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Advantages and Challenges of a Home- and Clinic-Based Model of Behavioral Intervention for Individuals Diagnosed with Autism Spectrum Disorder

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Justin B. Leaf
Justin B. Leaf
Justin B. Leaf
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Ronald Leaf
Ronald Leaf
Ronald Leaf
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John McEachin at Autism Partnership
John McEachin
  • Autism Partnership
Joseph Cihon at Autism Partnership Foundation
Joseph Cihon
  • Autism Partnership Foundation
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Abstract

Researchers have demonstrated that comprehensive behavioral intervention can result in significant improvements in the lives of individuals diagnosed with autism spectrum disorder (ASD; e.g.; Lovaas, Journal of Consulting and Clinical Psychology 55(1):3–9, 1987; McEachin et al., American Journal of Mental Retardation 97(4):359–372, 1993). This intervention has occurred in a variety of settings (e.g., school, home, and clinic). Even though procedures based upon the principles of applied behavior analysis (ABA) can be implemented across a variety of settings, there is often confusion about the differences and relative advantages of home- versus clinic-based settings. The purpose of this paper is to provide a discussion of home- and clinic-based intervention within the context of a progressive approach to ABA and discus possible advantages of each type of setting.
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Vol:.(1234567890)
Journal of Autism and Developmental Disorders (2018) 48:2258–2266
https://doi.org/10.1007/s10803-017-3443-3
1 3
COMMENTARY
Advantages andChallenges ofaHome- andClinic-Based Model
ofBehavioral Intervention forIndividuals Diagnosed withAutism
Spectrum Disorder
JustinB.Leaf1,2· RonaldLeaf1· JohnMcEachin1· JosephH.Cihon1,2· JuliaL.Ferguson1
Published online: 20 December 2017
© Springer Science+Business Media, LLC, part of Springer Nature 2017
Abstract
Researchers have demonstrated that comprehensive behavioral intervention can result in significant improvements in the lives
of individuals diagnosed with autism spectrum disorder (ASD; e.g.; Lovaas, Journal of Consulting and Clinical Psychol-
ogy 55(1):3–9, 1987; McEachin etal., American Journal of Mental Retardation 97(4):359–372, 1993). This intervention
has occurred in a variety of settings (e.g., school, home, and clinic). Even though procedures based upon the principles of
applied behavior analysis (ABA) can be implemented across a variety of settings, there is often confusion about the differ-
ences and relative advantages of home- versus clinic-based settings. The purpose of this paper is to provide a discussion of
home- and clinic-based intervention within the context of a progressive approach to ABA and discus possible advantages
of each type of setting.
Keywords Behavioral intervention· Clinic-based· Home-based· Autism
For over the past 60years researchers and clinicians have
demonstrated the effectiveness of procedures based upon the
principles of applied behavior analysis (ABA) for individu-
als diagnosed with autism spectrum disorder (ASD; e.g.,
DeMyer and Ferster 1962; Lovaas 1987; Wolf etal. 1963).
Some of the first studies demonstrated that procedures based
upon the principles of ABA were effective in changing
behavior for individuals diagnosed with ASD. These pro-
cedures included reinforcement paradigms (e.g., DeMyer
and Ferster 1962), shaping (e.g., Stuecher 1972; Wolf etal.
1963), punishment (e.g., Lovaas and Simmons 1969), and
prompting (e.g., Schreibman 1975). Following evaluations
of specific procedures, researchers began to evaluate the
effectiveness of comprehensive behavioral intervention as
it applies to individuals diagnosed with ASD (e.g., Lovaas
1987; Lovaas etal. 1973).
Lovaas etal. (1973) conducted one of the first com-
prehensive behavioral intervention evaluations for 20
individuals diagnosed with ASD, all of whom were between
3 and 10years of age. The comprehensive behavioral inter-
vention included discrete trial teaching, shaping, and dif-
ferential reinforcement. Additionally, some parents were
trained to implement behavioral intervention in the later
stages of the study. Progress was evaluated across multi-
ple behavioral measures and standardized assessments.
