Friday, August 07, 2009

Autism Jabberwocky Puzzled by Michelle Dawson's Obsession With Trash Talking ABA

Autism Jabberwocky (MJ) expresses his puzzlement with Michelle Dawson's opposition to ABA as an intervention for autistic children in Michelle Dawson. MJ notes the overwhelming evidence against Ms Dawson's anti-ABA position, the lack of a clear basis for her ethical concerns, and the lack of any reported life experience with ABA that would explain her views and actions in opposing ABA.

MJ also notes the fact that Michelle Dawson "has a bad habit of discouraging parents from using ABA to help their children". As anyone who reads this blog knows I share MJ's concerns about Michelle Dawson's ABA (anti0ABA) views, particularly when parents of newly diagnosed autistic children are discouraged from seeking ABA help for their children.




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24 comments:

farmwifetwo said...

I find it more frightening that it's pedalled as a "proven" therapy when there's no research to prove it works anymore than any other therapy out there. Anymore than just good parenting.

I find it frightening that it excludes the usage of other professionals who actually have degrees and proven professions like speech and OT.

I find it frighening, that anyone can put up a shingle at their door and claim to practice ABA.

I find it frighening that it's OK to put a child in a closest 1:1 with someone for hours on end and claim it's "good for them".

Which is why I keep lobbying against one therapy type and lobby that parents should make therapy choices for their children not just some special interest group who's only truly interested in themselves. That all parents should receive funds for therapy for their children and purchase that therapy that suits them and theirs.

Life With PDD-NOS said...

She is clearly deranged, and definitely NOT autistic.

I find it laughable when VERY verbal, highly educated, clearly independent, self professed (possibly self diagnosed) 'autistics ' feel they have ANY say in what therapies non-verbal, highly afflicted children of complete strangers need or do not need.

They are not that child's parents, their physicians, their therapists, or even distant relatives. So, what is it to them? They do not experience the day to day strike or troubles that child might have and therefore cannot possibly CARE about what measures might need to be taken to help them (GFCF, supplements, ABA, speech therapy, or whatever).

Autism Reality NB said...

farmwifetwo your statement with respect to ABA that "it's pedalled as a "proven" therapy when there's no research to prove it works more than any other therapy out there" is incorrect. NO other therapy has been evaluated by any credible review as being as effective an autism intervention as ABA.

Several such reviews have been conducted since the US Surgeon General's Office, the NYSDOH, the MADSEC Report and the AAP report in 2007. These reviews examined hundreds of studies over several decades. The MADSEC Report 1999-2000 concluded that:


""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.
Other major contributions of ABA to the education and treatment of individuals with autism
include:
• a large number of empirically-based systematic instruction methods that lead to the
acquisition of skills, and to the decrease/elimination of aberrant behaviors;
• a technology for systematically evaluating the efficacy of interventions intended to affect
individual learning and behavior; and
• substantial cost/benefit.
Over 30 years of rigorous research and peer review of applied behavior analysis’ effectiveness
for individuals with autism demonstrate ABA has been objectively substantiated as effective based upon the scope and quality of science. Professionals considering applied behavior
analysis should portray the method as objectively substantiated as effective. Methods of applied
behavior analysis should be considered to evaluate the effectiveness of any intervention used to help individuals with autism. Researchers should continue to vigorously investigate behavioral intervention as the most promising area of research and treatment benefiting individuals with
autism known today. Early interventionists should leverage early autism diagnosis with the
proven efficacy of intensive ABA for optimal outcome and long-term cost benefit.""

ABA was the ONLY autism intervention ranked as evidence based and proven effective by the MADSEC task force.

As you know from the sidebar of this blog site the 2007 American Academy of Pediatrics review stated :

"" 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.31–4""

NO other intervention received any where near that level of evaluation by the AAP.

You do not like ABA which is your right. BUT your statement that ABA has not been show by research to be any better than any other autism intervention is incorrect.

MJ said...

