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Transcript of 1 Science, Research, APA Style, and Assessing Treatments for Children with Autism Ps553 Applied...
1
Science, Research, APA Style, and Assessing
Treatments for Children with
Autism
Science, Research, APA Style, and Assessing
Treatments for Children with
Autism
Ps553Applied Behavior Analysis Programs
Caldwell College
Ps553Applied Behavior Analysis Programs
Caldwell College
2
It All Begins with Knowledge…
It All Begins with Knowledge…
Knowledge is information about how things work
Information is only useful if it is accurate (“valid”)
Unfortunately, lots of knowledge sources have errors and subjective biases
How do we know what knowledge (information) is accurate?
Knowledge is information about how things work
Information is only useful if it is accurate (“valid”)
Unfortunately, lots of knowledge sources have errors and subjective biases
How do we know what knowledge (information) is accurate?
3
ScienceScience
Is nothing more than a certain way to gather knowledge
Strives to minimize subjective bias and maximize accuracy
Uses objective, systematic, and direct observation of phenomena being studied
Likely to be most accurate source of knowledge for how things work in the world
Is nothing more than a certain way to gather knowledge
Strives to minimize subjective bias and maximize accuracy
Uses objective, systematic, and direct observation of phenomena being studied
Likely to be most accurate source of knowledge for how things work in the world
4
Science and Assessing Effective
Treatment
Science and Assessing Effective
Treatment Science provides certain criteria to
decide what information is (and is not) valid (accurate)
Actually, “validity” of information is along a continuum (from “baloney” all the way to “fact”)
Ultimate goal for autism treatment: to identify what maximally benefits the child in need of intervention (and what doesn’t work or may even harm the child!)
Science provides certain criteria to decide what information is (and is not) valid (accurate)
Actually, “validity” of information is along a continuum (from “baloney” all the way to “fact”)
Ultimate goal for autism treatment: to identify what maximally benefits the child in need of intervention (and what doesn’t work or may even harm the child!)
5
Some TermsSome Terms
MEASUREMENT = to quantify the characteristics of what (or whom) you’re looking at (or to label it) “Diagnosis” is a type of measurement involving
labeling “severity” of a disorder on a scale of 1-10 is a
type of measurement involving quantification “number of requests” made by a child in an hour
is another measurement involving quantification DATA = the collected measurements of what
you’re examining These provide evidence about how good our
information is
MEASUREMENT = to quantify the characteristics of what (or whom) you’re looking at (or to label it) “Diagnosis” is a type of measurement involving
labeling “severity” of a disorder on a scale of 1-10 is a
type of measurement involving quantification “number of requests” made by a child in an hour
is another measurement involving quantification DATA = the collected measurements of what
you’re examining These provide evidence about how good our
information is
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Some TermsSome Terms
VARIABLE = anything that can be measured and that can change in value (what you are investigating)
DEPENDENT VARIABLE = the part of the child’s behavior you are measuring (outcome)
INDEPENDENT VARIABLE (“types of intervention”) = how you are teaching the child
VARIABLE = anything that can be measured and that can change in value (what you are investigating)
DEPENDENT VARIABLE = the part of the child’s behavior you are measuring (outcome)
INDEPENDENT VARIABLE (“types of intervention”) = how you are teaching the child
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Some TermsSome Terms
HYPOTHESIS = a statement predicting how one variable will be related to, or affect, another variableIt is not really an educated “guess” but a well
informed prediction based on past evidenceTHEORY = a statement explaining why a
relationship exists between two variables What makes a theory a good one or a bad one?Shall we talk about Bettelheim’s Refrigerator
Mother theory?
HYPOTHESIS = a statement predicting how one variable will be related to, or affect, another variableIt is not really an educated “guess” but a well
informed prediction based on past evidenceTHEORY = a statement explaining why a
relationship exists between two variables What makes a theory a good one or a bad one?Shall we talk about Bettelheim’s Refrigerator
Mother theory?
8
Some TermsSome Terms
OPERATIONAL DEFINITION = an objective definition of a variable (everyone can measure what you are measuring)
INTEROBSERVER AGREEMENT (IOA) – extent to which observers agree on what they are observingIOA will be high ONLY when the variables
have been defined so that everyone understands what is being studied
OPERATIONAL DEFINITION = an objective definition of a variable (everyone can measure what you are measuring)
INTEROBSERVER AGREEMENT (IOA) – extent to which observers agree on what they are observingIOA will be high ONLY when the variables
have been defined so that everyone understands what is being studied
9
Some TermsSome Terms
FUNCTIONAL RELATIONSHIP = degree to which the independent variable affects the dependent variable (and can you isolate this effect!!)Main focus in research in autism
treatment is to determine functional relationship between treatment X and behavior Y
(Does the treatment benefit the child? AND Can we conclude that it was NOT something else that benefited the child?)
FUNCTIONAL RELATIONSHIP = degree to which the independent variable affects the dependent variable (and can you isolate this effect!!)Main focus in research in autism
treatment is to determine functional relationship between treatment X and behavior Y
(Does the treatment benefit the child? AND Can we conclude that it was NOT something else that benefited the child?)
10
Research: Search for Answers!
Research: Search for Answers!
How can we possibly answer those last two questions? (Does the treatment benefit the child? AND Can we conclude that it was NOT something else that
benefited the child?) Need to investigate functional
relationships using particular, agreed upon investigation techniques called RESEARCH…
How can we possibly answer those last two questions? (Does the treatment benefit the child? AND Can we conclude that it was NOT something else that
benefited the child?) Need to investigate functional
relationships using particular, agreed upon investigation techniques called RESEARCH…
11
Research TechniquesResearch Techniques
POOR RESEARCH TECHNIQUES: COMMON SENSE, INTUITION, HUNCHES – too many people use these as the final answer about how the world works (are MOST susceptible to errors and biases); also called “street smarts”
Perfectly fine to use these to come up with hypotheses and theories to test out!“Hmm, it seems that some kids first show
signs of autism after vaccinations, so maybe…”
POOR RESEARCH TECHNIQUES: COMMON SENSE, INTUITION, HUNCHES – too many people use these as the final answer about how the world works (are MOST susceptible to errors and biases); also called “street smarts”
Perfectly fine to use these to come up with hypotheses and theories to test out!“Hmm, it seems that some kids first show
signs of autism after vaccinations, so maybe…”
12
Research TechniquesResearch Techniques
BETTER RESEARCH: INFORMATION FROM AUTHORITIES – a better way to gain information
but is only as good as the authority’s credentials, expertise, and objectivity); also called “book smarts”
See what other experts of equal credentials also say about the topic you’re investigating
we should always check the credentials of anyone claiming to be an expert on a topic See the policy on autism treatment from the
“experts” in Freeman’s (2003) book Does an M.D. make you an automatic expert?