Although the results demonstrated that the intervention was
effective, the results also indicated that for those partici-
pants whose parents received training, continued improve-
ment was observed, while participants who returned to state
hospitals regressed.
Lovaas (1987) extended Lovaas etal. (1973) study by
comparing comprehensive, intensive behavioral interven-
tion to a minimally intensive behavioral intervention for 38
children diagnosed with ASD. The participants were quasi-
randomly assigned into the intensive or non-intensive group.
Students assigned to the intensive group received an average
of 40h per week of one-on-one treatment as well as parent
training and support and did not receive any other treatments
(e.g., speech, occupational, alternative treatments). Partici-
pants assigned to the minimally intensive group received
10h or less per week of behavioral intervention as well as
parent training and support and could participate in other
treatments. The results showed that participants assigned to
* Justin B. Leaf
Jblautpar@aol.com
1 Autism Partnership Foundation, 200 Marina Drive,
SealBeach, CA90740, USA
2 Endicott College, 376 Hale Street, Beverly, MA01915, USA
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... Desse modo, somente 463 estudos foram eleitos para a segunda etapa. Nas últimas cinco décadas, a intervenção ABA na população com TEA expandiu-se e demonstrou eficácia na melhoria das habilidades sociais, de comunicação, de aprendizagem, acadêmicas e de autocuidado, como por exemplo, a escovação de dentes e a vestimenta, além de melhorar o funcionamento social de indivíduos autistas (Parker et al., 2017;Leaf et al., 2018). A discussão sobre ABA experimenta uma mudança significativa, evoluindo de uma ênfase exclusiva em sua eficácia para a exploração de sua aplicação em contextos diversos, enfrentando potenciais desafios e integrando-a a outras disciplinas. ...
... Logo, a intervenção precoce (antes dos 28 meses) possui impacto positivo, mesmo com uma quantidade relativamente menor de horas de intervenção. Entretanto, um modelo de intervenção ABA baseado em casa e clínica pode ser menos intensivo e mais acessível (Leaf et al., 2018). ...
Contribuições da Análise do Comportamento Aplicada (ABA) no transtorno do Espectro Autista: Uma revisão integrativa
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  • Aug 2024
A Análise do Comportamento Aplicada é uma abordagem baseada nos princípios da psicologia do comportamento. É frequentemente utilizada no tratamento de pessoas com Transtorno do Espectro do Autismo (TEA). No contexto do TEA, a ABA é usada para ensinar novas habilidades e reduzir comportamentos desafiadores. Este estudo objetiva descrever as contribuições da Análise do Comportamento Aplicada no tratamento e no desenvolvimento de habilidades psicossociais em indivíduos com Transtorno do Espectro Autismo. Foi realizada uma revisão integrativa da literatura dos últimos 10 anos, nas bases de dados Science Direct, Scopus e Web Of Science empregando-se os descritores controlados Applied Behavior Analysis”, “Autism Spectrum Disorder”, “Behavioral Therapy” e “Behavioral Intervention”, cruzando-os com o operador booleano AND. Dezessete artigos compuseram esta revisão, os quais mostram resultados positivos para as intervenções avaliadas. Contudo, ressalta-se que cada indivíduo com autismo tem necessidades únicas e pode responder de forma diferente a diferentes abordagens. A escolha da intervenção deve ser feita em consulta com profissionais qualificados e levar em conta as necessidades específicas, preferências e recursos de cada indivíduo. É importante continuar a realizar pesquisas para desenvolver e avaliar novas intervenções e melhorar os resultados para pessoas autistas.
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... For example, homebased interventions can help generalize learned behaviors (e.g. daily living skills like using the toilet) in natural living settings; mainstream school-based intervention settings provide more social oppotunities for children with ASD to interact with neurotypical peers (Leaf et al. 2018). ...
