABA." Also, just because someone is a BCBA does not mean they are very good at what they do. Some of the worst people in the industry are technically some of the most qualified. A parent really needs to be educated on who and what is effective in the ABA field.

farmwifetwo said...

One thing I've learned is that "evidence based" and "peer reviewed" mean NOTHING. Link wars between bloggers in autism-land are amusing and dangerous IMO.

For every child that a certain therapy helped, for another it didn't. Yet, these are never noted in these "peer reviewed", "evidence based" write ups. If you want 50 kids you take 100 and write about the 50 that supported your hypothesis.

To prove this.... I just finished reading Portia Iversen's "Strange Son" and how her son is an auditory learner not the visual that everyone ass(u)me(d)and how Tito's Mother taught him to communicate using an alphabet board and how ABA did nothing to help.

To force one therapy on all ASD children.... helps no one.

S

Autism Reality NB said...

farmwifetwo

What constitutes an evidence based intervention is not determined by me, or any other internet blogger. Generally it is a term applied to an intervention which meets evidentiary standards of effectiveness set by a professions governing bodies. See the Wikipedia article on Evidence based practice at:

http://en.wikipedia.org/wiki/Evidence_based_practice

Marius Filip said...

Saying that "peer reviewed" and "evidence based" means nothing is a dangerous statement.

Without these scientific standards all we have left is to address our problems by hearsay, by the work of charlatans or simply to pray to God so that He'll take all our problems away.

Science has many limits and it's made many serious mistakes in the past (and probably it's doing some mistakes nowadays).

Yet, it's the best tool we have at our disposal. And "evidence based" and "peer reviewed" come with the package.