BETTER RESEARCH: INFORMATION FROM AUTHORITIES – a better way to gain information
but is only as good as the authority’s credentials, expertise, and objectivity); also called “book smarts”
See what other experts of equal credentials also say about the topic you’re investigating
we should always check the credentials of anyone claiming to be an expert on a topic See the policy on autism treatment from the
“experts” in Freeman’s (2003) book Does an M.D. make you an automatic expert?
13
Research TechniquesResearch Techniques
BEST: EXPERIMENTATION – best way to gain information about functional relationships because you can isolate effects of particular variables under objective conditionsMajority of us are CONSUMERS of research
findings generated by experiments. So?So at worst we should be able to
understand the basics; at best, we should be able to conduct our own experiments
BEST: EXPERIMENTATION – best way to gain information about functional relationships because you can isolate effects of particular variables under objective conditionsMajority of us are CONSUMERS of research
findings generated by experiments. So?So at worst we should be able to
understand the basics; at best, we should be able to conduct our own experiments
14
Causation vs. Correlation
Causation vs. Correlation
CORRELATION – two variables seem to change in a regular fashion with one anotherBig Problem: WAY too many people
infer CAUSALITY from this kind of relationship when we don’t really know, and they then act on it
AUTISM AND MMR VACCINES?
CORRELATION – two variables seem to change in a regular fashion with one anotherBig Problem: WAY too many people
infer CAUSALITY from this kind of relationship when we don’t really know, and they then act on it
AUTISM AND MMR VACCINES?
15
Causation vs. Correlation
Causation vs. Correlation
CAUSATION – when evidence collected shows us that when one variable alone changes, the second variable also changes as a result of the first variable!Using an EXPERIMENT is what allows
us to make such inferences of CAUSALITY
FACILITATED COMMUNICATION?
CAUSATION – when evidence collected shows us that when one variable alone changes, the second variable also changes as a result of the first variable!Using an EXPERIMENT is what allows
us to make such inferences of CAUSALITY
FACILITATED COMMUNICATION?
16
Experimental Designs
Experimental Designs
To reiterate, goal is to determine functional relationships (for this class: how does a particular treatment affect a child?)
To do this, need to rule out effects of other variables you are not studying (called extraneous variables)
you need to CONTROL FOR the other extraneous variables by holding them as CONSTANTS while varying the treatment (independent variable)…
To reiterate, goal is to determine functional relationships (for this class: how does a particular treatment affect a child?)
To do this, need to rule out effects of other variables you are not studying (called extraneous variables)
you need to CONTROL FOR the other extraneous variables by holding them as CONSTANTS while varying the treatment (independent variable)…
17
Experimental Designs
Experimental Designs
One way to do this is to observe a single person, or a group of persons, under one condition (“treatment”) and then another (“control condition”) WITHOUT LETTING ANY OTHER VARIABLES CHANGE! Why?
Another way to do this is to get two or more groups of people who ARE THE SAME, and then apply the treatment to one group (“treatment group”) but not the other (“control group”) WITHOUT LETTING ANY OTHER VARIABLES CHANGE! Why?
One way to do this is to observe a single person, or a group of persons, under one condition (“treatment”) and then another (“control condition”) WITHOUT LETTING ANY OTHER VARIABLES CHANGE! Why?
Another way to do this is to get two or more groups of people who ARE THE SAME, and then apply the treatment to one group (“treatment group”) but not the other (“control group”) WITHOUT LETTING ANY OTHER VARIABLES CHANGE! Why?
18
Ethical Issues in Experimental
Designs
Ethical Issues in Experimental
DesignsPart of the reason why things get
so confused in research for therapies is that the people we are studying are entitled to effective therapy ABOVE AND BEYOND WHAT VALUE CONTROLLED RESEARCH MIGHT PROVIDE US
That is, the person comes first, the research findings come second…
Part of the reason why things get so confused in research for therapies is that the people we are studying are entitled to effective therapy ABOVE AND BEYOND WHAT VALUE CONTROLLED RESEARCH MIGHT PROVIDE US
That is, the person comes first, the research findings come second…
19
Ethical Issues in Experimental
Designs
Ethical Issues in Experimental
DesignsThis has led to some compromises in
research designs that make them a bit less than optimal, but still good quality
But, we can still draw inferences about functional relationships in experiments that are not quite optimal but have been REPLICATED
The more frequently we see a functional relationship demonstrated, the more sure we are that it is a VALID relationship
This has led to some compromises in research designs that make them a bit less than optimal, but still good quality
But, we can still draw inferences about functional relationships in experiments that are not quite optimal but have been REPLICATED
The more frequently we see a functional relationship demonstrated, the more sure we are that it is a VALID relationship
20
Reading (and Writing) About
Research Studies
Reading (and Writing) About
Research Studies Is this fun? Not usually but we can be duped
by others if we don’t know the research!!! Peer-reviewed journals contain the most
VALID research findings (beware of pseudo-scientific journals!)
Studies are written up in “APA style” which is an agreed upon way to present research findings (from American Psychological Association)
The following “tips” apply when reading an article
Is this fun? Not usually but we can be duped by others if we don’t know the research!!!
Peer-reviewed journals contain the most VALID research findings (beware of pseudo-scientific journals!)
Studies are written up in “APA style” which is an agreed upon way to present research findings (from American Psychological Association)
The following “tips” apply when reading an article
21
Types of APA PapersTypes of APA Papers
LITERATURE REVIEW ARTICLE (“ARGUMENTATIVE PAPER”) – less common Involves reviewing and summarizing past
research and drawing some kind of conclusion about what the research has shown to this point in time
Also usually makes suggestions for additional studies that need to be conducted to answer questions about the topic
RESEARCH STUDY ARTICLE – more common Involves presenting original research study and
its findings
LITERATURE REVIEW ARTICLE (“ARGUMENTATIVE PAPER”) – less common Involves reviewing and summarizing past
research and drawing some kind of conclusion about what the research has shown to this point in time
Also usually makes suggestions for additional studies that need to be conducted to answer questions about the topic
RESEARCH STUDY ARTICLE – more common Involves presenting original research study and
its findings
22
APA Style: Parts of Research Study
APA Style: Parts of Research Study
ABSTRACT – this summarizeswhat purpose the study hadhow it was conductedwhat the findings wereand what the implications of these finding
are It’s what you read when you search an
article on PsychInfo databases It’s like the Reader’s Digest condensed
version of the entire research report
ABSTRACT – this summarizeswhat purpose the study hadhow it was conductedwhat the findings wereand what the implications of these finding
are It’s what you read when you search an
article on PsychInfo databases It’s like the Reader’s Digest condensed
version of the entire research report
23
APA Style: Parts of Research
Study
APA Style: Parts of Research
Study INTRODUCTION – this section has a few
important parts It defines the topic of the research report (the
WHAT) It then tells the reader what other earlier
researchers have already learned about this topic (called a “literature review”) and how they conducted their studies (the BACKGROUND)
Lastly, it tells the reader what the purpose is of the research conducted by the author of the paper (the PURPOSE)
INTRODUCTION – this section has a few important parts It defines the topic of the research report (the
WHAT) It then tells the reader what other earlier
researchers have already learned about this topic (called a “literature review”) and how they conducted their studies (the BACKGROUND)
Lastly, it tells the reader what the purpose is of the research conducted by the author of the paper (the PURPOSE)
24
APA Style: Parts of Research
Study
APA Style: Parts of Research
StudyMETHOD – this section has many sub-
partsPARTICIPANTS (SUBJECTS) - provides relevant
information about who we studied (the WHO)SETTING / MATERIALS – gives information
about where the study was conducted and with what materials
PROCEDURE – how the study was conducted (in great detail!). Also includes description of the VARIABLES studied and what the hypothesized functional relationship is expected to be.