... In addition, the center-based group programs were used by about 40% of parents in our survey. This format is important because it provides children with ASD more opportunities to interact with their peers, which facilities children's learning and practice of social communication skills (Leaf et al. 2018). However, the qualitative interview showed that some parents were concerned about some therapists' capacities for handling a group of children. ...
Applied behavior analytic intervention services for children with autism spectrum disorders: an investigation of Chinese parents
Article
Full-text available
  • Dec 2023
Introduction: Applied behavior analysis (ABA)-based interventions have been used worldwide for several decades to improve socially significant behaviors of individuals with autism. However, as the utilization of the ABA-based interventions in the Chinese mainland is relatively new, it remains unclear about some fundamental aspects of using these interventions in this region. Method: This study investigated the use of ABA-based interventions in Beijing and surrounding areas by using a quantitative survey (N = 85) and a qualitative semi-structured interview (N = 10) to collect data from parents of children with autism. Results: This study found that (a) the ABA-based intervention service was the most popular one chosen by parents, and the majority of these parents reported improvements in children's behaviors and gave positive evaluations for the work of professionals; (b) this service was mainly delivered at autism organizations (i.e. autism clinics/schools) or children's homes, but rarely used in mainstream school settings; (c) the high cost of ABA interventions was a financial burden for families; and (d) a high proportion of parents were involved in interventions as assistant therapists. Furthermore, some aspects of the use of this service varied with fami-lies' socioeconomic levels. The qualitative interviews expounded upon motivations for parents' choices and evaluations for this service. Conclusion: These findings provided valuable insights for service providers, policymakers, and researchers to optimize ABA-based intervention services for Chinese children with autism.
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... One problem with current evidence-based interventions for ASD is that most of them (e.g., Applied Behavioral Analysis or ABA) require either the direct presence or regular involvement of specialists trained in administration of the specific intervention [11,12]. This may be difficult in settings (e.g., forensic facilities) or geographic areas where availability of such staff is limited. ...
Exercise in the Treatment of Repetitive, Self-Injurious, and Aggressive Behavior in Adults with Autism Spectrum Disorder: A Neurobiological Analysis
Article
Full-text available
  • Jan 2024
Objective: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by markedly impaired social interaction and restricted/ repetitive patterns of behavior, interests, and activities. Maladaptive behaviors associated with ASD can include stereotyped, self-injurious, and aggressive behaviors. Current evidence-based interventions for ASD involve specialist availability, financial, time, and side effect constraints. Physical exercise has received increasing attention in the treatment of children with ASD, but research in adults is comparatively scarce. The purpose of this paper is to explore possible mechanisms by which exercise can reduce repetitive, self-injurious, and aggressive behaviors in adults with ASD. Methods: The literature on the neurobiology of exercise is reviewed and compared with the literature on the neurobiology of ASD. Information from this comparison is then used to formulate possible mechanisms by which exercise may reduce maladaptive behaviors in adults with ASD. Results: Plausible mechanisms for an exercise-induced beneficial effect on maladaptive behaviors in adults with ASD include modulation of neurotransmitter release and function, facilitation of endocannabinoid release, increased expression of neurotrophic factors, improved functional connectivity in higher-level cognitive networks, reduced oxidative stress, improved HPA axis function, treatment of comorbid depression, and reduction in amyloid beta deposition in cortical GABAergic neurons and subcortical structures. Conclusions: Future research should attempt to confirm the efficacy of exercise in reducing maladaptive behaviors in adults with ASD as well as the proposed mechanisms for such a relationship. Verification of these issues would have major implications in terms of supporting an evidence-based, inexpensive, widely available, and broadly beneficial treatment for adults with ASD.
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... In the practice of ABA, the location, such as a school or community setting, may be an integral part of the treatment plan and may be necessary to ensure treatment goals are met, especially generalization of skills across settings (Gunning et al., 2019;Leaf et al., 2018). According to the Warning Signs guidance, "Restrictions based on geographic location, facility type, provider specialty, and other criteria that limit the scope or duration of benefits for services provided under the plan or coverage" are an NQTL (U. ...
