Showing posts with label applied behaviour analysis. Show all posts
Showing posts with label applied behaviour analysis. Show all posts

Wednesday, October 07, 2015

Autism, Politics and the Return of the Run Jump Fly Boy





I have been engaged in autism advocacy during the recent Canadian federal election.  I do so at the federal level for the sole purpose of trying to ensure that all Canadians with serious autism disorders have access to Applied Behavior Analysis for treatment of their core autism symptoms.  

I have advocated for over 15 years with other parents and with politicians like the late Fredericton MP Andy Scott who with Nova Scotia MP Peter Stoffer did manage to put autism on the Canadian political map with their joint private members' motion.  The motion set out some directions for a federal National Autism Strategy, directions which have been totally ignored by the current Harper Conservative government and by their pet autism charity Autism Canada which has never contributed to the struggle by parents from BC to Atlantic Canada who fought for, and continue to fight for Medicare coverage of evidence based Applied Behaviour Analysis for those with autism disorders. Watching the Harper Conservatives and their charity Autism Canada continue to ignore the only science based autism treatment for autism can be discouraging but not defeating.

As long as I can have daily adventures with my son Conor, now 19, I will never quit, I will never stop fighting for the right things to be done to actually help people who actually suffer from autism disorders and related conditions.  Conor has had some serious health issues in recent years with the full blooming of his seizure issues and dangerous adverse reactions to some seizure meds.  Today though as we walked Fredericton's North Riverfront Trail that we have walked so often I saw something I hadn't seen in a while ... the Run Jump Fly Boy was back.  He flew down the trail jumping into the air, both feet leaving the ground and enjoying life to the max.  Then he sat on a bench with Dad for a few minutes soaking in the fresh fall air.  And it made his old Dad and grizzled autism advocate feel good too ... very, very good and more determined then ever to continue fighting for meaningful, evidence based treatment for all persons suffering from autism disorders and related conditions.

Thursday, January 15, 2015

Manitoba Autism Crisis Demonstrates Need For A REAL Canadian National Autism Strategy




Canada, despite a private members motion championed by the late Fredericton MP Andy Scott and Nova Scotia MP Peter Stoffer which called for one, does not have a REAL National Autism Strategy.  The failure to enact a REAL National Autism Strategy means that in some provinces very few autistic children receive intensive early ABA intervention.

The  private member's bill, Bill C-304, introduced by former PEI MP Shawn Murphy, set out below was crushed by the Harper Conservatives and Quebecois MPs.   Had Bill C-304 passed 9 years ago many,  many more autistic Canadian children would have received early ABA intervention and made the substantial cognitive, linguistic and behavioral gains reported decades ago by Dr. Ivaar Lovaas and confirmed by studies and reviews since.

 Manitoba's Wait List Autism Crisis

One example of the checkerboard pattern of ABA service for autistic children in Canada is Manitoba as reported in the CBC article Autistic children's families frustrated by therapy wait-list:

"Some Manitoba families with autistic children say they might get turned away from a highly sought-after therapy program because they have been on a waiting list for so long, their children may end up being too old to qualify. Families that want access to applied behaviour analysis (ABA) therapy for their children must wait roughly 1½ years on a list. The program is available only to children under the age of five. With the waiting list so long, some children may end up being too old to qualify for ABA, meaning they would be turned away this September.

"I just can't imagine where kids are going to wind up without having ABA," said Guy Mercier, president of Manitoba Families for Effective Autism Treatment. "Without ABA in my son's life, he wouldn't be where he is."

The ABA program gives children three years of intensive therapy, teaching them social skills and life skills before they enter kindergarten. It also provides support for five years while they are in school.
Samantha Bawtinheimer said she placed her 2½-year-old son, Noah, on the waiting list for ABA soon after he was diagnosed with autism last September.

Bawtinheimer said she is frustrated by how long it will take for Noah to get into the program. "You're supposed to be there to protect them. You're supposed to be there to help him. I can only do so much," she said. "I've done my research. I can't do it all. I still have to work, I have to provide for him. I can't do it all. I need their help."
The Manitoba situation proves the need for a real national autism strategy. 