Thanks for the mention, Harold. I really wish that I understood where Michelle Dawson was coming from, her position makes no sense to me.

Autism Reality NB said...

Life With PDD-NOS I have always found it bizarre that Michelle Dawson and other HFA/Aspergers adults would consider it their business, their right, to interfere with parents seeking to help their own children.

As for Ms Dawson's actual diagnosis the decision in by the Canadian Human Rights Tribunal in a case she brought against her employer Canada Post Corporation includes a quote from an unidentified "Dr. T" which appears to indicate that Ms Dawson was diagnosed with Autistic Disorder:

"[54] In a letter, dated April 9, 1999, addressed to Mr. Christian Potvin, Dr. T. states the following: `Autism is characterised by qualitative deficits in social interactions, qualitative difficulties in communication, an intense need for structure as well as certain behaviors that may be perceived as peculiar'. And he adds: `Due to this disorder, Ms. Dawson needs a highly structured and consistent environment to function well and will thus experience difficulties adjusting to changes in her work routines. Ms. Dawson is an intelligent woman who seems to have been able to cope and adapt to her environment to meet the special needs that her disability creates'. At the end of his letter, Dr. T. makes himself available to clarify any questions Canada Post may have regarding Autistic Disorder and that with Ms. Dawson's permission, he would also be happy to make himself available to discuss specifics about her case."

navywifeandmom said...

"Life With PDD-NOS I have always found it bizarre that Michelle Dawson and other HFA/Aspergers adults would consider it their business, their right, to interfere with parents seeking to help their own children."

That's it right there in a nutshell. It is none of Michelle Dawson's business what parents who want to help their children are doing.

Autism Reality NB said...

MJ you are not alone in your puzzlement with Ms Dawson's ABA issues.

She has spent a good portion of her adult life fighting to prevent other people from obtaining ABA services for THEIR children. It is bizarre behavior and I do not believe for a second she has done it out of concern for the children.

Roger Kulp said...

Life With PDD-NOS said...
I find it laughable when VERY verbal, highly educated, clearly independent, self professed (possibly self diagnosed) 'autistics ' feel they have ANY say in what therapies non-verbal, highly afflicted children of complete strangers need or do not need.


Autism Reality NB said...
Life With PDD-NOS I have always found it bizarre that Michelle Dawson and other HFA/Aspergers adults would consider it their business, their right, to interfere with parents seeking to help their own children.


This is probably the number one complaint I have with the neurodiversity movement.I would suggest you go see something I posted to this effect in the Asperger's thread over at left brain/right brain last night.

As I said,over there,and as you and Johnathan have said many times,Ari Ne'eeman is probably the worst example of this behavior I have seen.

Recently I came to the conclusion that whatever it is that is going on in the brain that makes Asperger's what it is, makes these people completely unaware that they are doing this.(Speaking so they seem to represent everybody on the spectrum,whether they intend to or not.)Which is odd because other autistics,with different spectrum disorders,Droopy, Stephanie,Johnathan,myself,and no doubt many others can plainly see this is what they are doing.

farmwifetwo said...
I find it frighening, that anyone can put up a shingle at their door and claim to practice ABA.


This is true not only of ABA,but of DAN!doctors as well.For both groups ,there needs to be either a regulating body that sets standards and grants licenses,or a high profile website like Angie's List, where people can post experiences and ratings of these people.

Stephanie Lynn Keil said...

The funny thing about Michelle Dawson is that she thinks EVERY treatment for autism has no standards for science and ethics. But, for some strange reason, she does have this weird obsession with bashing ABA.

She thinks other treatments are better than ABA when, according to her own words, no autism treatment has any standards of science and ethics and none have been proven to work in double blind studies.

I don't understand it, either.

Roger Kulp said...

Neurodiversity types don't believe in treatment for autism,you know that.

Marius Filip said...

FarmWifeTwo, good parenting cannot and is not supposed to teach basic cognitive skills like matching, sorting and pattern imitation.