METHOD – this section has many sub-partsPARTICIPANTS (SUBJECTS) - provides relevant
information about who we studied (the WHO)SETTING / MATERIALS – gives information
about where the study was conducted and with what materials
PROCEDURE – how the study was conducted (in great detail!). Also includes description of the VARIABLES studied and what the hypothesized functional relationship is expected to be.
25
APA Style: Parts of Research
Study
APA Style: Parts of Research
StudyRESULTS
presents the data AND what conclusions we can draw from the data
Tells the reader whether the study turned out as was hypothesized
Studies with large groups of participants will often have STATISTICS which tell the reader how confident we can be that the results were not a fluke occurrence (“SIGNIFICANT” = NOT LIKELY DUE TO CHANCE)
Also refers to graphs or tables that depict the data
RESULTS presents the data AND what conclusions we
can draw from the dataTells the reader whether the study turned
out as was hypothesizedStudies with large groups of participants will
often have STATISTICS which tell the reader how confident we can be that the results were not a fluke occurrence (“SIGNIFICANT” = NOT LIKELY DUE TO CHANCE)
Also refers to graphs or tables that depict the data
26
APA Style: Parts of Research
Study
APA Style: Parts of Research
StudyDISCUSSION
Explains WHY the data turned out as they did (presents THEORY underlying the effect seen)
Compares the findings of the study to past studies: did they agree with or disagree with past studies? Did the new study add anything to what we already knew?
Is it possible that other causes not identified by the researcher (called CONFOUNDS) might have led to the findings?
What future research questions do we still need to investigate?
DISCUSSION Explains WHY the data turned out as they did
(presents THEORY underlying the effect seen)Compares the findings of the study to past
studies: did they agree with or disagree with past studies? Did the new study add anything to what we already knew?
Is it possible that other causes not identified by the researcher (called CONFOUNDS) might have led to the findings?
What future research questions do we still need to investigate?
27
So…of course everyone uses scientifically validated
treatment, right? Not if…
So…of course everyone uses scientifically validated
treatment, right? Not if…
IT’S EXPENSIVEBecause governments, school districts,
and insurance companies need to remain fiscally responsible, they may be hesitant to fund expensive treatments EVEN IF MEDICALLY NECESSARY
Sad to say, but there’s some evidence that this is a major problem in autism treatment
IT’S EXPENSIVEBecause governments, school districts,
and insurance companies need to remain fiscally responsible, they may be hesitant to fund expensive treatments EVEN IF MEDICALLY NECESSARY
Sad to say, but there’s some evidence that this is a major problem in autism treatment
28
So…of course everyone uses scientifically validated treatment, right? Not if…
So…of course everyone uses scientifically validated treatment, right? Not if…
IT REQUIRES A GREAT DEAL OF TRAININGPeople have careers invested in
particular intervention techniquesNot fun to have to go back for training
in new treatments!Easier to just use what you already
know (even if it doesn’t work well!)
IT REQUIRES A GREAT DEAL OF TRAININGPeople have careers invested in
particular intervention techniquesNot fun to have to go back for training
in new treatments!Easier to just use what you already
know (even if it doesn’t work well!)
29
So…of course everyone uses scientifically validated
treatment, right? Not if…
So…of course everyone uses scientifically validated
treatment, right? Not if…
IT DISAGREES WITH A “WORLD VIEW”See Autism National Committee (
www.autcom.org)Many folks are “anti-science” and feel
that we must trust our gut, feel our inner child, get back to a simpler mind-set, become “noble savages”, connect with one another, see reward use as “manipulation”, etc.
This is a good example of how SUBJECTIVE BIASES may affect policy
IT DISAGREES WITH A “WORLD VIEW”See Autism National Committee (
www.autcom.org)Many folks are “anti-science” and feel
that we must trust our gut, feel our inner child, get back to a simpler mind-set, become “noble savages”, connect with one another, see reward use as “manipulation”, etc.
This is a good example of how SUBJECTIVE BIASES may affect policy
30
So…of course everyone uses scientifically validated
treatment, right? Not if…
So…of course everyone uses scientifically validated
treatment, right? Not if…
YOU’VE INVESTED A GREAT DEAL IN ANOTHER THERAPYCertain states, school districts, and
agencies have put into place huge amounts of resources so they are hesitant to switch
YOU’VE INVESTED A GREAT DEAL IN ANOTHER THERAPYCertain states, school districts, and
agencies have put into place huge amounts of resources so they are hesitant to switch
31
So…of course everyone uses scientifically validated
treatment, right? Not if…
So…of course everyone uses scientifically validated
treatment, right? Not if…
IT’S COMPLICATED TO UNDERSTAND We tend to feel uncomfortable when we
don’t understand something, even if it is the most effective
We tend to embrace simple explanations, even if these are not shown to be effective
Goal of advocates and researchers is to make validated treatments more understandable
IT’S COMPLICATED TO UNDERSTAND We tend to feel uncomfortable when we
don’t understand something, even if it is the most effective
We tend to embrace simple explanations, even if these are not shown to be effective
Goal of advocates and researchers is to make validated treatments more understandable
32
So…of course everyone uses scientifically validated
treatment, right? Not if…
So…of course everyone uses scientifically validated
treatment, right? Not if…
AUTHORITIES PRESENT ONLY A BIASED SET OF EVIDENCEIf policy makers do not present a true
picture of all the research that has been conducted, then POLICY DECISIONS will be based on inaccurate claims!
Compare the British Columbia Office of Health Technology Assessment’s report on autism treatment to the one by the New York State Department of Health
AUTHORITIES PRESENT ONLY A BIASED SET OF EVIDENCEIf policy makers do not present a true
picture of all the research that has been conducted, then POLICY DECISIONS will be based on inaccurate claims!
