Lisa Jo Rudy Does A Bettelheim, Demeans ABA Parents While Pushing Her New Autism Book

Lisa Jo Rudy and I seldom, if ever, agreed on autism issues while she was the host of the About Autism web page. Lisa Jo has a high functioning autistic son and leans towards a Neurodiversity perspective on most autistm issues while my son is severely autistic and I have NEVER been accused of buying into Neurodiversity ideology. I did, at one time,  actually praise Lisa Jo Rudy though for her courteous approach to me and others with whom she disagreed on autism issues:

"About.com Autism by Lisa Jo Rudy is a corporate blog written by a parent who shares a neurodiversity perspective but tries honestly to present all sides of autism issues objectively and with impeccable courtesy."

Now that Lisa is no longer the host of the About.com Autism page though she appears to be taking a new approach to discussing autism issues. She has done a  Full Bettleheim in order to promote her new book "Get Out, Explore, and Have Fun: How Families of Children With Autism or Asperger Syndrome Can Get the Most Out of Community Activities."

In promoting her new autism book Lisa Jo demeans parents who employ evidence based ABA therapy to help their autistic children by actually stating that their resort to ABA therapy for their children is more about dumping their kids with the therapists and freeing themselves up to go shopping than in helping their autistic children. In a Wicked Local Cape Cod article linked by Autism Speaks "In the News" section the following segment appears:

“Rudy said although the most common form of autism therapy is Applied Behavior Analysis (ABA) she opted for another method.“The ABA recommendation is for 40 hours a week and it’s more about handing your child over to a therapist while you go to the grocery store,” she said. 

Rudy discovered the Greenspan Floortime Approach, developed by the late Stanley Greenspan, which focuses on parent and child interaction.”

Bettleheim's refrigerator mom's theory essentially blamed lack of parent child interaction for causing children to become autistic.  The theory was in fact a fantasy with no evidence in support but it was widely accepted by the psychiatric/psychological professionals for many years and caused great harm to both autistic children and their parents.  Although Bettleheim's fantasies have long been discredited it appears Lisa Jo is still reading his books when she suggests that parents seek ABA therapy not because it is the most evidence based effective intervention for autism but because, according to Lisa, it frees the parents up to go shopping.  Lisa of course prefers the 

Greenspan Floortime Approach because, according to her, it focuses on parent child interaction.

How Lisa Jo knows anything about ABA as someone who didn't "opt for" ABA for her child has always puzzled me.  What is most interesting though, apart from her new willingness to demean ABA oriented autism parents while promoting her book is her failure to mention the different evidence bases for the effectiveness of the two approaches as autism interventions.

Many credible authorities have recommended ABA as the most evidence based effective intervention for autistic children including the office of the US Surgeon General and the Association for Science in Autism Treatment.  The American Pediatric Association issued the following statements about ABA and Floortime therapies in December 2007 noting the abundant evidence over several decades in support of ABA as an autism intervention and the scarcity of quality evidence in support of Floortime and similar relationship/developmental models:

ABA

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.

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

Floortime

"Relationship-focused early intervention models include Greenspan and Wieder's developmental, individual-difference, relationship-based (DIR) model,⁵⁵ Gutstein and Sheely's relationship-development intervention (RDI),⁵⁶ and the responsive-teaching (RT) curriculum developed by Mahoney et al.^57,58 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"

American Academy of Pediatrics, Management of Children with Autism Spectrum Disorders, Published online October, 29, 2007, Reaffirmed by the APA, September 2010.  

Lisa Jo Rudy has chosen to depart from a previously courteous, objective approach to discussing autism issues, unfortunately for autistic children whose parents abandon ABA efforts based on Ms Rudy's personal prejudices.  Most parents demeaned by such comments will not take them too seriously because the Bettelheim cold mother's fantasy has been widely exposed as nonsense (outside of France anyway).  The autistic children  of parents who look to Ms. Rudy for guidance though may not be as fortunate.

Autism leader helps UNB remain at forefront of autism intervention training

The University of New Brunswick has engaged a renowned expert to examine best practices in autism treatment.

Dr. David Celiberti is president of the Association for Science and Autism Treatment. His report, commissioned by UNB’s College of Extended Learning (CEL), examines program quality indicators already in place in other jurisdictions. The findings will be used to provide quality assurance for UNB’s program and to help UNB remain a leader with its Autism Intervention Training program.

“At UNB’s College of Extended Learning, we have great programs in place,” said CEL Executive Director Lloyd Henderson. “The methodology taught in our program is an Established Treatment as per National Autism Centre’s (NAC) standards.”

The NAC published a National Standards Report which classifies autism intervention treatments in a range from Established (known to be effective) and Emerging (some evidence of effectiveness), to Un-established (no sound evidence of effectiveness) and Ineffective (having no beneficial effects).

“We want to continue to lead in this area by taking a global approach, examining best practices, and making sure we continuously improve to offer the best intervention training possible. We monitor emerging treatments and will incorporate them into our programs if and when they are deemed established,” said Henderson.

“Autism treatment providers and program administrators should be required to report and justify why they are bypassing established treatment,” Celiberti said, in his report. “Parents should be educated and fully informed about which aspects of their child’s treatment are comprised of established treatment and which are not.”

The findings in the report will be used to establish a protocol for the CEL’s training program. It will also be made available to those involved in the administration and support of autism programs across the province and throughout Atlantic Canada.

“In light of the overwhelming body of growing intervention methods that parents and professionals are presented with on a daily basis, UNB’s intentions in undertaking this research project were to identify evidence-based proof of the support methods being used to treat children with autism,” Henderson said. “Thanks to Dr. Celiberti, we now have the information we need and are examining our programs to see if there are areas we can continue to improve.”

For more information on UNB’s program, or to read the report, visit: www.unb.ca/cel/intervention/index.html

LA Times Gets It Right: ABA Is An Autism Treatment Worth Funding

I am a frequent critic of the mainstream media's tendency to misrepresent autism disorders. The mainstream media routinely presents feel good stories of autistic accomplishments, painting autism as merely a different way of thinking and speculating that many of histories great geniuses were probably autistic.  Discussion of autism treatments ranges from riding horses in Mongolia to swimming with dolphins.  More serious mainstream media treatments of autism treatments will acknowledge that early intervention is important for successful outcomes without mentioning ABA, applied behavior analysis, the most solidly evidence backed treatment shown for many years to result in a number of intellectual, language and behavior gains in autistic children who receive early intensive ABA intervention.

I have criticized all aspects of mainstream media misrepresentation of autism including the tendency to hide the evidence based effectiveness of ABA known for many years and confirmed by authorities from the US Surgeon General to the American Academy of Pediatrics.  It is only right that I acknowledge, with gratitude, when a mainstream media institution gets it right as the LA Times has done with its clear, straight to the point,  statement about the importance of ABA as a treatment for autism disorders:

"An autism treatment worth funding


Editorial


A California bill would require insurance companies to cover the cost of applied behavioral analysis for the autistic. It's good policy.


September 30, 2011


State law requires insurers to include coverage for autism in comprehensive healthcare policies. Now, lawmakers want to go a step further, requiring coverage of a particular autism treatment: applied behavioral analysis. Insurers are resisting. They don't question the effectiveness of the therapy; they just say it doesn't fit the definition of "medical" treatment. Their position reflects how crucial parts of the healthcare system are wedded to the status quo, regardless of what's best for patients. State lawmakers have passed a bill to overcome the insurers' resistance, and Gov. Jerry Brown should sign it."