Good parenting cannot and is not supposed to teach basic skills of verbal behavior like echoic, mand, intraverbal or sequelic.

Good parenting cannot and is not supposed to teach basic social abilities like motivation, responsiveness, joint attention, various kinds of play, responding to multiple cues and the like.

Good parenting cannot and is not supposed to deal with and gradually diminish tantrums, disruptive behaviors and other behavioral ills.

... And the list goes on and on.

While good parenting is essential to all children, autistic or not, good parenting is no substitute for doctors, researchers, therapists and treatments.

As for the lack of evidence regarding what ABA can do and how effective is compared to other methods of autism treatment, Harold answered quite clearly, I guess.

Anonymous said...

What more evidence does farmwife want? I think it sounds like she had very bad ABA providers, which happens a lot in the field, but that does not mean the science of ABA is not effective.

Neil Samuels said...

The deeply misleading and systemic notion that ABA is the only "scientifically proven" and effective method for the treatment is autism and other complex neuro-developmental disorders is completely and utterly misleading.

Let us take for example, the creme d' la creme of studies: The seminal 1987 Lovass study that evinced a 47% success rate in I.Q., academic performance scores. It was subsequently concluded, as significantly misleading, as it did not meet the basic criteria for scientific clinical test design (i.e., random assignment to treatment and control group).

Now, when redone using a standard basic scientific clinical test design by Lovass' protege Tristam Smith in 2000, we see the previous tremendous success rate in terms of measurable gains adjusted a wee bit downward shall we say, from 47% to 13%!!

It is extraordinarily misleading to proceed with the term "scientifically proven" or behaviorally evidenced-based. For a wonderful article here - a few years past but absolutely essential reading for everyone see, Dr. Morton Gernsbacher, "Is one method 'scientifically proven'?"

ABA continues to be effective not because of its so-called "scientifically proven results" but because in large part of its tremendous successful PR campaign deeply funded/supported by the bio-phramaceutical industry and many other significant vested interests.

As a developmental special educator who extensively practices with toddlers and children on the spectrum using a DIR/floortime based approach, what is being measured in terms of "actual gains" over five decades in behaviorally oriented approaches unfortunately are NOT the Primary Core Deficits associated with ASD (but sh! don't tell anyone, okay?).

Now, ABA does indeed show some measurable gains in surface behavioral compliance. However, surface behavioral compliance to tasks are not the core issues involved with autism spectrum challenges! Unfortunately, this is where ignorance combined with deception runs rampant.

The primary core deficits in ASD and related complex neurodevelopmental disorders involves not aberrant or "inappropriate behaviors" (or conversely with treatment, the ability for the child to evince "behavioral compliance to task"), but both a theoretical and practical applied understanding of the Developmental processes behind "surface behaviors", namely, the underlying Affect Emotional-Developmental processes of spontaneous thinking, relating and communicating (the latter allows for a strong and healthy foundation/re-integration of the child's spontaneous - not prompted - relationship-and-language skills).

The understanding of attachment theory and crucial role of complex affect-guided two-way emotional problem solving based upon the child's natural affect(terms that are entirely foreign to ABA)takes into consideration a Full and Integrated picture of the child, not in terms of a one-size fits all or cookie-cutter approach (such as ABA) but in terms of the child's differing emotional-developmental levels, affect sensory-motor processing reactivities and caregiver relationship styles.

The latter is not touched by traditional task based approaches, such as the vast majority of methodologies found under the vast and misleading umbrella of ABA!

Neil Samuels

Autism Reality NB said...

Neil Samuels thank you for visiting this site and sharing your comments. I have read them elsewhere on the world wide web but I appreciate you sharing your opinions here as well.

The various credible reviews conducted over the past 12 years that literally review hundreds of studies confirming the evidentiary support for the effectiveness of ABA as an autism intervention speak for themselves and, with all respect, are not diminished in any way by your comments.