Compare the British Columbia Office of Health Technology Assessment’s report on autism treatment to the one by the New York State Department of Health
33
So…of course everyone uses scientifically validated
treatment, right? Not if…
So…of course everyone uses scientifically validated
treatment, right? Not if…
YOU CAN MAKE MONEY OFF PEOPLE’S TRUST, VULNERABILITY, OR LACK OF KNOWLEDGEThis is an ugly part of our world!These unethical individuals often cloak
themselves as scientists to appear legitimateThey use fancy sounding words and present
bogus research findingsThey may even publish bogus journals to
convince people they are legitimate (more…)
YOU CAN MAKE MONEY OFF PEOPLE’S TRUST, VULNERABILITY, OR LACK OF KNOWLEDGEThis is an ugly part of our world!These unethical individuals often cloak
themselves as scientists to appear legitimateThey use fancy sounding words and present
bogus research findingsThey may even publish bogus journals to
convince people they are legitimate (more…)
34
Some great examples of PSEUDOSCIENCE Autism
“Treatments”
Some great examples of PSEUDOSCIENCE Autism
“Treatments”
The “ADAM Technology”http://www.galaxywave.com/
Psychoanalysis http://www.skepdic.com/psychoan.html
Facilitated communication http://www.skepdic.com/facilcom.html
Cranial Massagehttp://www.quackwatch.org/01Quackery
RelatedTopics/cranial.html
The “ADAM Technology”http://www.galaxywave.com/
Psychoanalysis http://www.skepdic.com/psychoan.html
Facilitated communication http://www.skepdic.com/facilcom.html
Cranial Massagehttp://www.quackwatch.org/01Quackery
RelatedTopics/cranial.html
35
The many “Choices” for Autism “Treatments”
The many “Choices” for Autism “Treatments”
Grouping in the good with the bad and the unknown: http://w02-0211.web.dircon.net/pubs/pubscat/docs/approa
ch.pdf
Grouping in the good with the bad and the unknown: http://w02-0211.web.dircon.net/pubs/pubscat/docs/approa
ch.pdf
36
Science vs. Pseudoscience: Assessing
Effective Treatment
Science vs. Pseudoscience: Assessing
Effective Treatment
Now we know that science provides certain criteria to decide what information is, and is not, valid (accurate)
Certain characteristics are seen in PSEUDOSCIENTIFIC “treatments” that are NOT scientifically validated
How do we recognize them? Learn to be a “skeptic” (see next)
Now we know that science provides certain criteria to decide what information is, and is not, valid (accurate)
Certain characteristics are seen in PSEUDOSCIENTIFIC “treatments” that are NOT scientifically validated
How do we recognize them? Learn to be a “skeptic” (see next)
37
Becoming a SKEPTICBecoming a SKEPTIC
The word SKEPTIC has a lot of negative connotations
Many people think it means “rejects everything, non-believing, anti-feelings, cold, cranky” etc.
It actually means “SHOW ME THE MONEY!”
It means “weigh the evidence” It means “recognize the baloney” It means “present what really works”
The word SKEPTIC has a lot of negative connotations
Many people think it means “rejects everything, non-believing, anti-feelings, cold, cranky” etc.
It actually means “SHOW ME THE MONEY!”
It means “weigh the evidence” It means “recognize the baloney” It means “present what really works”
38
How do I (as a skeptic) evaluate treatment claims?
Pseudoscientific Therapies: Some Warning Signs
*originally printed in Science in Autism Treatment, Spring
1999.http://www.asatonline.org/about_autism/faq.html,,
How do I (as a skeptic) evaluate treatment claims?
Pseudoscientific Therapies: Some Warning Signs
*originally printed in Science in Autism Treatment, Spring
1999.http://www.asatonline.org/about_autism/faq.html,,
High "success" claimed without valid supporting evidence
Rapid effects promised Therapy said to be effective for many
symptoms or disorders without evidence that you can generalize these effects
High "success" claimed without valid supporting evidence
Rapid effects promised Therapy said to be effective for many
symptoms or disorders without evidence that you can generalize these effects
39
How do I (as a skeptic) evaluate treatment claims?
Pseudoscientific Therapies: Some Warning Signs
*originally printed in Science in Autism Treatment, Spring
1999.http://www.asatonline.org/about_autism/faq.html
How do I (as a skeptic) evaluate treatment claims?
Pseudoscientific Therapies: Some Warning Signs
*originally printed in Science in Autism Treatment, Spring
1999.http://www.asatonline.org/about_autism/faq.html
“Theory” behind the therapy contradicts objective knowledge (and, sometimes, common sense)
Therapy said to be easy to administer, requiring little training or expertise
“Theory” behind the therapy contradicts objective knowledge (and, sometimes, common sense)
Therapy said to be easy to administer, requiring little training or expertise
40
How do I Evaluate Treatment Claims?
How do I Evaluate Treatment Claims?
Other scientifically validated treatments are said to be unnecessary, inferior, or harmful.
Promoters of the therapy work outside their area of expertise.
Only testimonials, anecdotes, or personal accounts are offered in support of claims about the therapy's effectiveness. Little or no objective evidence is provided.
Catchy, emotionally appealing slogans are used in marketing the therapy.
Belief and faith are said to be necessary for the therapy to "work."
Other scientifically validated treatments are said to be unnecessary, inferior, or harmful.
Promoters of the therapy work outside their area of expertise.
Only testimonials, anecdotes, or personal accounts are offered in support of claims about the therapy's effectiveness. Little or no objective evidence is provided.
Catchy, emotionally appealing slogans are used in marketing the therapy.
Belief and faith are said to be necessary for the therapy to "work."
41
How do I Evaluate Treatment Claims?
How do I Evaluate Treatment Claims?
Skepticism and critical evaluation are said to make the therapy's effects evaporate.
Promoters resist objective evaluation and scrutiny of the therapy by others.
Negative findings from scientific studies are ignored or dismissed.
Critics and scientific investigators are often met with hostility, and are accused of persecuting the promoters, being "close-minded," or having some ulterior motive for "debunking" the therapy.
Skepticism and critical evaluation are said to make the therapy's effects evaporate.
Promoters resist objective evaluation and scrutiny of the therapy by others.
Negative findings from scientific studies are ignored or dismissed.
Critics and scientific investigators are often met with hostility, and are accused of persecuting the promoters, being "close-minded," or having some ulterior motive for "debunking" the therapy.
42
More…How do I Evaluate Treatment Claims?
More…How do I Evaluate Treatment Claims?
Source: American Academy of Pediatrics Committee on Children with Disabilities http://pediatrics.aappublications.org/cgi/reprint/107/5/e85.pdf
Treatment is based on overly simplified scientific theories (e. g., “certain sounds can re-organize the brain”)
Treatment fails to identify specific treatment objectives or target behaviors
Treatments are stated to have no adverse effects without supporting evidence; thus, proponents deny the need to conduct controlled studies (This contradicts ALL ethical codes, which require
“First, do no harm!”)
