Thursday, April 21, 2011

Quebec Autism Experts (Mottron Excluded) Support Early Intensive Behavioral Intervention

In Quebec a number of Quebec based autism research and treatment organizations have spoken up and defended ABA based EIBI against attacks on the treatment based on the beliefs of high functioning autism expert  Dr. Laurent Mottron.  Dr. Mottron has involved himself in a long media, political and legal campaign to prevent autistic children from receiving ABA or EIBI autism interventions.  Dr. Mottron has been intensely involved with the anti ABA career of Michelle Dawson who appeared, with Mottron's expert affidavit support, as an "autistic" before the Supreme Court of Canada in the Auton case.  He also testified as an unidentified autism expert in Michelle Dawson's Canadian Human Rights Tribunal case with Canada Post Corporation. The  anti-ABA duo have received coverage from CBC, Radio Canada and Quebec based publications.   Fortunately for autistic children in Quebec the Quebec government itself  has not been swayed by  Mottron and Dawson's anti ABA beliefs and has, along with most North American jurisdictions,  accepted ABA as the most evidence based intervention for autistic children.

In 2007, the Standing Senate Committee on Social Affairs, Science and Technology completed a study concerning the financing of autism treatment in Canada. The report, entitled ‘Pay Now or Pay Later,’ stated that treatment for autism is higher later in life if a child is not treated at an early stage. In Quebec, with families signed up for numerous waiting lists for more than a few years each, a child could be older than five by the time EIBI treatment is available to them — past the age of optimal early intervention.
Controversy over EIBI

EIBI is not without its critics, however. A series of articles published in La Presse questioned the effectiveness of the treatment. Quoting Doctor Laurent Mottron, lead researcher at University of Montreal's Centre for Excellence in Pervasive Development Disorders, the articles stated that research into EIBI is “scientifically weak.”
In response to the articles, researchers from UQAM as well as autism organizations which include Abe Gold Research and Learning Centre, WMRC and the Clinique d’Approche Behaviorale en Autisme, amongst others, published an open letter.
“Quebec did not make a unique or controversial decision when it chose to propose (EIBI) for children under six: they were following the lead of Ontario, Alberta and the majority of Canadian provinces and US states,” wrote lead authors Nathalie Poirier and Catherine des Rivières-Pigeon from UQAM. “(EIBI) is simply the standard method of treatment for intensive early intervention because its efficacy has been scientifically supported.”

The Suburban also reports that a dozen Quebec based autism experts have written a joint letter speaking out in support of EIBI as an autism treatment and criticized a series of articles in La Presse based on the opinions of one autism expert, and several self appointed experts, which had attempted to disparage behavioral intervention as an autism treatment:

“What these articles looked at was really a very limited group of people that have a different opinion,” says one of the letter’s signatories, Dr. Katherine Moxness, director of professional services at the West Montreal Readaptation Centre (WMRC) and associate professor in educational and counselling psychology at McGill University.

“But that difference of opinion was not supported with scientific literature; all it does is lay doubt and it brings Quebec back in time to debating over the approach rather than looking at how we are going to get children into service faster and provide them the services that they need. Nowhere else in North America is the approach put in question.”

The letter also claimed the La Presse articles took their lead from one autism specialist and a small group of self-proclaimed experts who question the evidence and wonder who profits from offering therapies; were “based on isolated cases, unfounded statements and even misrepresentation of sources,” and denounced them as giving an “inaccurate and misleading view of the reality and benefits of EIBI,” known as intervention comportementale intensive (ICI) in French.

EIBI — which was adopted by Quebec’s health ministry in 2003 — has for years been the standard treatment for autism across North America and is based on Applied Behaviour Analysis (ABA). It consists of intensive, one-on-one therapy that aims to develop the child’s skills in communication, language, play, social interaction, and so on.

The WMRC, a rehabilitation centre for people with an intellectual disability or pervasive developmental disorder, was one of the first centres in Quebec to develop an EIBI program and, since 2004, annually treats more than 100 children under the age of six who have autism spectrum disorder (ASD). “It’s really a teaching strategy that breaks down all the steps in learning across different development stages and it ensures that the child has the prerequisites to go into kindergarten,” Moxness explains.


Moxness also believes that the language issue may be keeping Quebec behind the rest of North America on EIBI because there is no French-language data on EIBI from a Quebec-based population. As a result, the EIBI community is constantly forced to defend the therapy. “It doesn’t move us forward,” she says.

“Quebec made a choice on a scientifically-supported approach for children with autism that is coherent with the rest of North America. Until there is a better approach that is scientifically-supported with good evidence-based data, it should not have a question mark.”

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