As for "surface behavioral compliance" that is a very dismissive and pejorative way of disregarding the fact that ABA is used to reduce and eliminate self injurious, even deadly behaviors from serious head banging and biting to self starvation. These are real behaviors with some autistic children. ABA has also been used to deal successfully with such issues as feces smearing and such practical and challenging issues as haircuts. And yes I am speaking from personal experience as well.

As for DIR/Floortime that you promote in your comment the AAP review 2007, stated:

"The DIR approach focuses on (1) “floor-time” play sessions and
other strategies that are purported to enhance relationships
and emotional and social interactions to facilitate
emotional and cognitive growth and development and (2) therapies to remediate “biologically based processing capacities,” such as auditory processing and language,
motor planning and sequencing, sensory modulation, and visual-spatial processing. Published evidence of the efficacy of the DIR model is limited to an unblinded review of case records (with significant methodologic
flaws, including inadequate documentation of the intervention,
comparison to a suboptimal control group, and lack of documentation of treatment integrity and how
outcomes were assessed by informal procedures55) and a descriptive follow-up study of a small subset (8%) of the original group of patients.59 ""

You take issue with proof of ABA effectiveness after decades of study, published articles and review by credible agencies and yet you promote RID/Floortime which has no credible evidence at all of its effectiveness? Amazing.

You also refer to Dr. Morton Gernsbacher who in fact is associated with anti-ABA activists Michelle Dawson and Dr. Laurent Mottron both of whom have advocated strenuously against government provision of ABA intervention for autistic children in Canada, despite being able to provide not credible alternative.

Thanks for your comments. I will give them the weight the AAP assigned to evidence, or more accurately, the non-evidence of DIR/Floortime efficacy as an autism intervention.

Autism Reality NB said...

Mr Samuels, sorry for the typo in the last comment. My reference to RID/Floortime in the 3rd last para should have been a reference to DIR/Floortime.

Neil Samuels said...

I'm afraid, and with all due respect, none of the so-called credible reviews conducted over the last 12 years with its evidentiary support - which apparently you take tremendous pride in bringing to attention of your readership - addresses in any shape, manner or form the primary core deficits that are associated with ASD and other related complex neurodevelopmental disorders.

Again,this involves the child connecting his "natural intent" or "affect" to his praxis (ideation, motor planing and execution). For example: "I see the ball, I want it, how am I going to get it." etc. This necessitates the child spontaneously maintaining reciprocal child/caregiver emotional problem solving circles of communication (without prompting)along with the accompanied natural emergence of higher critical thinking skills(e.g., spontaneous two-three symbolic or pretend play sequences). We do this by following the child's lead; consequently we are focusing on dyadic "meaning-making" rather than "task compliance." For example, validating what the child is doing as "meaningful" and subsequently forming deeper bonds of attachment.

This sets up the conditions that allows for greater regulation (not through task-compliance) but through increased synchronization of the limbic system (e.g. the amygdala - All or Nothing primitive reactions) and the prefrontal cortex (ideation, planning and execution).

Integrally, we address through OT the child's (or adult's) unique affect sensory-motor planning differences. For example: addressing the child's sensory over-reactivities, under-reactivities and mixed reactivities, which would include but not limited to auditory, tactile, visual-spatial and vestibular and propioceptive processing domains. Essentially, as a result of the integration of the above, this begins to result in the natural back and forth natural flow of social connections resulting in spontaneous (not prompted on cue) pre-verbal-and-verbal circles of communication!

The above is not speculation but in accord to neurosciences with respect to the emotional-Developmental stages of how a child learns grows and develops (both on and off the spectrum).

Biting, head banging and the like are severe behaviors. Various behavioral intervention techniques can be not only useful but necessary. However, useful and necessary as a temporary means ONLY and should NEVER be used as the primary intervention.

Behavioral intervention measures -
no matter what degree of amassed task-behavior analysis and data collection, which certainly does not need to be shelved but needs to be put into its proper place - will ever lead parent/child to a Developmentally Practically Based Understanding, where the child/adult can engage meaningfully and Spontaneously (that is without prompting and sustaining back and forth circles of affect gestural and verbal communication/dialogue).