Source: American Academy of Pediatrics Committee on Children with Disabilities http://pediatrics.aappublications.org/cgi/reprint/107/5/e85.pdf
Treatment is based on overly simplified scientific theories (e. g., “certain sounds can re-organize the brain”)
Treatment fails to identify specific treatment objectives or target behaviors
Treatments are stated to have no adverse effects without supporting evidence; thus, proponents deny the need to conduct controlled studies (This contradicts ALL ethical codes, which require
“First, do no harm!”)
44
Sensory Integration Therapy
Sensory Integration Therapy
Sensory Integration (SI) therapy is a sensory-motor treatment developed by Dr. A. Jean Ayres.
Proponents theorize that sensory integration is an innate neurobiological process (Hatch-Rasmussen, 1995), and that children with autism and other developmental delays experience dysfunction in which sensory input is not “integrated” or organized appropriately by the brain.
Sensory Integration (SI) therapy is a sensory-motor treatment developed by Dr. A. Jean Ayres.
Proponents theorize that sensory integration is an innate neurobiological process (Hatch-Rasmussen, 1995), and that children with autism and other developmental delays experience dysfunction in which sensory input is not “integrated” or organized appropriately by the brain.
45
Evaluating Sensory Integration Therapy
Evaluating Sensory Integration Therapy
Current research does not support SI as an effective treatment for children with autism, developmental delays or mental retardation
SI has not been shown to be responsible for positive change in a child's behaviors or skills.
In at least one study, SI was shown to actually increase self-injurious behaviors.
Association for Science in Autism Treatment
Current research does not support SI as an effective treatment for children with autism, developmental delays or mental retardation
SI has not been shown to be responsible for positive change in a child's behaviors or skills.
In at least one study, SI was shown to actually increase self-injurious behaviors.
Association for Science in Autism Treatment
46
Evaluating Sensory Integration Therapy
Evaluating Sensory Integration Therapy
"Though Sensory Integration Therapy does not appear to enhance language, control disruptive behaviors, or otherwise reduce autistic behaviors, it may offer enjoyable, healthy physical activity (Smith, 1996).”
“Professionals considering SI interventions should portray the intervention as experimental, and disclose this status to key decision makers influencing the child's intervention.”
Association for Science in Autism Treatment
"Though Sensory Integration Therapy does not appear to enhance language, control disruptive behaviors, or otherwise reduce autistic behaviors, it may offer enjoyable, healthy physical activity (Smith, 1996).”
“Professionals considering SI interventions should portray the intervention as experimental, and disclose this status to key decision makers influencing the child's intervention.”
Association for Science in Autism Treatment
47
Auditory Integration Training
Auditory Integration Training
Developed in 1960s by French physician Guy Berard
AIT is based on unproven theory that symptoms in autism are caused by auditory
perception defects that distort sound or produce auditory hypersensitivity (hyperacusis).
Treatment consists of identification of sound
distortion or hypersensitivity followed by twice daily sessions for 2 weeks in which computer modified music determined to be
optimum for the patient is played through a device called the Audiokinetron.
Developed in 1960s by French physician Guy Berard
AIT is based on unproven theory that symptoms in autism are caused by auditory
perception defects that distort sound or produce auditory hypersensitivity (hyperacusis).
Treatment consists of identification of sound
distortion or hypersensitivity followed by twice daily sessions for 2 weeks in which computer modified music determined to be
optimum for the patient is played through a device called the Audiokinetron.
48
ConcernsConcerns
Audiokinetron may potentially be unsafe, delivering levels of sound to the eardrum that may be harmful to hearing.
AIT devices do not have FDA approval for treating autism or any other medical problem.
The FDA has banned the importation of the Electric Ear and any other AIT device made by Tomatis International, of Paris, France.
Audiokinetron may potentially be unsafe, delivering levels of sound to the eardrum that may be harmful to hearing.
AIT devices do not have FDA approval for treating autism or any other medical problem.
The FDA has banned the importation of the Electric Ear and any other AIT device made by Tomatis International, of Paris, France.
49
Evaluating Auditory Integration Therapy
Evaluating Auditory Integration Therapy
No well-designed scientific studies demonstrate that AIT is useful (in any form including Tomatis®); therefore AIT is not recommended for children with autism.
The American Academy of Pediatrics The American Academy of Audiology
No well-designed scientific studies demonstrate that AIT is useful (in any form including Tomatis®); therefore AIT is not recommended for children with autism.
The American Academy of Pediatrics The American Academy of Audiology
50
Evaluating Auditory Integration Therapy
Evaluating Auditory Integration Therapy
AIT is not yet objectively substantiated as effective subject to the rigors of good science.
Professionals considering AIT should portray the method as experimental, and should disclose this status to key decision makers influencing the child's intervention.
Association for Science in Autism Treatment
AIT is not yet objectively substantiated as effective subject to the rigors of good science.
Professionals considering AIT should portray the method as experimental, and should disclose this status to key decision makers influencing the child's intervention.
Association for Science in Autism Treatment
51
Evaluating Auditory Integration Therapy
Evaluating Auditory Integration Therapy
A randomized controlled trial with an adequate sample size found no differences in children receiving auditory integration training as compared with those listening to the same music which had not been modified.
A recent controlled study found no benefit of AIT and poorer scores on social and adaptive and expressive language scores after AIT.
“Because of the lack of demonstrated efficacy and the expense of the intervention, it is recommended that auditory integration training not be used as an intervention for young children with autism.”
New York State Department of Health Early Intervention Guidelines
A randomized controlled trial with an adequate sample size found no differences in children receiving auditory integration training as compared with those listening to the same music which had not been modified.
A recent controlled study found no benefit of AIT and poorer scores on social and adaptive and expressive language scores after AIT.
“Because of the lack of demonstrated efficacy and the expense of the intervention, it is recommended that auditory integration training not be used as an intervention for young children with autism.”
New York State Department of Health Early Intervention Guidelines
52
Claims of Evidence for AITClaims of Evidence for AIT Two studies are offered by AIT proponents which do
not meet the rigors of scientifically valid research: Gilmor, T. M. (1999). The Efficacy of the Tomatis
method for Children with Learning and Communication Disorders, International Journal of Listening, 13, 12. This journal does not fit the definition of “peer
reviewed” (review by published scientists) Conclusions in the paper are based on the
technique of meta-analysis of past studies (conclusions drawn from selected pieces of many studies) not empirically validated research.
Credibility of Journal’s mother organization (International Listening Association) is questionable. Web page contains quotes from Artists, Writers, and Rock Stars "Listen, learn, read” from Deep Purple
Two studies are offered by AIT proponents which do not meet the rigors of scientifically valid research:
Gilmor, T. M. (1999). The Efficacy of the Tomatis method for Children with Learning and Communication Disorders, International Journal of Listening, 13, 12. This journal does not fit the definition of “peer
reviewed” (review by published scientists) Conclusions in the paper are based on the
technique of meta-analysis of past studies (conclusions drawn from selected pieces of many studies) not empirically validated research.
