Autism Reality

Evidence Based Autism Interventions

The expression “evidence based” is often encountered in discussion of autism treatments or interventions. Parents, government officials, professionals and researchers will use the expression when discussing the effectiveness of various interventions in treating or curing autism. A well known article in the Journal of the Australian Medical Association, linked on the sidebar of this blog site, is entitled “Autistic Children Deserve Evidence Based Intervention“. But what does the expression “evidence based” mean and which autism interventions, if any, meet the evidence based standard?

It is important for parents and political decision makers trying to determine what interventions to provide autistic persons to understand the concept of “evidence based” interventions. There have been many quack autism interventions offered both by self promoters and wishful thinkers. Such interventions waste valuable development time of autistic children, waste family and government funds, and in some cases, actually cause direct harm. Unfortunately there have also been those who are opposed to curing or treating autistic persons, those who wish to promote alternative interventions, or who wish to avoid expending public resources to provide treatment, who attack Applied Behavior Analysis (ABA) despite the quality and quantity of research supporting the efficacy of ABA as a health and education intervention for autistic children.

CAIRN, the Canadian Autism Intervention Network, defines “evidence based”:

By evidence-based, we mean the best available information based on scientifically rigorous research that produces consistent findings no matter how many times the study is repeated.

CAIRN also notes that there are substantial differences in the quality of evidence. It lists on its web site the characteristics of studies that provide high quality evidence.

Systematic reviews
A systematic review uses a clear and systematic method of finding and appraising relevant, high quality research studies whose combined results are used to answer a pre-determined question about treatment.

The strength of the systematic review is in its ability to combine data from studies of different populations in different settings to show if a treatment is widely applicable. By pooling data from patients in a number of studies, thus increasing the sample size, a systematic review can increase the reliability of the findings, showing whether a treatment actually works or may be useless or even harmful.

Randomized controlled trials (RCTs)
In RCTs, research subjects are randomly placed in one of two groups. One group receives the intervention that the study has been designed to measure; the other group (known as the control group) does not. The control group may receive a placebo, no treatment, or another therapy. Study participants (and ideally, the researchers) do not know to which group they have been assigned.

RCTs are considered the second strongest level of evidence for the effectiveness of a treatment. The strength of the RCT is that it helps ensure that the two groups under study do not have any important differences between them that could influence whether or not the treatment they receive works.

Controlled clinical trials (CCTs)
In a controlled clinical trial, one group receives a therapy and the other (control group) does not. As in RCTs, the control group may receive a placebo, no treatment, or another therapy. Unlike RCTs, however, the participants are not randomly assigned to each group.

With some populations, or in some situations, it is not possible to randomly assign participants to one group or another. CCTs still use a comparison group and efforts are made to ensure that the two groups do not have serious differences between them that could influence the results of the study.

Multiple and single case studies
In multiple and single case studies, subjects are tested to establish a baseline. They are then given an intervention, after which they are re-tested to determine what change, if any, has occurred.

Sometimes, especially when there is great variability in a condition, or small numbers of people with a condition, it is not possible to conduct research with two groups. In multiple and single case studies, the participants are used as their own comparison when they are given alternating treatments, or a treatment and then no treatment. Although not providing the same strength of evidence as an RCT or CCT, when done rigorously, these studies can yield valuable information about treatments.

In its February 2000 (Rev.) Autism Task Force Report the Maine Administrators of Services for Children with Disabilities (MADSEC) reported the results of its thorough review of the professional literature on educational interventions for autism. The MADSEC Task Force also interviewed leading practicioners of various autism interventions. It concluded that only one intervention met the standard of being an evidence based effective autism intervention – ABA.

• Substantiated as effective based upon the scope and quality of research:
Applied behavior analysis. In addition, applied behavior analysis’ evaluative procedures are effective not only with behaviorally-based interventions, but also for the systematic evaluation of the efficacy of any intervention intended to affect individual learning and behavior. ABA’s emphasis on functional assessment and positive behavioral support will help meet heightened standards of IDEA ‘97. Its emphasis on measurable goals and reliable data collection will substantiate the child’s progress in the event of due process.