History of the Struggle for A REAL National Autism Strategy

The struggle for a REAL National Autism Strategy is summarized following from a commentary on this site on March 29, 2014:

In The Courts Autons (BC) and Wynberg/Deskin (ONT)
Canadian parents fought initially , and ultimately unsuccessfully, through the courts in BC (Auton) and Ontario (Wynberg/Deskin) for autism treatment coverage under medicare and autism services before commencing their more overtly political efforts, including the Medicare for Autism NOW! campaign.

History of the Struggle for a REAL National Autism Strategy in the Maritimes

Andy Scott Fredericton NB MP,  Peter Stoffer NS MP, Shawn Murphy PEI MP,  Senator Jim Munson NB

Here in the Maritime provinces we took a political approach to developing a national autism strategy with the NB efforts in  which I was personally involved beginning  in 2001, primarily by many discussions with our Fredericton MP, the late Andy Scott.  In 2003  Andy Scott, made a public commitment in 2003 to work toward a National Autism Strategy at a tribute to his 10 years of service as an MP at the Boyce Famers' Market, an event I attended and reported on to the members of the Family Autism Centre for Education (FACE):

"October 19 2003

Hello everyone:

Some good news for those interested in autism issues emerged last night  at the Boyce Farmers' Market in Fredericton New Brunswick as Frederictonian's gathered to pay tribute to MP Andy Scott's  10 years of service as an MP on behalf of Frederictonians and as an advocate for human rights, services for the disabled, and cultural harmony. Andy announced that he would be meeting with Paul Martin in the hopes of pursuing a national Autism strategy. Although health care is primarily within provincial juridiction some health issues, such as breast cancer, HIV, etc. have been approached on a national level because of the magnitude of the issues involved.  While we have all heard political promises in the past,  Andy Scott has a proven track record of commitment to, and follow through on, disabilities and human rights issues.  Great news.


Harold Doherty
Family Autism Centre for Education (FACE)"

Andy's comments at the Boyce Farmers' Market were also featured in a 2003 Telegraph Journal article by Tali Folkins:


"Fredericton MP Andy Scott said Saturday he has been lobbying prime- minister-to-be Paul Martin for a federal program to help young children with autism. "I desperately want a national autism strategy - and let me just assure you that Paul Martin knows it," Mr. Scott told supporters at a party celebrating his 10th anniversary as an MP in Fredericton Saturday evening.

Early work by therapists with young autistic children, Mr. Scott said, can make a big difference in their capacity to lead fulfilling lives as adults - and can save money in the long run. But the costs of starting such early intervention programs are high and should be borne directly by Ottawa rather than each individual province, he said. "We have responses and therapies and so on that I genuinely believe can work," he said. "You're going to save millions of dollars over the lifetime of an autistic adult. If you can get in at the front end, you can make enormous progress.

"But it's very expensive, and there's not a lot of stuff being added to Medicare, generally - that's why we have catastrophic drug problems and other things," he said. "In the province of New Brunswick, P.E.I., or even Quebec or Ontario it's very, very expensive. The feds are going to have to step up to the plate." 

Andy did answer the call on behalf of autistic Canadians and  actively pushed for a National Autism Strategy which he ultimately realized with the passage of Motion M-172.  However, the motion was essentially a commitment in principle with few obligations being undertaken by our federal government but it did help put autism on our national agenda and it was Andy Scott being Andy ... getting done what could get done ... with a view to moving forward further in future.  One of the specific items that the federal government did commit to in the motion was a national surveillance program, a program that would tell us how many Canadians now suffer from autism disorders.  It is a commitment that has still not been honored 8 years later. 

Andy Scott himself did continue the fight   as demonstrated in his June 5, 2007 statement in the House of Commons:
"Autism 

[Table of Contents]

Hon. Andy Scott (Fredericton, Lib.):

Mr. Speaker, it is regrettable that we have seen little action by the government toward implementing a national autism strategy.

It has been more than a year since I introduced Motion No. 172. My private member's motion called for evidence based standards, innovative funding arrangements for diagnosis, treatment and research, and a national surveillance program.

The motion was adopted in good faith and supported by the government. However, it was very disappointing to see no reference to a national autism strategy in the recent budget or any discussion this spring.

Recently, I joined my colleagues from Charlottetown and Sackville—Eastern Shore and Senator Munson at a rally in Halifax that reinforced that there are families with autistic children across Canada who need the government's help.

