Saturday, December 04, 2010
October 27, 2010
Dear Ms. Shute,
Thank you for your recent article in Scientific American: "Desperate for an Autism Cure" (October 2010). As behavioral analysts, we have worked in the field of behavioral intervention for over 25 years combined, and have seen firsthand how parents are deceived by dubious "treatments" for autism. There is so much misinformation out there, and parents find themselves in a desperate position. We believe the only way to counteract decades of misinformation is to deliver messages of reason and a call for evidence-based treatment. Your voice can help steer families in the right direction toward effective intervention.
You cited quackwatch.com, a great resource of information about existing evidence for treatments for many conditions. On that website is an article titled, "Sense and Nonsense in Autism Treatment" by Herbert, Sharp & Gaudiano (2002). It describes the lack of evidence for many of the treatments mentioned in your article, and is a resource we have referred to many times in our careers.
Although we agree in principle with most of the points in your article, it was a bit disconcerting that you described the evidence for behavioral therapy as "somewhat effective." While behavior therapy was not the sole focus of your article, you did importantly touch upon some of the research that provides evidence for behavioral procedures. One thing that should be added is that there may not be as many of the randomly controlled trials that you touted as the gold standard in the field of applied behavior analysis (the applied research wing that develops behavioral procedures, also called "ABA") — largely because the majority of ABA research is built upon single-subject designs.
Most people are familiar with the group designs found in traditional psychology research — and often critics of ABA cite this as a weakness in evidence for its effectiveness. However, from an inductive approach (building from the ground up based on data) - it is a strength. In the applied behavior analytic research tradition, statistical significance is not equitable to social significance. In fact — critics often fail to mention that ABA is built on the notion that truly effective change is socially meaningful to the individuals who receive treatment.
Therefore, behavior analysts are much more interested in identifying and implementing interventions that are effective for the individual regardless of whether they will be effective for the majority, or even for the randomly selected "control" group. It is the individualization that lends power to the behavioral techniques, even on a larger scale (group level). This is what allows behavior analysts to be flexible and customize interventions for the individuals they work with. There are decades of research that demonstrate the effectiveness of behavioral procedures successfully increasing adaptive skills for individuals with autism.
Educating the community about what applied behavior analysis is and is not should be part of what professionals in the field of autism services need to do - if only to counteract all the voices touting "medical snake oil" that currently exist.
A. Benavides, PhD., BCBA-D
Media Review Committee, Association for Science in Autism Treatment
Joshua K. Pritchard, M.S., BCBA
Board Member, Association for Science in Autism Treatment