Sunday, May 10, 2009

Autism Recovery: More Evidence of ABA Effectiveness

It has been a very bad week for the anti-ABA, anti-autism treatment crowd.

Laurent Mottron, Morton Ann Gernsbacher and Michelle Dawson, amongst others, are probably not happy with the latest autism research news out of Chicago where a study was presented at an autism conference by University of Connecticut psychology professor Deborah Fein showing recovery of between 10 and 20% of subjects originally diagnosed as autistic who were later determined to have lost the autism diagnosis after years of intensive applied behavioral analysis.

The recovery story itself is not knew. The highly respected Dr. Doreen Granpeesheh and other researchers and clinical psychologists, who actually work with autistic children, have presented stories of autistic children who have recovered after years of ABA treatment. What is most significant in this instance is the rigour of the analysis which resulted in the initial autism diagnosis and the thorough documentation involved in the study as reported in the Washington Post:

Autism researcher Geraldine Dawson, chief science officer of the advocacy group Autism Speaks, called Fein's research a breakthrough.

"Even though a number of us out in the clinical field have seen kids who appear to recover," it has never been documented as thoroughly as Fein's work, Dawson said.

Previous studies have suggested between 3 percent and 25 percent of autistic kids recover. Fein says her studies have shown the range is 10 percent to 20 percent.

But even after lots of therapy _ often carefully designed educational and social activities with rewards _ most autistic children remain autistic.

Recovery is "not a realistic expectation for the majority of kids," but parents should know it can happen, Fein said.

Fein is being responsible in cautioning that recovery will not happen for most children with autism who receive ABA. But that does not mean that it is an all or nothing proposition either. Gains in reducing problem behaviors as in self injurious behavior and aggression, and skill acquisition with ABA use are well documented as noted in the American Academy of Pediatrics Management of Children with Autism Spectrum Disorders report (2007):

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

ABA for autism. The evidence of ABA effectiveness in treating autism has grown over the past decade despite the ideological obstinacy of those who condemn ABA. This week that evidence grew yet again.

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Unknown said...

Hi, Harold,

I saw this tweeted hundreds (thousands?) of times on Twitter.

I know those of us on the spectrum are all starting from different starting lines in terms of our ability to cope. I know we all have different goals, in terms of those that are severely autistic, and those of us that are high functioning.

I absolutely believe in ABA, and anything and everything that will help people increase their ability to cope, function, and interact.

Nevertheless, I have trouble with the words "recovery" and "lost the autism diagnosis".

To me, admittedly as someone high functioning, I don't believe anyone can say any child has "recovered" until they see them as an adult (20+), giving emotional support to others, and having normal friendships (as opposed to acquaintances which many of us mistake for friendships) and a normal social life.

Behaviors alone, including increased social behaviors as a child, in my view are not evidence of any complete cure.

So, I applaud Dr. Fein's work. I think it will improve the lives of many. But until the social lives of these children are evaluated when they are adults, I think it's a little early to call this a cure.


P.S. My thoughts apply to anyone using any therapy and saying AS children are "recovered" or cured. I've seen no follow up of any children who people have said have been cured, when these children become adults. When one is done, that's when I'll start to take the "cure" word more seriously.

walking said...

Here is video of Leo and another of a boy named EthanWhat is also interesting is to observe how the parents guide their children, too!

I agree with Chris. Personally, I would not feel comfortable about using the word recovered until a child has made a successful transition into the world of adulthood. I think "losing the label of autism" is more accurate.

Tanya @ TeenAutism said...

It should also be noted that even when children who receive ABA do not "recover," they will usually show improvement. My son definitely still has autism, but ABA made a tremendous difference in how well he is able to function.