BY CAITLIN LABARBERA

ABA 553 ASSESSING AUTISM INTERVENTIONS

The Appeal of Unvalidated Treatments

Introduction

With the rise of autism and other developmental disabilities there is a new claim for a cure around every corner.

Introduction

With all these new “fad” treatments, we as professionals need to be able to identify interventions that are both validated and

plausible.

Validated Treatments

Scientifically Valid Treatments Involve Increasing skills in specific areas Improving functioning in every day

situations Contain controlled studies Consistent with previous knowledge

Treatments with solid scientific support: Applied Behavior Analysis Psychotropic Medication

Unvalidated Treatments

Pseudoscientific Treatments

Interventions that are considered to have little to no scientific basis

Appealing because they are advertised as Cures Fast and Easy “Deeper” Benefits Natural

How can you determine if a treatment is both validated and plausible, or if it is

just another fad?

Red Flags

Tristram Smith gives us several key pointers on picking out Scientifically Valid Treatments while weeding out

Pseudoscientific Interventions.

CureMiracle

Breakthrough

Revolution

HEALING

Remedy

We found a cure…

Popular interventions that “found a cure” included:

Facilitated Communication Auditory Integration Training Gentle Teaching

All were found to be infective and some proved to create problems instead of eliminating them.

Important Sounding but Vague Benefits

Enhanced Learning

Increased Focus

Improved Body Awareness

Reduced Tactile Defensiveness

A Greater Well-Being

A Better Sense of Self

Important Sounding but Vague Benefits

Lack scientific evaluations

Lack controlled studies

Benefits are so vague that testing them would be difficult if not impossible.

http://www.youtube.com/watch?v=8JdDU0Ql8EI

Controlled vs. Uncontrolled Studies

ABA and Psychotropic Medication – Scientifically rigorous and controlled studies

Unvalidated treatments – Make no distinction between rigorous and nonrigorous studies Uncontrolled Lack objective measures

Megavitamin Therapies

Technology

Technology has extraordinary uses in science but having technology in a treatment does not mean that the treatment is ligament.

Is the technology used reliable and does it support the study?

Criticisms of Validated Treatments

Criticism may be used to justify implementing their own interventions

Using criticism to hide one of their own faults

“Criticisms of one treatment or its practitioners do not constitute evidence for the effectiveness of another treatment (Smith 2005) .”

Subjective Evidence

Unvalidated interventions tend to rely on Testimonies from parents Case studies Surveys Popularity Longevity

These things cannot be substitute for a controlled study

http://www.youtube.com/watch?v=3qR6aDkVjYY

Example: Diets – Eliminating Dairy and Wheat.

Is it really the diet? Parents desire to see gains Protein deficiency Spending more time with child Deprivation – Motivation Other environmental changes

Core Deficits

Once the deficit is corrected there will be global improvements in functioning

Two believed deficits include: The lack of ability to form reciprocal relationships Problem in processing or sensory input

Proposing that changes in one behavior will by itself lead to changes in other behaviors goes against a large body of research on humans and other organisms in both clinical and laboratory settings (Detterman&Sternberg,1995).

Natural Therapies

“Natural Therapies” Special diets to eliminate food additives Cut out wheat a dairy Chelation therapy Antifungal medications Shunning vaccinations

“Natural” does not mean safe or effective.

Treatment Combinations

Treatments are often combined in hopes to accelerate and maximize treatment

Some treatments encourage combinations Megavitamins

Reality - combining treatments have no effect and can even reduce effectiveness of treatments.

Experimenting

Implementing a new treatment First, make only one treatment change at a

time Second, Identify specific target behaviors Use objective measures to obtain a baseline Finally, monitor changes in the target

behavior on an on going basis with objective measures obtained by raters who are blind to treatment.

• HYMAN AND LEVY (2000)

http://www.youtube.com/watch?v=qbhkX2oBmJY

What would be appealing?How many red flags can you pick out?

Evaluating Treatments

Treatments that are both validated and plausible

Treatments that are Unvalidated and implausible

Should be Widely Used

Should be Avoided

Reference

Jacobson, J. W., Foxx, R. M., & Mulick, J. A. (2005). Controversial therapies for developmental disabilities, fad, fashion, and science in professional practice. Lawrence Erlbaum.

http://www.youtube.com/watch?v=s6Svp81lPhQ