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Dear Ms. Burgess,

We are writing in response to your article, “Mother ‘distressed’ by mental health services proposal to send autistic son to detention centre.”  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 and teens with autism spectrum disorders (ASD).  In this case, a 15-year-old boy with ASD and self-harming behavior was sent to an adult mental health facility due to lack of effective treatment options in Tasmania.  Because of his age and the lack of suitable treatment options, the management of the adult mental health facility proposed sending the boy to a youth detention centre.  This recommendation understandably caused considerable distress to the boy’s family.  When educators and service providers are not adequately prepared to work effectively with individuals with ASD, we should not be surprised when inappropriate options are pursued, such as placement in a detention centre.  In our view, that must change.

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 behavior analysis (ABA).  Within the field of ABA, a functional behavior assessment (FBA) may be used to identify the reasons why behaviors of concern, such as self-harming, occur.  The website of the Association for Science in Autism Treatment provides a more detailed description of the FBA process.  Understanding the underlying function of challenging behavior is the first step toward developing an effective treatment for reducing and eliminating behaviors of concern.  Intervention efforts that disregard the underlying function will likely fail.  Hundreds of peer-reviewed studies have demonstrated the effectiveness of treatments based on an understanding of behavioral function for reducing behaviors of concern displayed by people with complex disabilities.

Most Australian service providers who work with people with autism lack the training and expertise to conduct FBAs and write, implement, and monitor function-based treatment plans.  Given the acumen required to conduct proper functional behavior assessments, service providers should receive support and supervision from a Board Certified Behavior Analyst (BCBA) when working with people with autism, especially people who display more severe forms of challenging behavior.  Having training in applied behavior analysis or being a BCBA are the minimal requirements for conducting an FBA.  The Behavior Analyst Certification Board, an internationally recognized organization, describes the education and training requirement to obtain the BCBA credential, as well as offers a link to find certified professionals in your area.  Service providers that are responsible for addressing behaviors of concern displayed by people with autism would benefit greatly from collaboration with BCBAs.

We hope that you will consider sharing this information with your readers to help us disseminate information about evidence-based and humane strategies for safely and effectively addressing behaviors of concern displayed by people with ASD.

 Sincerely,

 Erin Leif, PhD, BCBA-D and David Celiberti, PhD, BCBA-D

Association for Science in Autism Treatment

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