Successful behavioral compliance - or the child giving verbal responses on cue is Not the basis of true relating or communicating. Not in any sense, nor any stretch of the imagination. It is unfortunate that many professionals in the field have given families the impression that this is the highest level of communication or "development" that can be achieved. They are wrong. And in some cases, I would argue, borders on criminality (for example, not presenting or making mention of Developmental approaches, which may not have to date the same prodigious or illustrious following behind it but which has shown not only mild but Dramatic success, and that I and colleagues have personally witnessed with hundreds of families).

Verbal behavior is not the basis or essence of true back and forth affect based preverbal relating (e.g., meaningful -not prompted - reciprocal attachment and joint attention) which is essential (and which Behavioral methodologies unfortunately entirely ignore). The former (an emotionally-developmentally based understanding) leads quite naturally to back and forth reciprocal circles of affect gestural and verbal communication (true dialogue).

Autism Reality NB said...

Mr Samuels, as you know my comments about the evidence in support of ABA as an effective autism intervention are based on hundreds of studies as reviewed by credible reviewing agencies over the past dozen years. Your attempt to imply that this research is not credible is not itself credible.

The developmental approaches in which you believe have no to date no science or support behind them. Your comments about surface behavioral compliance are based on nothing more than your own beliefs, intutition and ideology.

The only vested interest I have is in seeing my autistic son live as full and rewarding a life as possible. I have seen marked improvements, not cures, but substantial improvements because of ABA intervention even though he did not get Lovaas discrete trial 40 hrs per week, ages 2-5. I have seen reduction of serious self injurious behavior and I have seen skill acquisition including increased communication.

You are free to believe in your non evidence based approaches. But your criticisms of ABA are not substantiated.

Psych who cares said...

I have been working in the field of Autism using Evidence Based methods for almost 16 years. I am a Clinical Psychologist and have worked with over 300 children ages 2-9. Mr Samuels words are straight out of the OT handbook - which has NO neuroscientific support (please read more on Sensory Integration to be truly horriefied at how bad this 'research' is. I am sorry to report to him that almost every child I have worked with has done some sort of sensory motor intervention and in all cases the only success I saw came from ABA methods that the therapist called something else (eg balancing, accessing sensory system etc). IN regards to Floortime. I love many of its key points. I struggle though to see how operant principles can not account for it. Indeed I do target Joint Attention and attachment but in no way do I violate the STRONG scientific foundations (including neuroscience Mr Samuels) regarding learning and motivation (aka ABA). Mr Samuels criticisms come straight from the OT/ Greenspan handbook. It has been noted elsewhere that Greenspans understanding of ABA is so poor he reduces his arguments to the 'straw man' level. Having said that I have seen horrific things done by ABA practitioners (as I have by OT's who have wasted years of a childs development doing 'sensory balancing/integrating' while cognitive and communication needs are ignored) but this is always due to many ABA practitioners not having BCBA level training. Guys ABA is VERY technical and to do it right we can not have just anyone do it... But Mr Samuel's you really do not have a clue about what you are saying... And its sad because methods like PRT (an ABA method) would totally agree with some of your points about 'deep' targets (behaviourists call them 'cusps'.

What I would ay though it that EVERY parent should insist on measurable OBJECTIVE targets. Affect and attachment 'feel' good and are powerful words but whenever i work with these therapist and get them to clearly identify their outcome targets they either can't (so its all spin) or when they do they end up agreeing they are doing operant conditioning dressed up as something else!

Mr Samuels pLease stop just rehashing the spin you have been given and have the guts to read the other side before you criticise it - I did.

Psych who cares said...

