Wednesday, February 3. 2010
Posted under: Research
A recent research study by Dawson and colleagues has created both excitement and frustration for some proponents of ABA therapy. The study, conducted in a randomized controlled trial design, was published in the November 2009 issue of Pediatrics and demonstrated that behavioral intervention with toddlers resulted "in significant improvements in IQ, language, adaptive behavior, and autism diagnosis." ("Randomized, Controlled Trial of an Intervention for Toddlers With Autism: The Early Start Denver Model" Pediatrics, November 2009). However, proponents of ABA have pointed out that the New York Times coverage failed to mention that the study uses applied behavior analytic principles (http://www.blogcatalog.com/search.frame.php?term=aba+therapy&id=905ac454e81811bf6f06a9117f2f8761) and that the CNN coverage perpetuated a common misconception about ABA by comparing the pleasing, playful therapy of the study with "ABA, which is delivered at a desk" (http://blog.navigationbehavioralconsulting.com/).
While I find the misinformation unfortunate, I can't help but wonder if we behavior analysts who work with children with autism have done this to ourselves. The number of terms and brands currently in use in applied behavior analysis continues to grow, including: behavioral treatment, intensive behavioral therapy, intensive early intervention using behavior therapy, ABA therapy, Lovaas Model of ABA, Verbal Behavior, ABA/VB, traditional ABA, Pivotal Response Teaching (PRT), DTT, and Early Start Denver Model (ESDM) just to name a few. Further, brand names are sometimes misapplied, websites and conferences present misinformation on one form of behavioral treatment while propping up their own form of behavioral treatment, and new, often ambiguous terminology continues to emerge. Is it any wonder that those reporting on new evidence for ABA therapy don't always get things right?
I don't think branding is always bad. I've worked under the Lovaas Model of Applied Behavior Analysis for the past 15 years. The Early Start Denver Model deserves praise for this recent 2009 study. Branding can be a good thing. Branding of autism interventions provides a general package for delivery, including both a general curriculum and teaching procedures to follow. This general information can serve as a strong foundation for a child's intervention, particularly when there's empirical data to support the brand. However, I suggest the following guidelines for branding.
- One general term should be agreed upon (i.e., behavioral treatment, ABA, intensive behavioral therapy, etc.) as a general umbrella term under which all brands fall. When discussing their brand, individuals should always start by disclosing that their brand falls under this general term. For example, in these guidelines I'll use "ABA therapy" as the general term.
- Branding can continue for general interventions in ABA therapy (i.e., those interventions with a general curriculum and teaching procedures), but branding should be avoided when talking about specific procedures (e.g., discrete trial teaching vs. natural environment teaching, errorless learning vs. no-no-prompt, etc.) unless that new brand technique is observably and measurably distinct from other procedures, precisely defined, and demonstrated to be of enough significance that the technique deserves a separate name.
- Individuals who brand general interventions in ABA therapy need to be careful to clarify what observably and measurably distinguishes one brand from another and what procedures, guidelines, etc. are common to other ABA therapy brands.
- Individuals who brand general interventions should be careful not to contribute to the misinformation of other ABA therapy brands by supporting any claims they make about that other ABA therapy brand with observable evidence.
- Brand names should not be used in research literature unless the brand itself is actually the focus of the research.
ABA therapy has more research supporting its use with children with autism than any other type of intervention. We should always question whether the terminology we use in our research and our practice is supporting or weakening that fact. I can't help but end by noting that Dr. Lovaas, so famous for his research and methods throughout the years, describes his treatment in the 1987 research study as "behavioral treatment." The 2005 replication research of Dr. Lovaas' work describes treatment as "early intensive behavioral treatment developed at UCLA." The 2006 replication research describes treatment as "early intensive behavioral treatment...based on Lovaas' UCLA treatment model." In fact, no research article describes treatment simply as the "Lovaas method" or even "Lovaas Model of Applied Behavior Analysis." I was present at a meeting when Dr. Lovaas emphasized that his work was only one part of a larger body of research. His humility and understanding in this area is yet another contribution from which we all can benefit.
Lovaas Institute - Indianapolis