The Conservatives should move off their default position of jurisdictional excuses, show creativity and compassion and start helping these Canadians."


Jean Lewis, FEAT-BC, Medicare for Autism Now!

NB MP Andy Scott, FEAT-BC, Medicare for Autism NOW!'s Jean Lewis
National Autism Rally, Halifax, May 26 2007
Andy Scott's reference to his colleagues from Charlottetown and Sackville-Eastern Shore were  references to PEI's Shawn Murphy and Nova Scotia's Peter Stoffer both of whom, along with Andy Scott and Senator Jim Munson, also worked tirelessly toward achieving a National Autism Strategy.  The rally of which he spoke was a Halifax rally organized by Jean Lewis and FEAT-BC who had been raising autism awareness, lobbying politically and fighting for national autism coverage in the Courts for several years and continued to do so with its "Medicare for Autism NOW!" efforts.  I attended the FEAT autism really in Halifax and had the privilege of meeting Jean Lewis, several of the BC advocates and tireless Nova Scotia autism advocate Jim Young.  Under the BC leadership there have been subsequent national meetings in Oakville and Toronto.


NS MP Shawn Murphy, Senator Jim Munson, NB MP Andy Scott 
National Autism Rally, Halifax, May 26 2007


Nova Scotia MP Peter Stoffer,  National Autism Rally, 
Halifax, May 26 2007
In 2006 Shawn Murphy went on to introduce his own private member's bill, Bill C-304,  in the House of Commons which, if passed, would have put Canada well on the way to establishing a REAL National Autism Strategy:

C-304

First Session, Thirty-ninth Parliament,
55 Elizabeth II, 2006

HOUSE OF COMMONS OF CANADA

BILL C-304
_____________________________________________
FIRST READING, MAY 17, 2006
_____________________________________________

MR. MURPHY (Charlottetown)

1st Session, 39th Parliament,
55 Elizabeth II, 2006

HOUSE OF COMMONS OF CANADA

BILL C-304

An Act to provide for the development of a
national strategy for the treatment of
autism and to amend the Canada Health
Act

Her Majesty, by and with the advice and
consent of the Senate and House of Commons
of Canada, enacts as follows:

SHORT TITLE

1. This Act may be cited as the National
Strategy for the Treatment of Autism Act.


NATIONAL CONFERENCE

2. The Minister of Health shall, before
December 31, 2006, convene a conference of
all provincial and territorial ministers responsible
for health for the purpose of working
together to develop a national strategy for the
treatment of autism. The Minister shall, before
December 31, 2007, table a report in both
Houses of Parliament specifying a plan of action
developed in collaboration with the provincial
and territorial ministers for the purpose of
implementing that strategy.

AMENDMENTS TO THE CANADA
HEALTH ACT

3. Section 2 of the Canada Health Act is
renumbered as subsection 2(1) and is
amended by adding the following:

(2) For the purposes of this Act, services
that are medically necessary or required under
this Act include Applied Behavioural Analysis
(ABA) and Intensive Behavioural Intervention
(IBI) for persons suffering from Autism Spectrum
Disorder.
Bill C-304 was defeated soundly by a coalition of Harper Conservatives and separatist Blog Quebecois votes in the House of Commons. During debates in the House of Commons Harper conservative MP Mike Lake from Alberta, the autism face of the Harper government, a father of an autistic son, fought against the Murphy bill and helped vote it down to defeat.  

The hard truth is that there will never be a real National Autism Strategy as long as the Harper government rules in Ottawa.  Nor will a REAL NAS emerge from national autism charities that were never part of the struggle for a national autism strategy to begin with and who do not acknowledge the efforts made by parents across Canada who fought hard and long for a National Autism Strategy. National charities dare not speak contrary to federal government policy for fear of risking their charitable status. 

