Dear Ms. Macdonald,
We are writing in response to your article, “Autism cage details emerge as United Nations investigates abuse of children.” Firstly, we would like to thank you for raising awareness of a very important issue facing families in Australia, which is the education and treatment of children with autism spectrum disorders (ASDs). In Australia, the number of children receiving a diagnosis of autism continues to rise. In 2012, Autism Asperger’s Advocacy Australia (A4) reported that 1 in every 63 Australian school children have a formal autism diagnosis. This means that most Australian teachers will be responsible for educating a child with autism at some point within their careers.
In your article, you describe several cases of alleged abuse within Australian schools, which triggered an Australian submission to the United Nations Special Rapporteur on the Rights of Persons with Disabilities. It is extremely concerning to us to read that, of the 55 children alleging abuse, 93% had been diagnosed with autism. We agree with you that the use of restraint and seclusion with children with autism, in the absence of any appropriate behaviour support plans or education plans, is disturbing. We also agree with you that instances of cruel, inhumane, and degrading treatment present a violation of basic human rights and should be investigated urgently.
Your article presents an opportunity for us to share information regarding evidence-based treatment for autism. Virtually all interventions for autism that are classified as established are based on the scientific discipline of applied behaviour analysis (ABA). ABA is the application of the principles of learning, derived from experimental psychology research, to systematically change socially significant behaviours. ABA methods are effective for increasing adaptive behaviours, reducing interfering maladaptive behaviours, teaching new skills, and generalizing behaviours to new environments or situations. The effectiveness of ABA-based interventions in ASDs has been well documented through five decades of research by using a variety of research methods, including single-subject designs, randomized controlled clinical trials, meta-analyses, and cost-benefit analyses.
Within the field of ABA, a functional behaviour assessment may be used to understand the reasons why behaviours of concern occur in the classroom. When the function of the behaviour is identified, interventions can be designed that teach the child with autism to communicate or access his or her wants and needs in more socially appropriate ways. Hundreds of scientific studies have demonstrated the efficacy of function-based treatments, or those that link treatment to behavioural function, for reducing behaviours of concern in children with autism, without the use of restraint or seclusion.
Most Australian teachers lack the training and expertise to conduct functional behaviour assessments and write, implement, and monitor function-based treatment plans. Without proper training in evidence-based practices, teachers may resort to using restraint and seclusion, or even cages, to respond to and manage behaviour problems in the classroom. Given the acumen required to conduct proper functional behaviour assessments, educators should ideally receive support and supervision from a Board Certified Behaviour Analyst (BCBA) when working with children with autism, especially children who display more severe forms of challenging behaviour. Having training in applied behaviour analysis or being a BCBA are the minimum requirements for conducting a functional assessment. The Behaviour Analyst Certification Board (www.bacb.com), an internationally recognized organization, describes the education and training requirement to obtain the BCBA credential. We think schools that are responsible for educating children with autism would benefit greatly from collaboration with BCBAs. If a BCBA is unavailable, schools should receive, at a minimum, training in applied behaviour analysis and function-based assessment and treatment from professionals who have expertise in this area.
In summary, your article highlights the need for better supports for children with autism in Australian schools. Teachers also need high quality training, support, and supervision when addressing behaviours of concern in the classroom. We hope that you will consider sharing our response to your article with your readers to help us disseminate information about evidence-based and humane strategies for safely and effectively managing behaviours of concern displayed by children with autism (or any child) in Australian schools.
Sincerely,
Erin Leif, PhD, BCBA-D and Renee Wozniak, PhD, BCBA-D
Association for Science in Autism Treatment