Science over Cynicism: The Race to Preserve Best-Practice Applied Behavior Analysis through Expanded Awareness, Advocacy, and Enforcement of the Mental Health Parity and Addiction Equity Act
Article
  • Apr 2024
Widespread insurance funding of applied behavior analysis (ABA) as a medically necessary mental health benefit in the treatment of autism spectrum disorder (ASD) has placed behavior analysts in the role of health-care providers, and the race is on to see whether best-practice ABA will be defined by the insurance industry or behavior analysts. Behavior analysts who work with insurance and/or Medicaid have increasingly encountered payor guidelines that interfere with their efforts to implement treatment plans that reflect generally accepted standards of care. When these arbitrary limits are integrated into ABA practices, payors—not science—are shaping how ABA is implemented. Many common payor guidelines, such as location exclusions, caregiver participation requirements, and age and hour limits, violate the federal Mental Health Parity and Addiction Equity Act (MHPAEA). For the first time since MHPAEA became law, federal agencies are scrutinizing payor guidelines and practices through the lens of MHPAEA and working to increase compliance. In this new climate of MHPAEA enforcement, behavior analysts are uniquely positioned to identify, reject, and report improper guidelines that constrain their ABA practices and promote best practices to optimize patient outcomes. This review of MHPAEA in the context of ABA highlights common violations and current advocacy and aims to equip behavior analysts with the tools to free their practices from improper limits.
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... Research findings and public service agencies recommend that children with autism receive services in the least restrictive environment, with opportunities for frequent interactions with same-aged peers, and embedded within naturalistic routines and contexts. Others have emphasized the high costs of one-to-one delivery of early intervention and that this approach may not be feasible for some families, calling for the examination of other models that are also effective (Rogge & Janssen, 2019), including group-based approaches that may be more efficient (Leaf et al., 2018;Tupou et al., 2022). Relatedly, offering specialized supports within early childhood education settings is needed to support children and families in obtaining feasible and effective early care and education, which has been found to be a significant gap for working families (Houser et al., 2014;Vanegas & Abdelrahim, 2016). ...
Pilot Feasibility of a Community Inclusion Preschool Program for Children With Autism
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Few studies have reported outcomes from the delivery of naturalistic developmental behavioral interventions (NDBI) in group-based community care. Further, while the importance of inclusion for autistic individuals is well established, there is little research on the feasibility of community-based inclusion programs for preschool-aged autistic children. Positive outcomes have been reported from a few model inclusion programs. However, most involved extensive training from researchers, with limited available data on self-sustaining community-based programs. This quasi-experimental study tracked outcomes for 31 autistic preschool-aged children with verbal and play skills close to age level, who were enrolled in a community inclusion preschool program utilizing NDBI. Children, aged 2.5 to 5 years of age at entry, attended the program for 8 to 36 months. Paired sample t-tests indicated statistically significant improvements from time 1 to time 2 on standardized measures of adaptive behavior, social skills, and autism characteristics. Implications for the feasibility of using NDBI for autistic children in inclusive preschool settings and directions for future research are discussed.
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... With homes often serving as the environment in which children are initially exposed to rules and structure, caregivers are uniquely positioned to impact children's propensity for instruction following. While a large body of research and clinical data lend to the effectiveness of behavioral interventions implemented within a clinic-based model, home-based programming affords several practical advantages specific to parental involvement, generalization, and cost-effectiveness (Leaf et al., 2018). Equally important, prevention-focused strategies implemented within the home might be more appropriate for children who engage in mild task refusal and have greater appeal among caregivers less willing to bear the repeated occurrence of problem behavior to implement consequent strategies (Radley & Dart, 2016). ...