I have been working in the field of Autism using Evidence Based methods for almost 16 years. I am a Clinical Psychologist and have worked with over 300 children ages 2-9. Mr Samuels words are straight out of the OT handbook - which has NO neuroscientific support (please read more on Sensory Integration to be truly horriefied at how bad this 'research' is. I am sorry to report to him that almost every child I have worked with has done some sort of sensory motor intervention and in all cases the only success I saw came from ABA methods that the therapist called something else (eg balancing, accessing sensory system etc). IN regards to Floortime. I love many of its key points. I struggle though to see how operant principles can not account for it. Indeed I do target Joint Attention and attachment but in no way do I violate the STRONG scientific foundations (including neuroscience Mr Samuels) regarding learning and motivation (aka ABA). Mr Samuels criticisms come straight from the OT/ Greenspan handbook. It has been noted elsewhere that Greenspans understanding of ABA is so poor he reduces his arguments to the 'straw man' level. Having said that I have seen horrific things done by ABA practitioners (as I have by OT's who have wasted years of a childs development doing 'sensory balancing/integrating' while cognitive and communication needs are ignored) but this is always due to many ABA practitioners not having BCBA level training. Guys ABA is VERY technical and to do it right we can not have just anyone do it... But Mr Samuel's you really do not have a clue about what you are saying... And its sad because methods like PRT (an ABA method) would totally agree with some of your points about 'deep' targets (behaviourists call them 'cusps'.

Mr Samuels pLease stop just rehashing the spin you have been given and have the guts to read the other side before you criticise it - I did.

Neil Samuels said...

Let us clarify here, shall we, you are a cognitive behavioral psychologist, this is quite different than a psychoanalytical or a dyadic developmental psychotherapic orientation and approach. Whereas the latter specifically takes into strong consideration the effects of nurturance practice of primary caregiver/child dyads, focusing on such potential blind spots in your evidence based tunnel vision, such as secure attachment and the deepening of spontaneous affect co-regulated emotional signaling and symbolic two and three part sequencing, which then allows for further increased integrated affect-sensory motor regulatory functioning (e.g., vestibular, proprioceptive, tactile, visual spatial), behavioral based task analyses and approaches (ABA)
focuses on selective targeted outcomes and tragically misses the larger picture.

However, you are quick to remind the audience that there is no evidence based data with respect to sensory based challenges., which is risible and not worth dignifying, suffice to say that it had been under serious consideration for inclusion, Sensory processing disorders, in DSM-V). Begin your education, with Jean Ayers and work your way to Dr. Lucy Miller and similarly many other internationally respected others in the scientific community.

Once the developmental capacities, that is the functional emotional, individual processing and relationship based differences of the child are adequately addressed in terms of the child's affect preverbal foundation levels around his/her natural affect or intentionality in a spontaneous and meaningful dyadic social emotional problem solving manner (not in an inane rote and scripted surface behavioristic manner) then, and only then, the Developmental foundations toward meaningful sustained and connected pragmatic language/speech and higher critical thinking capacities become not only possible but probable with many children (and older).

Working with well over a hundred fifty families and clinicians using a Developmental based approach with children on the mild to high moderate end of spectrum I have attest to this.

Neil Samuels said...

Learning theory vis a vis operant conditioning was useful for rat and pigeon training, or early primate studies which proved limited and insufficient. However, it does not address the higher basis of learning and the core developmental deficits. For example,the resulting increased synchrony between cortical and subcortical functioning LHPA (limbic, hypothalamus, pituitary and adrenal axis), namely the amygdala (e.g., all or nothing meltdowns) and the frontal lobes (e.g., the executive functioning of the prefrontal cortex, ideation, sequencing and execution). Both (cortical/subcortical processes) are mediated by the very thing you apparently regard as fanciful but are core and essential: Affect meditated processes that come into play between caregiver and child by reinforcing secure dyadic attachment and deepening co-regulated affect gestural or emotional signalling around the child's current functional-emotional levels and affect sensory motor differences.

To account for these Developmental capacities in terms of operant conditioning or learning theory is atrociously reductionistic and vapid. Moreover, it violates the evidence based findings over the last several decades of cognitive epigenesis, systems theory based psychology (bio, socio- psychological dynamic functioning) and the ability to strengthen underlying synaptic connections (Neuroplasticity) or increased synchrony of hemispheric functioning through these affect-DEVELOPMENTAL processes.