……

Conclusions
There is a wealth of validated and peer-reviewed studies supporting the efficacy of ABA methods to improve and sustain socially significant behaviors in every domain, in individuals with autism. Importantly, results reported include “meaningful” outcomes such as increased social skills, communication skills academic performance, and overall cognitive functioning. These reflect clinically-significant quality of life improvements. While studies varied as to the magnitude of gains, all have demonstrated long term retention of gains made. Other major contributions of ABA to the education and treatment of individuals with autism include:

• a large number of empirically-based systematic instruction methods that lead to the
acquisition of skills, and to the decrease/elimination of aberrant behaviors;
• a technology for systematically evaluating the efficacy of interventions intended to affect individual learning and behavior; and
• substantial cost/benefit.
Over 30 years of rigorous research and peer review of applied behavior analysis’ effectiveness for individuals with autism demonstrate ABA has been objectively substantiated as effective based upon the scope and quality of science.

Since the publication of the MADSEC Autism Task Force Report there have been more studies confirming ABA as the most effective autism intervention. In “A comparison of intensive behavior analytic and eclectic treatments for young children with autism” published in Research in Developmental Disabilities, 26, (2005), pp. 359-383, the authors, Jane S. Howard, Coleen R. Sparkman, Howard G. Cohen, Gina Green, Harold Stanislaw reported the results of a non randomized comparison trial with three intervention groups of children with autism spectrum disorders. 29 children received one-on-one intensive behavioral therapy for 25 to 40 hours per week (IBT group); 16 received eclectic therapy (multiple treatment methods) with a teacher to student ratio of 1:1 or 1:2 for 30 hours per week (AP group); and 16 received a non-intensive, eclectic, small group, public early intervention program for 15 hours per week (GP group.) The study’s authors reported that 14 months after initiation of the interventions, the intensive behavioral therapy group scored significantly higher on all measures, with the exception of motor skills, where there was no difference among groups.

Alan Harchik, senior Vice President with the May Institute, has written an excellent article on the topic of evidence based interventions. Mr. Harchik describes evidence based standards and cautions against the use of the many treatments and interventions for autism that do not meet that standard including sensory integration, facilitated communication, auditory integration, chelation and hyperbaric oxygen treatments.

The term evidence-based practice is frequently used in the fields of science and medicine. It refers to procedures that have been tested using scientific research methods and shown to be most likely to produce positive results. This means that objective studies have been conducted using reliable data collection methods, consistent implementation of the treatments and the careful control of the research conditions.

The research findings are then published in professional journals after review by a panel of experts in the field.

Mr. Harchik, like the MADSEC Autism Task Force Report, concludes that ABA is the intervention with the most evidence supporting its effectiveness.

For children with autism, the procedures that have the most evidence supporting their effectiveness are those that use applied behavior analysis. …. applied behavior analysis methods include an assessment of the factors that are impeding learning or maintaining behavior problems, using positive rewards, teaching in small steps, using prompts and guidance, and collecting data to monitor progress.

The studies and expertise which provide evidence of the efficacy of ABA in autism intervention have not persuaded some who oppose the use of ABA interventions with autistic persons. Some will continue to insist on an unattainable standard being met before they will acknowledge the efficacy of ABA. For others though, for parents, professionals and government decision makers seeking to help autistic children now ABA, their only agenda is to find out what works, what really works, based on the best available evidence. To date, ABA is the only intervention for which claims of efficacy meet the high quality evidence based standard. That is why parents and sincere autism advocates try to obtain passage of legislation in Canada and the United States to ensure the availability of ABA treatment for autistic children.