Caregiver Telehealth Training on Antecedent Strategies to Increase Children's Instruction Following in the Home
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Full-text available
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  • J Behav Educ
In two studies, three caregivers of neurotypical children were trained via telehealth to deliver two antecedent strategies to increase instruction following in the home. Dependent measures included initiation latency and task completion with high-and low-probability instructions. In Study 1, a modified pretrial delivery procedure was evaluated in which caregivers jointly engaged with their child in a moderately preferred activity prior to the issuance of a predetermined instruction. Results showed that initiation latencies for low-p instructions trended downward for two of three children, while latencies for high-p instructions remained low and stable for two of three children. In Study 2, the three low-p instructions with the highest initiation latencies in Study 1 were further targeted with the high-probability instructional sequence. Using a multiple baseline across behaviors design, results showed decreased initiation latencies and increased levels of task completion for all three children. The results of both evaluations are discussed and practical issues are considered for future research on the use of technology to support caregiver's delivery of instruction-following programs in homes.
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... Inclusive preschool-based delivery may also offer several potential benefits over delivery in other settings. For example, in a preschool setting EI may be delivered to more than one child at a time which may be more cost-effective and efficient than one-on-one delivery (Leaf et al., 2018). The inclusive preschool setting also appears to satisfy current legal and best practice recommendations which suggest that EI should be delivered in a child's natural environment, with the least amount of restriction required to meet the child's needs (Ledford & Wolery, 2011) and with ongoing opportunities to interact with typically developing peers (Broderick, 2017;United Nations, 2006). ...
Teachers’ Perceptions of an Early Intervention Coaching Program
Article
Full-text available
  • Jun 2022
Objectives Inclusive preschools appear to be logical settings for the delivery of early intervention for young autistic children. Regular preschool teachers may also be well-suited to delivering early intervention. This study is part of a larger study, in which three preschool teachers participated in a coaching program based around the Early Start Denver Model (ESDM), a promising early intervention model for young autistic children. The aim of the present study was to evaluate teachers’ perceptions regarding the social validity of the coaching program and the ESDM techniques. Methods A quantitative questionnaire and semi-structured qualitative interviews were used to explore teachers’ perceptions of the acceptability and effectiveness of the intervention. Quantitative data were analyzed using descriptive statistics and thematic analysis was used to analyze qualitative data. Results Overall, findings suggest that teachers perceived the coaching program and the ESDM strategies to be highly acceptable and effective; however, there was some variation in teachers’ perceptions of specific elements and strategies. Teachers suggested that the program could be further improved through the provision of more targeted coaching support focused on behavioral teaching strategies and more time for one-on-one practice with target children. Conclusions This research could be viewed as providing preliminary support for the social validity of the focus intervention for this group of teachers. It seems important for future research to address the identified limitations in the present research and to examine in further detail the social validity of this intervention for ECE teachers in inclusive preschool settings. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR): Registration no. 12618000324213.
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... Parent-implemented interventions may be a costeffect means of increasing communication outcomes compared with business-as-usual treatment (i.e., Bellomo, 2016;Hong et al., 2016b;Nunes & Hanline, 2007;Wright & Kaiser, 2017). As noted in prior research, home-school partnerships are critical given the challenges that children with ASD often have generalizing skills across settings and communicative partners (Hong et al., 2016a;Leaf et al., 2018). This is particularly true for communication, which is ubiquitous. ...
Parent Coaching in a Multimodal Communication Intervention for Children with Autism
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  • Jun 2022
Social-communication deficits associated with autism spectrum disorder often lead to undesirable outcomes in other domains, such as interpersonal relationships, employment, and participation in community activities. Parents may be ideal implementers of interventions to address these deficits when provided with instruction that is efficacious and feasible. This study evaluated a web-based group training and multimodal communication protocol of individualized parent coaching to improve parent implementation of communication intervention components. Results indicated a moderate functional relation between the parent-coaching intervention and parent implementation of the instructional behaviors. Implications and suggestions for future research are discussed.