A real National Autism Strategy, even a real, current estimate of the number of Canadians who suffer from autism disorders will not come into existence until the Harper government is retired from office and will only come into existence with parent driven initiatives for whom helping their autistic sons and daughters is their most important objective.   Until then we will have to accept US figures for autism prevalence.  Accordingly, let it be known:

1 in 68 Canadians has an autism spectrum disorder. (Many of whom still do not receive effective ABA early intervention)

Tuesday, August 05, 2014

Autism Canada, With Some Help From the Globe and Mail, Promotes "Weak Evidence" Based Son-Rise Program®




Autism Canada suggests parents of autistic children should change course and head down a different trail, away from strong evidence based interventions like Applied Behaviour Analysis, toward programs with weak evidence base in support of their effectiveness like the Son-Rise Program®. The Globe and Mail has kindlly provided some support for this adventure with a less than thorough analysis or assessment of  the respective approaches and treatments or the possible outcomes for autistic children involved who might lose valuable therapy time during the critical early intervention period between ages 2 and 5. 

As I  previously noted on this site Autism Canada is busy Changing the Course of Autism from the evidence based approach that parents  advocated for across Canada over the last 15 years to an anything goes approach that encourages parents of young autistic children to try autism treatments with weak or no evidence supporting their effectiveness.  On July 3, 2014 the Globe and Mail Health section featured an article with several quotes by Dr. Wendy Edwards and Laurie Mawlam both of whom are affiliated with Autism Canada and their attempts to push Canadian parents of autistic children away from seeking evidence based effective interventions for their children ... Applied Behavior Analysis ... to programs with weak evidence in support of their effectiveness such as  ... the Son-Rise Program®. 

Lee Marshall is the author of the Globe and Mail article Facing down autism: The unconventional (and somewhat controversial) therapy that’s led to recovery  and  may not be responsible for the article title which assumes that the controversial therapy ACTUALLY leads to recovery even though the evidence that recovery results from the program is weak, anecdotal evidence. The article refers to a 2013 Lancaster University study Promoting child-initiated social-communication in children with autism: Son-Rise Program intervention effects a very small study which involved 6 children none of whom had an intellectual disability.  Intellectual disability is a serious complicating condition affecting from 41-44%  (CDC) to 50% (WHO) of persons with autism disorders.

Dr. Wendy Edwards provides her family's personal, anecdotal evidence of the benefits of the Son-Rise Program®.   Doctor or not her family story is still just that .... a family story.     Anecdotal evidence,  like  personal testimonials published promoting Son-Rise, is  considered the weakest form of evidence:


"Social scientists are wary about the use of stories as evidence for a claim. Anecdotes that are not backed up with systematic and rigorous comparative data are not trusted. Anecdotes are the weakest form of evidence, but they are often the most persuasive. Even scientists can be moved by a telling anecdote that contradicts a mass of statistical evidence. Anecdotes must always be used with care, precisely because we are psychologically susceptible to them." 

Laurie Mawlam, to her credit does acknowledge the substantial gulf between the evidence in support of Son-Rise  compared to ABA although she provides no credible explanation for the lack of evidence in support of the Son-Rise Program®:

"Mawlam of the Autism Canada Foundation said she had a “wonderful” experience using Son-Rise with her son. “While the scientific studies for Son-Rise are nowhere as plentiful as traditional discrete trial [Applied Behavioural Analysis], it doesn’t necessarily mean the treatment is not valid. It may just mean the studies have not been done,” she says."


The fact that Laurie Mawlam had a "wonderful experience" is not evidence of the effectiveness of Son-Rise.  Her weak dismissal of the lack studies providing evidence for Son-Rise is very questionable since the program began its development in the 1970's. There was ample time for studies to have been conducted between then and 2000.  One of the leading reviews of the evidence basis in support of various autism interventions is the Maine Administrators of Services for Children with Disabilities  (MADSEC) Autism Task Force Report (2000). The MADSEC Report reviewed and assessed the evidence basis of the Son-Rise Program®:

"According to Levy (1998), the Son-Rise Program does not guarantee results. The approach is based upon “. . .becoming a student of the child’s world, observing, learning, assisting and supporting the child’s flowering in a loving and non-judgmental environment” (Levy, 1998).

The Son-Rise Program does not seek to provide the child with information, or to teach the child to master predetermined skills. Instead, the program views the child’s current level of performance as being the best that the child can do; if the child could do better, he would (eg, if the child could follow instructions, he would). The Son-Rise program emphasizes total acceptance of the child, and encourages him to become a more motivated and participating individual (Levy, 1998).