The Denver based model utilizes PRT which comes closer to a developmental practice (as it focuses) on the child's intentionality (or true executive functioning) but still the denouement is predominantly a behavioral based thinking (selective targeted outcomes) and not the larger core developmental capacities.

What you (and many) are referring to "evidence based" is egregiously misleading. There is a ton of proven evidence based data in the areas, from attachment to psychodynamic theory and diathesis of hormonal functioning to recent studies in the neurosciences and cognitive epigenesis, which essentially is a systems theory based approach (a dynamic bio-psycho-social model of Development). There are also underway double blind fully randomized trials comparing DIR with ABA.

Autism Reality NB said...

Mr Samuels I am not sure what prompted you to revisit this site and again try to diminish ABA interventions for autistic children. You are entitled to your opinions. As the father of a severely autistic 15 year old boy with limited communication skills I find most of what you say to be of no value in helping my son. From another perspective I prefer to rely on the assessments by credible agencies such as the American Academy of Pediatrics, the Office of the US Surgeon General, the MADSEC (Maine) autism task force and other state agencies that have reviewed the research literature over the past decaded and a half and concluded that ABA stands alone in the amount of evidence in support of its effectiveness.

Neil Samuels said...

There are as I indicated much evidence for a comprehensive developmental based approach, which draws from numerous areas across the neurosciences to dyadic developmental psychotherapy and applied comprehensive developmental interventions, such as DIR/Floortime based approaches.

Below is an article from the American Academy of Pediatrics, April 2008.

http://pediatrics.aappublications.org/content/121/4/828.full?ijkey=gHA5XcwiSRYlQ&keytype=ref&siteid=aapjournals

In no manner shape or form have any of my previous comments here meant as insult or injury to you or your son. It has been merely to present a more balanced representation here to your readers and begin to address a much more comprehensive developmental picture on the heterogeneous complexity of Individual differences of ASD (from mild to severe) and other evidence-based treatment approaches, as well as to correct the often misguided and misleading perception of the phrase, "only evidence based approach..."

ABA can indeed be one component in a comprehensive developmental based approach when needed. Having said that, I fully respect, understand and empathize with where your particular sympathies lie.

The previous two posts were meant specifically for the poster, 'Psych Who Cares'.

MJ said...

@Neil Samuels -

Hmm, if you took your that badly- phrased and conceptualized, long and bimestrial, run-on comments into plain, simple, and understandable English, that being something conducive to having a productive correspondence, I could only conceptualize what your utterances meant.

Or to put it plainly, if you are trying to get a point across - especially in a blog comment - it is best to use language that is straight forward rather than dressing it to make it sound pretty. Because I have a pretty good grasp on ABA and at least a basic understanding of developmental psychology and what you said sounded like complete nonsense to me.

The point of your comments, once you strip away the verbal diarrhea, seem to be that you need more than just applied behavioral analysis alone to best help a child with autism. And while that may be the case, it does not diminish the evidence that shows that ABA can be an extremely powerful teaching technique. Nor does pointing out that there are other things to consider mean that these other approaches have the same demonstrated effectiveness as ABA.

Evidence based medicine is what it is and, if you want the benefits of an EBM approach, you have to follow the rules of EBM. These rules say that you have to be able to empirically demonstrate the effectiveness of your technique and this benefit has to be both measurable and reproducible.

To date, ABA is the only behavioral intervention that has a significant amount of evidence showing that it works. That isn't to say that other techniques don't work, for all we know they might work very well. But the effectiveness of other techniques haven't yet been established.

And until the effectiveness has been established, it is hard for a parent to separate out what is truly effective from something that simply sounds good because someone dresses it and makes it sound impressive. ABA has been demonstrated to be effective but as for what exactly you are saying all I see is someone trying to sound impressive.