Monday, August 24, 2009

EIBI as Intervention of Choice for Young Children with Autism

".... the results of our meta-analysis supports the implication that early intensive behavioral intervention (EIBI) should be the intervention of choice for young children with autism."

Sigmund Eldevik, Richard Hastings, and Carl Hughes, Bangor College, UK
Erik Jahr, Akershus University Hospital, Norway
Svein Eikeseth, Akershus University College, Norway
Scott Cross, Lovaas Institute for Early Intervention, USA

The recent meta-analysis by Eldevik and others must be very disheartening to anti-ABA crusaders in their efforts to disparage ABA intervention for children with autism. Parents seeking to actually help their autistic children though can take heart that yet another study supports their struggle to obtain ABA intervention for their children. Hopefully public decision makers will be guided by this and previous studies and reviews in determining how best to help autistic children.

The meta-analysis was summarized in Meta-analyses of research findings can help guide practice and policy in Issue # 9, of the newsletter of the Association of Professional Behavior Analysts. In conducting their meta-analysis the authors identified 34 studies through a systematic literature search and included 9 studies that had either a comparison or a control group. The authors found statistically significant improvements in IQ and adaptive behavior. They also reviewed a recent meta-analysis published in 2009 (Spreckley & Boyd) that purported to show that EIBI produced no better effects than what was described as standard care. The Eldevik team identified several serious errors in the Spreckley & Boyd meta-analysis though one of which I found particularly interesting, a misunderstanding by the authors of the Spreckly & Boyd meta-analyis of how EIBI and ABA are delivered:

"That analysis had a number of serious limitations, however. First, only 4 studies were included, so the full range of evidence for EIBI was not reviewed. Second, it was not clear from the report how EIBI was defined, so the studies may not reflect genuine EIBI as it is understood in our field. Third, and perhaps most problematic, the authors (Australian physical therapists) seemed to misunderstand how genuine EIBI is delivered, and what a study by Sallows and Graupner (2005) showed. In that study, one group of children with autism received EIBI directed by professional behavior analysts, and the other group received EIBI managed by their parents, who received training and frequent consultation from the behavior analysts. Both groups had comparably large gains on several measures after 4 years of EIBI. Spreckley and Boyd (2009) incorrectly characterized the parent-managed EIBI as “standard care,” i.e., non-ABA intervention. Because there were few differences between the groups after treatment, those authors concluded that EIBI was no more effective than what they erroneously treated as “standard care.”"

The misunderstanding of how EIBI and ABA are actually delivered is an impression that seems to permeate much of the online criticisms of ABA, particularly those by people who have absolutely no experience with ABA. Eldevik, Jahr, Eikeseth and Cross have performed a valuable service by helping to replace anti-ABA ideology with still more demonstrated evidence of ABA effectiveness.

Bookmark and Share

1 comment:

Marius Filip said...

I am so glad to learn that EIBI delivered by the parents can compare both in quality and results with EIBI delivered by professionals.

This shows two things: 1) the method counts, not who is delivering it 2) the method works.