Discussion

There have been no peer-reviewed, published studies of The Son-Rise Program’s effectiveness or outcome statistics.

Son Rise: The Miracle Continues chronicles the experiences of Barry and Samahria Lyte Kaufman as they created a program to meet the needs of their young son, diagnosed with autism and an IQ under 30. According the Kaufman (1997), their son currently has a near genius IQ, and no traces of his original condition.

Conclusions

There have been no studies of the Son-Rise Program’s effectiveness. Researchers should consider investigation using research protocols. Professionals considering Son-Rise should portray the method as without scientific evaluation of any kind, and should disclose this status to key decision makers influencing the child’s intervention."

I added the bold underlining for emphasis.  Autism Canada prides itself on being the "PREMIER" source for autism information in Canada.  Its spokespersons, especially medical and other professionals, should disclose to parents attending their conferences and reading their web site  seeking assistance with their children's autism disorders the lack of strong scientific evaluation for the Son-Rise program.

Mawlam does not explain why no scientific studies were done between the 1970's and 2000 to evaluate the Son-Rise program's effectiveness.  By contrast the 2007 American Academy of Pediatrics publication   Management of Children with Autism Spectrum Disorders, affirmed 2010,  assessed the evidence of effectiveness of ABA:
"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

The AAP report looked at a number of Developmental and Relationship intervention models including RDI and DIR but found limited studies and primarily anecdotal evidence.  No specific mention was made of the Son-Rise program.

A  January 2014 article in the Canadian Medical Association Journal  Autism spectrum disorder: advances in evidence-based  practice  compared the evidence base of support for ABA and contrasted it with non ABA autism interventions (Son-Rise Program again was not specifically  mentioned):

 "A recent overview of meta-analyses60 found significantly enhanced outcomes associated with early intensive ABA-based treatment (typically for 2–3 yr) in four of five included meta-analyses (effect sizes 0.30 to > 1); these findings have since been bolstered by a sixth meta-analysis.61 Gains appear to be greatest in verbal intelligence quotient (IQ) and language communication domains,62,63 for children with stronger pretreatment skills, if treatment is started earlier,64 and with greater intensity or duration of intervention. 60–62,64 These gains achieved in various domains have been summarized in a recent Cochrane review.63 Although the overall quality of evidence is low, it is the best evidence available. A recent study in Ontario reported predictors of outcome that account for some heterogeneity in treatment response.65

A recent RCT supported the efficacy of ABA-based intervention in toddlers by showing improvements in IQ, adaptive skills and diagnostic classification.37 Models vary, notably by how ABA principles are implemented, but everyday contexts (e.g., free play v. “tabletop”) and activities based on the child’s interests (v. therapist’s agenda) have advantages, including greater generalization of learning.66 Questions remain about which forms and intensities of treatment are most effective for which children. 

Research on non-ABA–based treatments is sparse and shows limited efficacy.67 Translation of evidence-based intervention into community practice is being evaluated, including in Canada.68 A key question is whether effective high-quality programs can be less costly and more sustainable; the findings from Nova Scotia are promising.38 Studies of the effectiveness of treatment programs for older children, youth and adults with ASD are scarce. Benefits have been reported for structured teaching practices, including ABA based interventions, for a wide range of skill deficits and maladaptive behaviours.58"

The studies and reviews of the solid basis of evidence of ABA effectiveness as an autism intervention span several decades while Son-Rise has almost no evidence in support of its effectiveness.  Laurie Mawlam enjoyed the Son-Rise experience with her autistic child which says nothing at all about the results for her child.  Son-Rise paints its program in feel good language and testimonials and tries to diminish ABA using the "robotic" mis-characterizations of ABA.  

Fortunately many Canadian parents of autistic children have fought for evidence based autism interventions.  It has not been an easy fight and the need to continue that fight persists with a patchwork quilt of autism interventions still existing from province to province.  Unfortunately governments and costs are not the only obstacles to obtaining early evidence based autism intervention.  Unfortunately there will always be those professionals and parents who abandon evidence based principles and who are of great help to politicians and civil servants looking for excuses to avoid providing effective evidence based ABA interventions for children with autism disorders. 

Autism Canada appears to be pulling out all the stops in "Changing the Course"   away from evidence based   autism programs. 

