GOLD STANDARD TREATMENT: APPLIED BEHAVIOURAL ANALYSIS (ABA)
According to Schreck & Miller’s (2010) research, “Applied Behavioural Analysis (ABA) has been extensively documented by researchers, national and state governments, and the US Surgeon General as the gold standard and most empirically validated of treatments for autism spectrum disorders”.
ABA is in essence the only teaching approach for autism supported by controlled studies and post treatment follow up data. There have been over 1000 scientific and peer-reviewed journal articles which have shown successful outcomes for treating children with autism. It develops communicative speech and improved social relatedness in 90% of those treated. This program produces virtually normal social interaction, communicative and cognitive abilities in 40% to 50% of children with autism (Lovaas, 1987, McEachin, Smith & Lovaas, 1993).
ABA uses methods of behavioural psychology including discrete trial and positive reinforcement to analyse information and behaviour, in order to systematically teach new skills. We work to address the needs of each child individually through a comprehensive curriculum that covers all major areas (Early Learner skills, Communication and Language, Social skills, Play skills, Daily Living skills, Academic and Cognitive skills, and Generalization of skills). The basics of ABA are – breaking skills down, pairing it with reinforcement and providing sufficient practice for a child to learn new skills and to retain those skills.
OTHER COMPLEMENTARY AND ALTERNATIVE TREATMENTS
Given the increasing autism prevalence in children (1 in 68 children as of March 2014), many families caring for individuals with autism are desperately seeking out various treatment options for their children. There are many options for treatments with new ones emerging on a regular basis. These treatments include various complementary and alternative therapies as an approach to dealing with the autism (Centers for Disease Control and Prevention, 2014).
However, research on the benefits of these different approaches have been much less studied or rather far less studied to confidently conclude their benefits, limitations and recommendation of use. Given the relative lack of information available about the various therapies, complementary and alternative therapies, Schreck and Miller (2010) encourage families and professionals to consider up-to-date scientific information of the given treatment and suggest the following:
- Awareness of scientific knowledge concerning treatments
- Choosing treatments based on scientific knowledge
- Recommend scientifically supported and most effective treatment
Additionally, we encourage families and professionals to use the following guidelines for evidence-based research recommended by Schreck and Miller (2010):
- Evidence based research has to have replicated studies
- A review of the studies have to be conducted by other professionals in the field
- Research has to be supported by two methodologically sound group studies conducted by independent research team or supported by at least 10 single subject design studies finding the AltT superior to no treatment or other treatment
- The treatment has to have a sound theoretical basis (e.g. based on a development model)
- The research has to measure observable outcomes
Additionally, it is crucially important to determine if a certain alternative treatment is not only supported by evidence but is safe and not dangerous to the child. Certain treatments that have “proven” verbally to be effective for children with an Autism Spectrum Disorder are perhaps better suited for other conditions and not for a child at that certain age.
According to the AMS-MOH Clinical Practice Guidelines for Autism Spectrum Disorder published by the Ministry of Health Singapore (2010), there are alternative treatments that are not recommended due to insufficient, inconclusive or conflicting evidence and there are alternative treatments that are not recommended due to potential harm and detrimental effects to the child. The following table describes the two different categories.
Written by Early Autism Project Malaysia
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Centers for Disease Control and Prevention (2014). Autism Spectrum Disorder (ASD): Data & statistics. Retrieved from: http://www.cdc.gov/ncbddd/autism/data.html
Ministry of Health Singapore (2010). Complementary and Alternative Medical Therapies (ASD). Retrieved from: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical/2010/cpgmed_autism_spectrum_disorders_preschool_children.html
Kemper, K. J. (2008). The use of complementary and alternative medicine in pediatrics. American Academy of Pediatrics, 122 (6), 1374-1386.
Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of consulting and clinical psychology, 55(1), 3.
Schreck, K. A. & Miller, V. A. (2010). How to behave ethically in a world of fads. Behavioural Interventions, 25 (4), 307-324.
McEachin, J. J., Smith, T. & Lovaas, O. I. (1993). Long-term outcome for children with autism who received early intensive behavioural treatment. American Journal of Mental Retardation, 97(4), 359-372.