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March 10, 2007 Posted by | applied behavioral analysis, autism, autism interventions, evidence based, Harchik, MADSEC, May Institute | 6 Comments

Mayo Clinic – No Evidence to Support Gluten Casein Free Autism Diet

An unidentified poster asked an expert from the Mayo Clinic whether there special diets, specifically Gluten Casein free diets can help children with autism. The Mayo Clinic per pediatrician Jay Hoecker, M.D., state clearly that there is NO EVIDENCE to support the effeciveness of gluten casein free diets. This one was popular when my son was diagnosed 9 years ago and we tried it for awhile and saw no benefit. Dr. Hoecker also emphasizes the potential harm from nutritional deficiencies that might arise from such a diet.

http://www.mayoclinic.com/health/autism-treatment/AN01519

There’s no evidence that special diets, such as restricting certain foods, are an effective treatment for autism.

Autism is a complex brain disorder that has no known cure. For this reason, many frustrated parents turn to unproven alternative treatments in an attempt to help their children. The most popular of these alternative treatments are diets that eliminate gluten or casein, or both.

Proponents of restrictive diets believe that casein, a protein found in dairy products, and gluten, a protein found in many grains, affect brain development and behavior, causing autism in some children. However, there’s no scientific evidence that this is true or that restricting these foods improves autism. Furthermore, restrictive diets can result in nutritional deficiencies in growing children.

Parents should talk to their child’s doctor before starting any alternative autism treatment. Although no cure for autism exists, early behavioral and educational interventions can help children with autism improve their communication and social skills.

January 27, 2007 Posted by | autism disorder, casein, diet, evidence based, gluten | 1 Comment

Progress and Challenges in the Behavioral Treatment of Autism

The Association for Behavior Analysis is sponsoring an Autism Conference in Boston next week with an excellent roster of speakers and topics on Behavioral Treatment in Autism. With so many myths and misconceptions about ABA and autism it looks like this conference could be very helpful for parents looking for professional guidance on how to improve conditions for their autistic children. The introduction for the conference program follows but the detailed list of speakers and topics can be found by accessing the ABA International web site at:

http://www.abainternational.org/autconf/downloads/Program_posters.pdf

Progress and Challenges in the Behavioral Treatment of Autism
Association for Behavior Analysis February 2 – 4, 2007 Boston Sheraton; Boston, MA

The diagnosis of Autism Spectrum Disorder in a child presents tremendous challenges for parents and educators. For several decades applied behavior analysis has provided the conceptual and empirical bases for designing and evaluating effective education and treatment programs for children with autism. It has been estimated that more than 550 articles have been published in the peer-reviewed literature reporting socially significant improvements in communication skills, social skills, academic skills, and adaptive functioning by children with autism as a result of behaviorally-based interventions. As the beneficial outcomes of behaviorally-based education and treatment have been reported by the media, the number of agencies and individuals offering “ABA services” for children with autism has grown exponentially. Inaccuracies and misconceptions in the popular media and in the professional literature about what applied behavior analysis is or is not and what it can or cannot achieve make it difficult for consumers and practitioners alike to separate fact from fiction.

In response to this situation, The Association for Behavior Analysis International is sponsoring the 2007 Autism Conference, Progress and Challenges in the Behavioral Treatment of Autism, to be held at the Sheraton Hotel in Boston on February 2-4, 2007. Planned with the support of ABA International’s Autism and Parent Professional Partnership Special Interest Groups, this conference will expose providers of home and school-based behavior analysis services, parents and family members, caregivers, researchers, teacher trainers, and students to the most current, scientifically validated information about behavior analysis in autism treatment.

The single-track conference will feature 14 invited presentations by prominent researchers and authorities on the treatment of autism and representatives from the May Institute and the New England Center for Children (past SABA Awardees for Enduring Programmatic Contributions to Behavior Analysis). The conference will also provide a forum for over 170 autism researchers to share their recent work in two poster sessions. The conference will close with a Round Table discussion by representatives of ABA International’s organizational members. The conference will provide many opportunities for personal exchange with researchers, presenters, and organizational members of ABA International.

