1 Science, Research, APA Style, and Assessing Treatments for Children with Autism Ps553 Applied...

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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

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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?

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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

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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!)

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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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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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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?

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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

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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?)

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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…

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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…”

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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?

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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

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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?

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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?

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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)…

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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?

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Ethical Issues in Experimental

Designs


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…

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Designs


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

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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

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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

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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

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APA Style: Parts of Research

Study


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)

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Study


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.

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Study


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

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Study


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?

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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

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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!)

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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

http://www.autcom.org/

http://www.autcom.org/

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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

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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

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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

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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…)

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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

http://www.galaxywave.com/

http://www.skepdic.com/psychoan.html

http://www.skepdic.com/facilcom.html

http://www.quackwatch.org/01QuackeryRelatedTopics/cranial.html


http://www.galaxywave.com/

http://www.skepdic.com/psychoan.html

http://www.skepdic.com/facilcom.html



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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

http://w02-0211.web.dircon.net/pubs/pubscat/docs/approach.pdf




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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)

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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”

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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,,




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

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1999.http://www.asatonline.org/about_autism/faq.html




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

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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."

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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.

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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!”)

http://pediatrics.aappublications.org/cgi/reprint/107/5/e85.pdf


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STOPSTOP

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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.

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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.


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"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.”


"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.”


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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.

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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


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



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.


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.


51



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.”


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.

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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

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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)


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



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


“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.”


“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.”


63



“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”


“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”


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:

http://bob.nap.edu/books/0309072697/html/

http://bob.nap.edu/books/0309072697/html/

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.

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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.

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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.

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• 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.

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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

http://www.health.state.ny.us/nysdoh/eip/autism/autism.htm


http://www.bacb.com/

http://www.asatonline.org/autism_info.html

http://www.behavior.org/autism/



http://books.nap.edu/books/0309072697/html/index.html




http://www.bacb.com/

http://www.asatonline.org/autism_info.html

http://www.behavior.org/autism/





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