Credibility of Journal’s mother organization (International Listening Association) is questionable. Web page contains quotes from Artists, Writers, and Rock Stars "Listen, learn, read” from Deep Purple
53
Claims of Evidence for AITClaims of Evidence for AIT Second study offered by AIT proponents:
Neysmith-Roy, J. M. (2001). The Tomatis Method with severely autistic boys: Individual case studies of behavioral changes, South African Journal of Psychology, 31.
Case study does not qualify as empirically validated research. It is a description of somebody’s characteristics but has no controlled assessment of treatment variables.
Second study offered by AIT proponents:Neysmith-Roy, J. M. (2001). The Tomatis
Method with severely autistic boys: Individual case studies of behavioral changes, South African Journal of Psychology, 31.
Case study does not qualify as empirically validated research. It is a description of somebody’s characteristics but has no controlled assessment of treatment variables.
54
Traditional Speech & Language TherapiesTraditional Speech & Language Therapies
Non-behavioral speech and language therapists have developed many different treatments (e.g., PROMPT) most of which are aimed at stimulating children’s natural interest and ability in learning language.
The treatments usually take place in one-to-one sessions held from ½ to 3 hrs per week.
Non-behavioral speech and language therapists have developed many different treatments (e.g., PROMPT) most of which are aimed at stimulating children’s natural interest and ability in learning language.
The treatments usually take place in one-to-one sessions held from ½ to 3 hrs per week.
55
Evidence of Traditional Speech & Language
Therapies
Evidence of Traditional Speech & Language
Therapies No scientific studies have evaluated
whether any form of speech and language therapy, other than behavior analysis, helps children with autism.
There have been no studies to evaluate the effectiveness of PROMPT therapy with children with autism Dr. Rogers at the MIND Institute is currently
heading up a project comparing PROMPT with other models of language
No outcome data have been produced, as of yet.
No scientific studies have evaluated whether any form of speech and language therapy, other than behavior analysis, helps children with autism.
There have been no studies to evaluate the effectiveness of PROMPT therapy with children with autism Dr. Rogers at the MIND Institute is currently
heading up a project comparing PROMPT with other models of language
No outcome data have been produced, as of yet.
56
Evaluating Traditional Speech & Language
Therapies
Evaluating Traditional Speech & Language
TherapiesBy itself, speech and language
therapy is probably not intensive enough to be very effective.
However, it may augment other interventions by identifying areas that need remediation or offering strategies for promoting the use of language skills in everyday settings.
By itself, speech and language therapy is probably not intensive enough to be very effective.
However, it may augment other interventions by identifying areas that need remediation or offering strategies for promoting the use of language skills in everyday settings.
57
Speech & Language Therapies Using ABASpeech & Language Therapies Using ABA
A variety of behavioral techniques has been shown to be effective for increasing and improving language and communication in children with autism (e.g., activity schedules, audio modeling, video modeling, PECS)
When teaching children with autism, speech and language therapy has been shown to be maximally effective when delivered using the principles of ABA
A variety of behavioral techniques has been shown to be effective for increasing and improving language and communication in children with autism (e.g., activity schedules, audio modeling, video modeling, PECS)
When teaching children with autism, speech and language therapy has been shown to be maximally effective when delivered using the principles of ABA
58
What is an “Integrated” Treatment Model”?
What is an “Integrated” Treatment Model”?
(Sometimes referred to as combination model, comprehensive model, eclectic model, whole person model)
Using an “integrated” model assumes there are multiple effective therapies that, when combined, work even better than the single effective therapies.
Using an “integrated model” also assumes that proponents are using only the therapies that have been shown to work while ignoring the ones that have not.
But to find out which ones work, you MUST look for controlled studies that demonstrate effectiveness (use objective data, not testimony).
If this has not been done, then proponents may be taking away time from therapies that have been shown to be effective by advocating for an integrated model
There is currently NO evidence that combinations of therapies for autism are better than the sum of their parts.
(Sometimes referred to as combination model, comprehensive model, eclectic model, whole person model)
Using an “integrated” model assumes there are multiple effective therapies that, when combined, work even better than the single effective therapies.
Using an “integrated model” also assumes that proponents are using only the therapies that have been shown to work while ignoring the ones that have not.
But to find out which ones work, you MUST look for controlled studies that demonstrate effectiveness (use objective data, not testimony).
If this has not been done, then proponents may be taking away time from therapies that have been shown to be effective by advocating for an integrated model
There is currently NO evidence that combinations of therapies for autism are better than the sum of their parts.
59
Evaluation of Integrated Therapies
Evaluation of Integrated Therapies
Eikeseth, Smith, Jahr, & Eldevik (2002) Compared applied behavior analysis (ABA)
with an integrated treatment ABA treatment consisted of language, social,
academic, fine/gross motor, and self-help skills
Integrated treatment consisted of: sensory integration therapy, speech therapy, and ABA
At a 1-year evaluation, 13 children who had received ABA treatment made significantly larger improvements than a comparison group of 12 children who had receive intensive, integrated therapy.
On average the ABA group gained 17 points in IQ, 13 points in language comprehension, 23 points in expressive language, and 11 points in adaptive behavior.
Eikeseth, Smith, Jahr, & Eldevik (2002) Compared applied behavior analysis (ABA)
with an integrated treatment ABA treatment consisted of language, social,
academic, fine/gross motor, and self-help skills
Integrated treatment consisted of: sensory integration therapy, speech therapy, and ABA
At a 1-year evaluation, 13 children who had received ABA treatment made significantly larger improvements than a comparison group of 12 children who had receive intensive, integrated therapy.
On average the ABA group gained 17 points in IQ, 13 points in language comprehension, 23 points in expressive language, and 11 points in adaptive behavior.
60
Greenspan (DIR; Floortime)
Greenspan (DIR; Floortime)
Stanley Greenspan, MD and colleagues have published papers on theories of child development.
Only one relates specifically to children with autism; others may include references to autism among an array of disabilities.
Greenspan and others have created a “developmental approach” for early intervention with children with disabilities (Developmental Individual-Difference, Relationship-Based Model) commonly referred to as the "Floor Time" approach (Greenspan, 1998).
Stanley Greenspan, MD and colleagues have published papers on theories of child development.
Only one relates specifically to children with autism; others may include references to autism among an array of disabilities.
Greenspan and others have created a “developmental approach” for early intervention with children with disabilities (Developmental Individual-Difference, Relationship-Based Model) commonly referred to as the "Floor Time" approach (Greenspan, 1998).
