Intense earliest autism intervention has not been proven to provide sustained or substaintial benefit over long term, even shorter term presents many questions. Most recently, mandates for insuring autism treatments have been instated, state by state. The main goal of these mandates is to fund intense and early autism intervention. Intense earliest intervention has not been proven to change the neurology behind autism...Read on to consider how much is true and how much is false in the autism insurance mandate debate.
"There is an increasing concern that in modern research, false findings may be in the majority or even the vast majority of published research claims...A new claim about a research finding is more likely to be false than true." (link)
"The sins of science" tells us:
...everything from data fabrication, plagiarism to fraud to embezzlement is on the roster of rotten scientific behavior. It is a high stakes game where pressure is frenzied to publish positive results. (link)
A list from the above link gives multiple examples of researchers and their famous, faked, scientific results. The list includes; breast cancer research, skin graft technique, fabricated patient data for implementation of hormonal treatment, embryonic stem cell cloning, Celebrex faked research, menopause/ aging/ hormonal supplement research, cognitive evolution studies, and COX2-NSAIDS. One researcher on this list was respected and had written over 200 articles in high profile research journals.
What about articles in well respected research journals; ones that are cited as sources for upholding important policy making decisions?
The American Academy of Pediatrics (AAP) is quite respected and yet the group has presented conclusions that have not yet been validated. In its 2007, Management of Children With Autism Spectrum Disorders the AAP gave a stamp of approval in recommendations for intense earliest autism intervention. The AAP made claims that earliest intense autism intervention is shown to: "...make substaintial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior - and their outcomes have been significantly better than those of children in control groups." (31-40) The above claims have yet to be validated by any hard data in the scientific community.
AAPs own sources defy the lone empirically represented statement: Upon looking through the AAP's own sources (31-40) provided in support of the representation that substaintial and sustained gains are realized via intense earliest intervention, the very source experts themselves defy the AAP stated conclusion that substaintial, sustained gains have even been realized from intense earliest intervention. The source experts' own contributions in the cited papers, state that more research is required to settle what type of benefit earliest intense intervention provides over the shorter and longer term. The one study (Lovaas) that might support the AAP conclusion in a small way - has yet to be replicated since it's decades' old results.
From source data provided for the recommendation given by AAP, that did not support conclusive findings on intensive earliest autism intervention outcome:
31) Cohen, H, Amerine-Dickens M, Smith T. (Early intensive behavioral treatment; replication of the UCLA model in a community setting) J Dev Behav Pediatr
- A three year study in which involved no longer term follow up after initial gains.
32) Eikeseth s, Smith T, Jahr E, Eldevik S. Intensive behavioral treatment at school for 4- to 7- year - old children with autism: a 1- year comparison controlled study. Behav Modif
- No follow up after initial study.
33) Eldevik S, Eikeseth S, Jahr E, Smith T (Effects of low- intensity behavioral treatment for children with autism and mental retardation) J Autism Dev Disord
- After two years the behavioral group made gains as compared to the control group - but they were not significant.
- No long term follow up.
34) Howard JS, Sparkman CR, Cohen HG, Green G, Stanislaw H (A comparison of intensive behavioral analytic and eclectic treatments for young children with autism) Res Dev Disabil
- A comparison between intensity and type of programming. No long term follow up.
35) Lovaas OI (Behavioral treatment and normal education and intellectual functioning in young autistic children) J Consult Clin Psychol
- No long term follow up.
36) McEachin JJ, Smith T, Lovaas OI (Long term outcome for children with autism who recieved early intensive behavioral treatment) Am J Ment Retar
- Outcomes to the initial study of this group are questioned. A follow when the study group subjects were older indicated that they had become worse. The term recovered was used to describe children whose measured ability fell into the average range (upon initiation of programming) and (also to those) who were being educated within mainstream schools. Children with higher functioning autism could well achieve such outcomes via other interventions, and (furthermore) a follow-up of some of the recovered children at age 13 revealed a continuation of significant behavioral issues. (link)
- This initial study group result has not been replicated - to this day. (link)
37) Sallows GO, Graupner TD, (Intensive behavioral treatment for children with autism; four- year outcome and predictors) Am J Ment Retar
- Hours of treatment for the study were the closest replication as far as intensity of hours utilized in UCLA study (Lovaas).
- While results were comparable, high hours of intense supervision were not sufficient to make up for low levels of pretreatment skills.
- ...Consistent with previous study, low IQ and absence of language predicts limited progress. All this is according to the researchers.
38) Smith T, (Outcome of early intervention for children with autism) Clin Psychol Sci Pract
In part, this source presents the following: A number of investigators have reported that children with autism make major gains with early intervention. The present review included nine such reports on behavior analytic treatment (and other treatments)...
- ...Unfortunately, close inspection of these reports reveals that the results have been less favorable than reviewer have claimed (Dawson & Osterling)
- ...Of great concern, is that most studies have lacked even the most basic features fo scientifically sound studies.
- ...11 of 12 studies did not provide data on childrens' progress following the termination of treatment, a crucial ommission because initial acquisition of some skills does not guarantee continuation of betterment or long term benefit.
39) Smith T, Groen AD, Wynne JW (Randomized trial of intensive early intervention for children with pervasive developmental disorder) Am J Ment Retar
- The study had no follow up.
40) Weiss M. (Differential rates of skill acquisition and outcomes of early intensive behavioral intervention for autism) Behav Interv
- Early learning rates may predict outcome, but more research needs to be done.
- The answers may be gleaned from future research.
41) Lovaas (Teaching Individuals with Developmental Delays)
- I have this book. From when we utilized earliest intervention in our home. It says was Lovaas usually says.
In many ways, the AAP recommendation of intense earliest intervention has been a little like yelling fire in a crowded theatre. The AAP statement referring to substaintial and sustained gains from earliest intense intervention, as a factual and scientific result that is indicated by research, is fallacy. It is being used in the wrong way - to force a kind of AutismCare that is not proven. It has presented added pressure to parents, professionals and communities. Why is it that the AAP and many other professionals are engaging in this kind of activity? Whatever the reason, Earliest Autism Intervention Insurance Mandates seems to be in the bag; coming to every state near you.