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A progressive approach to discrete trial teaching: Some current guidelines
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Discrete trial teaching (DTT) is one of the cornerstones of applied behavior analysis (ABA) based interventions. Conventionally, DTT is commonly implemented within a prescribed, fixed manner in which the therapist is governed by a strict set of rules. In contrast to conventional DTT, a progressive approach to DTT allows the therapist to remain flexible, making in-the-moment analyses and changes based on several variables (e.g., individual responding, current and previous history). The present paper will describe some guidelines to a progressive approach to DTT. The guidelines presented here should not be taken as a set of rules or as an exhaustive list.
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In this study we evaluated a social skills group which employed a progressive applied behavior analysis model for individuals diagnosed with autism spectrum disorder. A randomized control trial was utilized; eight participants were randomly assigned to a treatment group and seven participants were randomly assigned to a waitlist control group. The social skills group consisted of 32, 2 h sessions. Teachers implemented a variety of behaviorally based procedures. A blind evaluator measured participants' behavior immediately prior to intervention, immediately following intervention, and during 16 and 32-week maintenance probes. Results of the study demonstrated that participants made significant improvements with their social behavior (p < .001) following intervention, and the results were maintained up to 32 weeks after intervention had concluded.
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Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children
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  • Feb 1987
Autism is a serious psychological disorder with onset in early childhood. Autistic children show minimal emotional attachment, absent or abnormal speech, retarded IQ, ritualistic behaviors, aggression, and self-injury. The prognosis is very poor, and medical therapies have not proven effective. This article reports the results of behavior modification treatment for two groups of similarly constituted, young autistic children. Follow-up data from an intensive, long-term experimental treatment group (n = 19) showed that 47% achieved normal intellectual and educational functioning, with normal-range IQ scores and successful first grade performance in public schools. Another 40% were mildly retarded and assigned to special classes for the language delayed, and only 10% were profoundly retarded and assigned to classes for the autistic/retarded. In contrast, only 2% of the control-group children (n = 40) achieved normal educational and intellectual functioning; 45% were mildly retarded and placed in language-delayed classes, and 53% were severely retarded and placed in autistic/retarded classes.
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Cost Offset Associated With Early Start Denver Model for Children With Autism
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  • Jul 2017
  • J AM ACAD CHILD PSY
Objective To determine the effect of the Early Start Denver Model (ESDM) for treatment of young children with autism on healthcare service use and costs. Method We use data from a randomized trial that tested the efficacy of the ESDM, which is based on developmental and applied behavioral analytic principles and delivered by trained therapists and parents, for 2 years. Parents were interviewed about their children’s service use every 6 months from the onset of the intervention to follow-up (age 6). The sample for this study consisted of 39 children with autism who participated in the original randomized trial at age 18 to 30 months, and were also assessed at age 6 years. Of this sample, 21 children were in the ESDM, and 18 children were in the community care (COM) group. Reported services were categorized and costed by applying unit hourly costs. Annualized service use and costs during the intervention and post intervention for two study arms were compared. Results During the intervention, children who received the ESDM had average annualized total health-related costs that were higher by about 14,000thanthoseofchildrenwhoreceivedcommunity−basedtreatment.ThehighercostofESDMwaspartiallyoffsetduringtheinterventionperiodbecausechildrenintheESDMgroupusedlessappliedbehavioranalysis(ABA)/earlyintensivebehavioralintervention(EIBI)andspeechtherapyservicesthanchildreninthecomparisongroup.Inthepost−interventionperiod,comparedwithchildrenwhohadearlierreceivedtreatmentasusualincommunitysettings,childrenintheESDMgroupusedlessABA/EIBI,occupational/physicaltherapy,andspeechtherapyservices,resultinginsignificantcostsavingsintheamountofabout14,000 than those of children who received community-based treatment. The higher cost of ESDM was partially offset during the intervention period because children in the ESDM group used less applied behavior analysis (ABA)/ early intensive behavioral intervention (EIBI) and speech therapy services than children in the comparison group. In the post-intervention period, compared with children who had earlier received treatment as usual in community settings, children in the ESDM group used less ABA/EIBI, occupational/physical therapy, and speech therapy services, resulting in significant cost savings in the amount of about 19,000 per year per child. Conclusions Costs associated with ESDM treatment were fully offset within a few years after the intervention due to reductions in other service use and associated costs.