61
Greenspan (DIR; Floortime)
Greenspan (DIR; Floortime)
DIR/Floor Time includes interactive experiences, which are child-directed, in a low stimulus environment, ranging from two to five hours a day.
During a preschool program, DIR/Floor Time includes integration with typically-developing peers.
Greenspan contends that interactive play, in which the adult follows the child's lead, will encourage the child to "want" to relate to the outside world. (Greenspan, 1998).
DIR/Floor Time includes interactive experiences, which are child-directed, in a low stimulus environment, ranging from two to five hours a day.
During a preschool program, DIR/Floor Time includes integration with typically-developing peers.
Greenspan contends that interactive play, in which the adult follows the child's lead, will encourage the child to "want" to relate to the outside world. (Greenspan, 1998).
62
Evaluating Greenspan therapy
Evaluating Greenspan therapy
“There have been no peer-reviewed, published studies of Greenspan's DIR/Floor Time's effectiveness for children with autism. Professionals considering Greenspan's Floor Time should portray the method as without peer-reviewed scientific evaluation, and should disclose this status to key decision makers influencing the child's intervention.”
Association for Science in Autism Treatment
“There have been no peer-reviewed, published studies of Greenspan's DIR/Floor Time's effectiveness for children with autism. Professionals considering Greenspan's Floor Time should portray the method as without peer-reviewed scientific evaluation, and should disclose this status to key decision makers influencing the child's intervention.”
Association for Science in Autism Treatment
63
Evaluating Greenspan therapy
Evaluating Greenspan therapy
“There are no adequate controlled trials that have evaluated the efficacy of intervention approaches based on the DIR model for treating young children with autism”
“Approaches based on the DIR model can be time intensive for both professionals and parents and may take time away from other therapies that have been demonstrated to be effective”
New York State Department of Health Early Intervention Guidelines
“There are no adequate controlled trials that have evaluated the efficacy of intervention approaches based on the DIR model for treating young children with autism”
“Approaches based on the DIR model can be time intensive for both professionals and parents and may take time away from other therapies that have been demonstrated to be effective”
New York State Department of Health Early Intervention Guidelines
64
Miller MethodMiller Method
The Miller Method™ uses adaptive equipment, including platforms (that elevate the child in hopes of increasing eye contact), large swinging balls (to expand the child's reality system), and Swiss cheese boards (to teach motor planning, as well as to increase the child's understanding of his or her relation to environment and space.) (Miller, 1998).
The Miller Method™ uses adaptive equipment, including platforms (that elevate the child in hopes of increasing eye contact), large swinging balls (to expand the child's reality system), and Swiss cheese boards (to teach motor planning, as well as to increase the child's understanding of his or her relation to environment and space.) (Miller, 1998).
65
Evaluation of Miller Method
Evaluation of Miller Method
The Miller Method™ may have promise, but it is not yet objectively substantiated as effective subject to the rigors of good science.
Professionals considering the Miller Method™ should portray the method as experimental, and should disclose this status to key decision makers influencing the child's intervention. Association for Science in Autism Treatment
The Miller Method™ may have promise, but it is not yet objectively substantiated as effective subject to the rigors of good science.
Professionals considering the Miller Method™ should portray the method as experimental, and should disclose this status to key decision makers influencing the child's intervention. Association for Science in Autism Treatment
66
Nutritional Supplements and Megavitamin TherapyNutritional Supplements
and Megavitamin Therapy Anecdotal and case reports have
generated interest in the use of a variety of nutritional supplements to treat children with ASD.
Studies have shown mixed results Some studies have been criticized
for their methodological shortcomings and failure to address the issue of safety of use.
Anecdotal and case reports have generated interest in the use of a variety of nutritional supplements to treat children with ASD.
Studies have shown mixed results Some studies have been criticized
for their methodological shortcomings and failure to address the issue of safety of use.
67
Elimination dietsElimination diets
The presence of allergies or food intolerance in children often stimulates families to explore unconventional diets.
Recent investigations failed to document a higher prevalence of hypersensitivity to common food allergens in children with autism compared with controls.
The presence of allergies or food intolerance in children often stimulates families to explore unconventional diets.
Recent investigations failed to document a higher prevalence of hypersensitivity to common food allergens in children with autism compared with controls.
68
Immune Globulin therapyImmune Globulin therapy
There is some evidence for immunologic abnormalities in small numbers of children with autism including abnormalities of T cells, B cells, natural killer cells, and the complement system
In a study of 20 children with ASD, 10 who received intravenous immune globulin for a 6-month period reportedly demonstrated improvements in social behavior, eye contact, echolalia, and speech articulation.
Note: The investigators did not use standard outcome measures and did not state whether participants received other concurrent treatments during the course of the study.
There is some evidence for immunologic abnormalities in small numbers of children with autism including abnormalities of T cells, B cells, natural killer cells, and the complement system
In a study of 20 children with ASD, 10 who received intravenous immune globulin for a 6-month period reportedly demonstrated improvements in social behavior, eye contact, echolalia, and speech articulation.
Note: The investigators did not use standard outcome measures and did not state whether participants received other concurrent treatments during the course of the study.
69
Immune Globulin therapyImmune Globulin therapy
• Two recent reports failed to demonstrate significant changes in behaviors associated with autism in 17 children who received regular infusions of immune globulin for a 6-month period.
• There is no scientific evidence to justify the use of infusions of immune globulin to treat children with autism.
• Two recent reports failed to demonstrate significant changes in behaviors associated with autism in 17 children who received regular infusions of immune globulin for a 6-month period.
• There is no scientific evidence to justify the use of infusions of immune globulin to treat children with autism.
70
SecretinSecretin
Anecdotal reports of 3 children whose behaviors were seemingly helped by secretin generated much publicity and interest in its treatment potential
Recent studies, however, have failed to demonstrate any scientific evidence to justify the use of secretin infusion to treat children with autism.
Anecdotal reports of 3 children whose behaviors were seemingly helped by secretin generated much publicity and interest in its treatment potential
Recent studies, however, have failed to demonstrate any scientific evidence to justify the use of secretin infusion to treat children with autism.
71
Chelation TherapyChelation Therapy
Some theorize that autism might be caused by early childhood exposure to environmental toxicants, particularly mercury
To date, there are no published studies linking mercury exposure to the development of autism or demonstrating that children with autism have had greater exposure to mercury than have unaffected children.
Some theorize that autism might be caused by early childhood exposure to environmental toxicants, particularly mercury
To date, there are no published studies linking mercury exposure to the development of autism or demonstrating that children with autism have had greater exposure to mercury than have unaffected children.
72
Evaluating Chelation Therapy
Evaluating Chelation Therapy
Although several chelating agents have been shown to accelerate mercury elimination from the body, there is no evidence that chelation therapy will improve developmental function.
Moreover, chelating agents can have significant toxicity and cause allergic reaction.