Sometimes "Changing the Course" is not a good thing.

Sunday, July 20, 2014

Why ABA for Autism? Because Children with Autism Disorders Deserve Evidence-Based Intervention and ABA Meets That Standard




Autism Canada Foundation, a Canadian autism charity,  promotes itself as "The PREMIER Resource for Information on Autism Spectrum Disorders" but  typically downplays the importance of evidence support for ABA as the Premier autism intervention while promoting interventions with less substantial  evidence bases as determined by study and  credible authorities.

 Why criticize Autism Canada Foundation an autism charity? Why ABA for Autism? Why Evidence Based Intervention?  Because, as stated by Couper and Sampson in the Medical Journal of Australia 11 years ago,  ineffective therapies, while they may be immediately harmless, waste the child's valuable therapy time and parents' money.  Delay in implementing effective treatment may have a negative impact on the child's ultimate outcome.  ABA is the only intervention to date that meets the evidence based standard in every credible review, a fact downplayed by the Autism Canada Foundation.

ABA has for many years been confirmed by study and credible authorities as  the most substantially evidence based effective autism intervention.  If parents choose to try other methods they should in fact make informed choices. Autism Canada is a charitable organization which will be staging an autism conference this October called Changing the Course of Autism 2014.  The brochure highlights RDI and the Son-Rise program but makes no express mention of  Applied Behavior Analysis.  

As the following credible reviews indicate RDI and Son-Rise are not supported by the same level of evidence of their effectiveness as ABA ( I can't find any authoritative review mentioning any level of evidence  support for Son-Rise).   What the Autism Canada conference attendees are unlikely to be informed is that when it comes to autism therapies it  is not a close call - ABA was and remains the most substantiated, evidence based, effective autism intervention. 

The US Surgeon General, the MADSEC Maine Administrators of Services for Children with Disabilities (Maine Autism Task Force) Report (2000 revision),  American Academy of Pediatrics, Management of Children with Autism Spectrum Disorders, and a recent article in the Canadian Medical Association Journal all confirm ABA as the most effective autism intervention (specific treatment necessary for associated medical conditions - eg. seizures, gastro intestinal).  And as Couper and Sampson wrote ... Children with autism deserve evidence based intervention:

1. Couper and Sampson - Children with autism deserve evidence based intervention.

Children with autism deserve evidence-based intervention  
Jennifer J Couper and Amanda J Sampson
Med J Aust 2003; 178 (9): 424-425.


Jennifer J Couper and Amanda J Sampson, in the 2003 editorial in the MJA, reviewed some of the evidence in support of the effectiveness  of behavioral interventions for autism. The authors stressed the importance of an evidence based approach to autism interventions:

"While ineffective therapies may be harmless, they waste parents' money and the child's valuable therapy time. Furthermore, the delay in implementing effective treatment may compromise the child's outcome." 

- [Bold Highlighting Added - HLD]

Couper and Sampson reviewed the evidence at that time (2003) in relation to behavioral treatment for autism:

The early intervention that has been subjected to the most rigorous assessment is behavioural intervention. There is now definite evidence that behavioural intervention improves cognitive, communication, adaptive and social skills in young children with autism. In 1987, Lovaas showed apparent recovery, persisting into adolescence, in nine of 19 young children who received an intensive home-based intervention based on applied behavioural analysis, a scientific method of reinforcing adaptive and reducing maladaptive behaviours.5,6 Subsequent studies also showed that behavioural intervention caused significant, albeit somewhat lesser, gains.7-11 This has modified the orthodox view that autism is always a severe, lifelong disability. Criticisms of the adequacy of the design and power of these studies are being addressed by the multisite Lovaas replication Early Autism Project. The first US site has released data (Wisconsin Early Autism Project).12 Again, after three to four years of intensive applied behavioural analysis intervention, about half the preschool children with autism acquired near-normal functioning in language, performance IQ and adaptability. Ninety-two per cent of intervention children acquired some language. Control children who received special education showed no gains in IQ or adaptability.12

2. American Academy of Pediatrics - Management of Children with Autism Spectrum Disorders, (2007, reaffirmed 2010)

The American Academy of Pediatrics article Management of Children With Autism Spectrum Disorders, Scott M. Myers, MD, Chris Plauché Johnson, MD, MEd, the Council on Children with Disabilities (2007), reaffirmed (2010):