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Interview-informed functional analyses: A comparison of synthesized and isolated components
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Hanley, Jin, Vanselow, and Hanratty (2014) described a functional analysis (FA) format that relied on a synthesis of multiple contingencies described by caregivers during open-ended interviews. These interview-informed synthesized contingency analyses (IISCA) provided effective baselines from which to develop socially validated treatments, but the synthesis precluded a precise understanding of individual contingencies influencing problem behavior. We conducted IISCAs and standard FAs (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) for nine children with autism to evaluate the likelihood of differentiation given a number of synthesized versus isolated variables. The IISCA was differentiated for all. The standard FA was differentiated for four; this number increased to six when we included precursors in the standard FA. We then compared treatments based on sets of differentiated analyses for four children. Treatment based on the IISCA was effective for all four; treatments based on the standard FA were effective for two. The role of synthesis in analysis is discussed.
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Concerns About the Registered Behavior Technician? in Relation to Effective Autism Intervention
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  • Sep 2016
In 2014, the Behavior Analyst Certification Board (BACB®) initiated a program for credentialing behavior technicians. The new credential, Registered Behavior Technician™ (RBT®), is for providers of behavioral intervention to a wide range of individuals with mental health needs and developmental delays, including individuals diagnosed with autism spectrum disorder (ASD). The RBT® would represent the entry-level position within the range of the BACB® credentials. Despite the increasing acceptance of this newest level of credential from the behavioral community, the authors of this paper have substantial concerns with the RBT® credential as it relates to the delivery of intervention to individuals diagnosed with ASD. The purpose of this paper is to detail these concerns and propose remedies that would ensure that individuals diagnosed with ASD receive effective behavioral intervention.
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“The Lovaas Model: Love It or Hate It, But First Understand It”
Chapter
  • Jan 2016
Although applied behavior analytic approaches have achieved greater attention as an effective treatment for individuals with Autism Spectrum Disorder, there is a tremendous amount of misinformation about what constitutes applied behavior analysis. The foundational work conducted at University of California, Los Angeles (UCLA) by Ivar Lovaas, which became known as the Lovaas Model, stands as one of the most misinterpreted behaviorally based treatment approaches to date. Details are presented of the Young Autism Project (YAP), which followed the progress of 38 young children receiving varying intensities of ABA that emphasized language, social, behavior, play, and self-help skill development. Results of the project indicated that intensity of services does matter, as well as what type of services, when reviewing child outcomes posttreatment. The explicit message from the conclusions of this work is that there is no “single” Lovaas model. The model used in the YAP was dynamic and tailored to the needs of the child while relying on behavioral principles that had a strong research base of support. A contemporary implementation of the Lovaas model is described, with specific attention given to the high level of expertise required of the staff and strong parent involvement as necessary components of effective treatment.
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Progress and Outcomes for Children with Autism Receiving Parent-Managed Intensive Interventions
Article
  • Dec 2001
  • RES DEV DISABIL
Parent-managed behavioral interventions for young children with autism are under-researched. We analyzed data from 66 children served by 25 different early intervention consultants. After a mean of 31.6 months of intervention IQ scores had not changed (N = 22). Vineland adaptive behavior scores had increased significantly by 8.9 points (N = 21). No children aged > 72 months attained normal functioning, i.e., IQ > 85 and unassisted mainstream school placement (N = 42). Progress for 60 children across 12 months was found for mental age (5.4 months), adaptive behavior (9.7 months), and language (5.1 months). The interventions did not reproduce results from clinic-based professionally directed programs. The effectiveness of the parent-managed intervention model as it has developed and the adequacy of professional services in that model are discussed.
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