Dear Ms. Marshall,
Thank you for your article entitled “Facing down autism: The unconventional (and somewhat controversial) therapy that’s led to recovery” (Theglobeandmail.com, August 3, 2014). We applaud you for highlighting the difficulties families face when they have a child with autism, and for pointing out that experts emphasize the importance of starting treatment as early as possible when a child is first diagnosed.
We enjoyed reading about Patrick Hindmarsh, who was diagnosed with autism as a toddler, and who has made great strides, now receiving good grades and getting ready to start high school. However, his improvements are credited to the Son-Rise® program, even implying that this approach can lead to recovery from autism. While it is wonderful that Patrick is doing so well, the Son-Rise® method is not considered an evidence-based intervention for autism due to the lack of research, and therefore your article could be misleading to parents who are searching for a successful program for their child.
You quote Laurie Mawlam of the Autism Canada Foundation as saying, “while the scientific studies for Son-Rise® are not as plentiful as traditional discrete trial, it doesn’t mean that the treatment is not valid. It means that the studies haven’t been done.” We agree that more research needs to be conducted, but until that is done, one cannot make the argument that this approach is effective or can result in recovery, as your story headline claims. You mention that the first controlled trial for Son-Rise® was recently conducted and found that a small group of children receiving the therapy showed more improvements in social communication. While this is a good first step in determining its efficacy, many replication studies need to be done to support the findings.
James Bebko, a professor at Toronto’s York University, indicates that there is no way to predict which treatment will work best for any individual child; yet, applied behaviour analysis (ABA) is the treatment of choice for children with autism at this time, with several hundred peer-reviewed studies documenting its success. In addition, ABA is supported by many agencies and task forces, such as the American Medical Association and the United States Surgeon General.
There were some other misconceptions that we would like to address. You wrote that intensive behavioural intervention (IBI), which is derived from ABA, teaches by rewarding appropriate behaviour with toys or treats, while the Son-Rise® program considers the relationship itself the reward. IBI actually uses motivators in the form of reinforcers, the use of which has been supported in over 50 years of research. Reinforcers can come in many forms, including social interactions and praise. Bebko also states that other therapies could learn from the emphasis that Son-Rise® places on family involvement, but it should be noted that one of the core features of IBI is family interaction and participation. Parents are trained to be able to teach their child and are expected to carry out the treatment at home and in the community. Finally, you state that research for ABA often does not look at social interactions or communication skills, despite the fact that there has been extensive research documenting the success of ABA in teaching social and communication skills to children with autism.
Although we appreciate your emphasis on treatment and the importance of early intervention, it is important that we focus on treatments that have actually been proven to have scientific validity. Before promoting the Son-Rise® approach as one that can lead to recovery, more research needs to be done so that families of children with autism can make an informed decision before deciding on an appropriate and effective form of treatment.
Sincerely,
Shannon Wilkinson MADS, BCBA and Mary E. McDonald, Ph.D., BCBA-D
Association for Science in Autism Treatment