"Applied Behavior Analysis



Applied behavior analysis (ABA) is the process of applying interventions that are based on the principles of learning derived from experimental psychology research to systematically change behavior and to demonstrate that the interventions used are responsible for the observable improvement in behavior. ABA methods are used to increase and maintain desirable adaptive behaviors, reduce interfering maladaptive behaviors or narrow the conditions under which they occur, teach new skills, and generalize behaviors to new environments or situations. ABA focuses on the reliable measurement and objective evaluation of observable behavior within relevant settings including the home, school, and community. 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.31–40"


As with every other major research review of the effectiveness of early autism interventions only ABA, applied behavior analysis, received the highest rating: E  - Established/Eligible based on evidence.

 4. Canadian Medical Association Journal, Autism spectrum disorder: advances in evidence-based practice (2014)

 An article in the January 13, 2014 issue of the Canadian Medical Association Journal, Autismspectrum disorder: advances in evidence-based practice, confirms what American authorities have told us for decades, from the US Surgeon General to MADSEC and the American Academy of Pediatrics, ABA still represents evidence based, effective best treatment practice while "Research on non-ABA–based treatments is sparse and shows limited efficacy.":

" Autism spectrum disorder: advances in evidence-based practice "What treatments and interventions are available, and are they effective?



 The goal of existing interventions is to facilitate the acquisition of skills, remove barriers to learning and improve functional skills and quality of life.



 Behavioural interventions



  Current best practices for preschool-aged children with ASD include a focus on improving language, cognitive and adaptive skills using applied behaviour analysis (ABA) techniques.58 Applied behaviour analysis refers to the application of empirically derived learning principles(i.e., the antecedent–behaviour–consequence contingency) to produce meaningful changes in behaviour.59 Such strategies are carefully engineered and implemented through a variety of approaches (e.g., discrete trial teaching to more naturalistic learning contexts) to teach skills and reduce problem behaviour. Applied behaviour analysis interventions can be provided in a variety of settings (e.g., home, specialized treatment centres, specialized or public schools) by a range of front-line therapists, ideally supervised by a psychologist or board-certified behaviour analyst who specializes in ASD.



 A recent overview of meta-analyses60 found significantly enhanced outcomes associated with early intensive ABA-based treatment (typically for 2–3 yr) in four of five included meta-analyses (effect sizes 0.30 to > 1); these findings have since been bolstered by a sixth meta-analysis.61 Gains appear to be greatest in verbal intelligence quotient (IQ) and language communication domains,62,63 for children with stronger pretreatment skills, if treatment is started earlier,64 and with greater intensity or duration of intervention. 60–62,64 These gains achieved in various domains have been summarized in a recent Cochrane review.63 Although the overall quality of evidence is low, it is the best evidence available. A recent study in Ontario reported predictors of outcome that account for some heterogeneity in treatment response.65



 A recent RCT supported the efficacy of ABA-based intervention in toddlers by showing improvements in IQ, adaptive skills and diagnostic classification.37 Models vary, notably by how ABA principles are implemented, but everyday contexts (e.g., free play v. “tabletop”) and activities based on the child’s interests (v. therapist’s agenda) have advantages, including greater generalization of learning.66 Questions remain about which forms and intensities of treatment are most effective for which children.



 Research on non-ABA–based treatments is sparse and shows limited efficacy.67 Translation of evidence-based intervention into community practice is being evaluated, including in Canada.68 A key question is whether effective high-quality programs can be less costly and more sustainable; the findings from Nova Scotia are promising.38 Studies of the effectiveness of treatment programs for older children, youth and adults with ASD are scarce. Benefits have been reported for structured teaching practices, including ABA based interventions, for a wide range of skill deficits and maladaptive behaviours.58" [Highlighting added - HLD]


Hopefully conferences such as the Autism Canada Foundation 2014 conference are not seeking to change the course of autism intervention away from evidence based interventions toward largely  anecdotal approaches.  Hopefully attendees and those who access the conference information will be informed of the importance of evidence based support for autism interventions and the level of credible evidence in support of ABA effectiveness, a level of evidence support which remains unmatched by ANY other behavioural, social or educational intervention.