Thursday, May 21, 2009

Applied behavior analysis and evidence-based practice

Facing Autism in New Brunswick often posts commentary regarding autism treatment from a parent's perspective, and is a strong proponent of applied behavior analysis as an evidence-based treatment. The current post examines the difference between evidence-based treatments and those lacking evidence -- and the attraction of the latter.

Readers may find Facing Autism thought provoking. The posts are generous in their openness -- please, check it out. (The blog also presents strong opinions on issues like vaccinations and autism and neurodiversity advocates; WisABA does not currently have a position on these issues.)

4 comments:

Regina Claypool-Frey said...

Well,
While giving full marks for the passion, having spent the last couple of months looking at standards of evidence, it kind of depends on the evaluation criteria, whether the basis is scientific or a matter of policy, since standardization is being closely looked at, esp. at this time of "evidence-based medicine", "evidence-based practice", efficacy vs. effectiveness. The Academy of Pediatrics did recommend ABA, but as an educational, not medical intervention, and thus subject to all the limitations and intention of IDEA providing a Free and Appropriate Education in the Least Restrictive Environment vs. a medical model emphasizing rehabilitation and remediation of deficits. I suspect that some of the widely cited reports are going to be seen as somewhat out of date as they are supplanted by newer ones--at least two this year. And then it again depends on whether you are approaching this from an educational or medical perspective, and whether even meta-analyses are calling for RCTs as the next step (vs. the only admissible step) in determining level of "evidence".

As an FYI, the National Autism Center will be issuing their National Standards Project report on Evidence-Based Practices regarding autism mid-July. This has been a massive undertaking involving hundreds of studies and several years. It will be interesting to see the conclusions.

As far as why parents might run to pseudoscience vs. that which has at least a running shot of a theoretical basis and even limited evidence, nature does abhor a vacuum and the testimonial of others more like ones self has more weight than a bushel of experts who are not going through the same experience, but I disagree that it isn't because researchers aren't studying the questions--my experience is that in many cases the questions are being, and have been studied; it's just that people often don't like the results or are looking for confirmation bias.

Regina Claypool-Frey said...

BTW, on a side note, I added this blog to the blog roll at
ABA-International Conference 2009 blogThanks for your posts on what's going in the public sphere on behavior analysis!

Cheers.

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Corky said...

Thanks for adding us to the ABAI 2009 Conference Blog!!!

What about the evidence that was presented several years ago at ABA (or another behavior conference I attended) that showed that exrays of the brain showed positive changes in brains of youngsters following ABA treatment? Does anyone remember that? In which case, ABA could be considered a medical intervention. I definitely believe someone should be hooking up with neurological researchers and testing ABA treatment.

This term "evidenced based treatment" is certainly problematic! Corrine