Chelation therapy is therefore not recommended to treat autism
Although several chelating agents have been shown to accelerate mercury elimination from the body, there is no evidence that chelation therapy will improve developmental function.
Moreover, chelating agents can have significant toxicity and cause allergic reaction.
Chelation therapy is therefore not recommended to treat autism
73
Applied Behavior Analysis(Behavior Management; Intensive Behavioral
Intervention)
Applied Behavior Analysis(Behavior Management; Intensive Behavioral
Intervention)
“Intensive, behavioral intervention early in life can increase the ability of the child with autism to acquire language and ability to learn.”
“Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior. A well-designed study of a psychosocial intervention was carried out by Lovaas and colleagues (Lovaas, 1987; McEachin et al., 1993). Up to this point, a number of other research groups have provided at least a partial replication of the Lovaas model (see Rogers, 1998).”
U.S. Surgeon General David Satcher, M.D., Ph.D.
“Intensive, behavioral intervention early in life can increase the ability of the child with autism to acquire language and ability to learn.”
“Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior. A well-designed study of a psychosocial intervention was carried out by Lovaas and colleagues (Lovaas, 1987; McEachin et al., 1993). Up to this point, a number of other research groups have provided at least a partial replication of the Lovaas model (see Rogers, 1998).”
U.S. Surgeon General David Satcher, M.D., Ph.D.
74
Applied Behavior AnalysisApplied Behavior Analysis “All programs educating children with
autism should include intensive behavioral interventions and year-round education”.
The US Dept. of Education and the National Research Council's Report
'Educating Children with Autism‘ “Since intensive behavioral programs appear to
be effective in young children with autism, it is recommended that principles of applied behavior analysis and behavioral intervention strategies be included as an important element of any intervention program”.
NYS Department of Health Early Intervention: Clinical Practice Guidelines:
“All programs educating children with autism should include intensive behavioral interventions and year-round education”.
The US Dept. of Education and the National Research Council's Report
'Educating Children with Autism‘ “Since intensive behavioral programs appear to
be effective in young children with autism, it is recommended that principles of applied behavior analysis and behavioral intervention strategies be included as an important element of any intervention program”.
NYS Department of Health Early Intervention: Clinical Practice Guidelines:
75
ReferencesReferences American Academy of Pediatrics Committee
on Children With Disabilities. (2001). Technical Report: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children, Pediatrics, 107(5).
Fenske, E. C., Zalenski, S., Krantz, P. J., & McClannahan, L. E. (1985). Age of intervention and treatment outcome for autistic children in a comprehensive intervention program. Analysis and Intervention in Developmental Disabilities, 5, 49-58.
American Academy of Pediatrics Committee on Children With Disabilities. (2001). Technical Report: The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children, Pediatrics, 107(5).
Fenske, E. C., Zalenski, S., Krantz, P. J., & McClannahan, L. E. (1985). Age of intervention and treatment outcome for autistic children in a comprehensive intervention program. Analysis and Intervention in Developmental Disabilities, 5, 49-58.
76
ReferencesReferences Jacobson, J. W. (2001). Early intensive
behavioral intervention: Emergence of a consumer-driven service model. The Behavior Analyst, 23(2), 149-171.
McEachin, J. J, Smith, T., & Lovaas, O. I. (1993). Long term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97(4), 359-372.
Smith, T. (1993). Autism. In T. Giles (Ed.), Handbook of effective psychotherapy (pp. 107-133). NY: Plenum Press.
Jacobson, J. W. (2001). Early intensive behavioral intervention: Emergence of a consumer-driven service model. The Behavior Analyst, 23(2), 149-171.
McEachin, J. J, Smith, T., & Lovaas, O. I. (1993). Long term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97(4), 359-372.
Smith, T. (1993). Autism. In T. Giles (Ed.), Handbook of effective psychotherapy (pp. 107-133). NY: Plenum Press.
77
ABA ResourcesABA Resources
• Books Handleman, J. S., & Harris, S. L. (2001).
Preschool education programs for children with autism. Austin, TX: Pro-Ed.
Harris, S. L., & Weiss, M. J., (1998). Right from the start: Behavioral intervention for young children with autism. Bethesda, MD: Woodbine House.
McClannahan, L. E., & Krantz, P. J. (1999). Activity schedules for children with autism: Teaching independent behavior. Bethesda, MD: Woodbine House.
• Books Handleman, J. S., & Harris, S. L. (2001).
Preschool education programs for children with autism. Austin, TX: Pro-Ed.
Harris, S. L., & Weiss, M. J., (1998). Right from the start: Behavioral intervention for young children with autism. Bethesda, MD: Woodbine House.
McClannahan, L. E., & Krantz, P. J. (1999). Activity schedules for children with autism: Teaching independent behavior. Bethesda, MD: Woodbine House.
78
ABA ResourcesABA Resources
• Books Leaf, R., & McEachin, J. (Eds.). (1999). A work in
progress: Behavior management strategies and a curriculum for intensive behavioral treatment of autism. New York: DRL Books.
Lovaas, O. I. (2002). Teaching individuals with developmental delays: Basic intervention techniques. Austin, TX: Pro-Ed.
Maurice, C., Green, G., & Fox, R. M. (Eds.). (2001). Making a difference: Behavioral intervention for autism. Austin, TX: Pro-Ed.
Maurice, C., Green, G., & Luce, S. C. (Eds.). (1996). Behavioral intervention for young children with autism. Austin, TX: Pro-Ed.
• Books Leaf, R., & McEachin, J. (Eds.). (1999). A work in
progress: Behavior management strategies and a curriculum for intensive behavioral treatment of autism. New York: DRL Books.
Lovaas, O. I. (2002). Teaching individuals with developmental delays: Basic intervention techniques. Austin, TX: Pro-Ed.
Maurice, C., Green, G., & Fox, R. M. (Eds.). (2001). Making a difference: Behavioral intervention for autism. Austin, TX: Pro-Ed.
Maurice, C., Green, G., & Luce, S. C. (Eds.). (1996). Behavioral intervention for young children with autism. Austin, TX: Pro-Ed.
79
ABA ResourcesABA Resources
Websites NY State Guidelines
www.health.state.ny.us/nysdoh/eip/autism/autism.htm
- Behavior Analysis Certification Board www.bacb.com
- General Information about Autism www.asatonline.org/autism_info.html www.behavior.org/autism/ pediatrics.aappublications.org/cgi/reprint/107/5/e
85.pdf books.nap.edu/books/0309072697/html/index.ht
ml
Websites NY State Guidelines
www.health.state.ny.us/nysdoh/eip/autism/autism.htm
- Behavior Analysis Certification Board www.bacb.com
- General Information about Autism www.asatonline.org/autism_info.html www.behavior.org/autism/ pediatrics.aappublications.org/cgi/reprint/107/5/e
85.pdf books.nap.edu/books/0309072697/html/index.ht
ml