January 26, 2007 Posted by | aba, autism, autism disorder, education, evidence based, scientific, treatment | Leave a comment

Autism Interventions Over the Internet

The Canadian Senate committee examining autism funding heard testimony from an autism expert, Dr. Jeannette Holden, in which Dr. Holden advocated the use of computer technology to alleviate the problem of providing autism intervention services to families of children with autism. Dr. Holden referred specifically to Virtual Experts Clinic a company which produces an online program called Autism Pro. Dr. Holden stated that Autism Pro “is not meant to replace therapists, but gives parents on waiting lists a chance to start doing something with their children.”

The waiting list problem for autism interventions is a serious problem in most areas of Canada and if a child is not actually involved with a therapist then in one sense it could not be said that parents would be replacing therapists by relying on an internet program to provide their own intervention for their children while they wait for the assistance of actual therapists. In a different sense, however, parents providing interventions are in fact performing the functions of, and thereby replacing, therapists. The parents who provide such interventions may or may not have any training or supervision while they are doing so. As a parent I understand fully that a parent will probably not want to sit back and wait for a therapist to become available to work with their child. Non-professional intervention though raises the question of potential harm from improperly provided interventions.

Virtual Experts Clinic originated in New Brunswick. As an active member of the autism advocacy community in New Brunswick I have met its creator, Ms. Cynthia Howroyd and had the opportunity to review Ms. Howroyd’s proposal in 2003 when it was in a more conceptual stage. The concept was presented to an autism steering committee established at the University of New Brunswick of which I am, and was at the time, a member. I had several concerns about the concept which I still hold.

1) Environment – as a parent of a profoundly autistic 11 year old boy I know that his environment is a critical factor in understanding his behavior and potential negative influences on his behavior. It is difficult to assess and analyze problem behavior from a distance without actually viewing, hearing, touching or smelling the environmental factors that might bother my son at a given point. Even being present in that environment it is not easy since he is much more sensitive to environmental stimuli than I am. The program of course relies upon the input of the parent or professional who is using the program and presumably has taken the environmental factors into account in analyzing the behavior. But with the transfer of that input to a program written by experts on a generic basis the possibility for an improper analysis and recommendation would seem to me to be greater.

2. Accountability – if interventions are not done properly at any stage will Virtual Experts or the experts who provide the input for the program be held accountable at least to their professional bodies and if so in what jurisdiction? It is not clear that users will have any real recourse for problems that might arise from use of the program – other than a return of funds which may be small consolation if a child has regressed as a result of improper intervention. While Autism Pro adverises a no-risk trial that no-risk claim clearly refers to fees paid not to risk of harm or delay in a child that might result from use of Autism Pro:

No Risk TrialVirtual Expert Clinics Inc. will refund the full value paid for AutismPro if you are not satisfied with the program within 30 days of receipt. If you wish to cancel your subscription after 30 days, a refund payment will be prorated at the monthly price paid in advance, based on the number of months remaining on your subscription. We do not require a reason for cancellation or any advance notice.

http://www.autismpro.com/

3. Non-evidence Based Interventions

In the Autism Pro press releases Ms. Howroyd states that Autism Pro uses evidence based interventions. “Because AutismPro is online intelligent software and because it integrates the full range of evidence based interventions in autism it is also a powerful tool for researchers to collect data on intervention choices and related outcomes for different children.”

http://ww1.prweb.com/releases/2006/12/prweb489594.htm#

The problem I have with that statement is that, to my knowledge, only one intervention, Applied Behavior Analysis, is considered to have met the standard of evidence based intervention for autism. See for example the MADSEC Autism Task Force Report and the Association for Science in Autism Treatment. Most of the experts and expertise associated with Autism Pro are not ABA oriented.

http://www.madsec.org/docs/ATFReport.pdf#search=%22madsec%20report%22/
http://www.asatonline.org/resources/informedchoice.htm

4. Potentially Ineffective Use of Scarce Resources

I became aware of the conceptual precursor to Autism Pro shortly after the New Brunswick Provincial government announced on April 1, 2003, that it would provide funding for some autism services. Ms. Howroyd sought out various autism organizations in New Brunswick shortly thereafter to present her idea for an internet based answer to the demand for autism intervention assistance. More recently, a motion has been passed in the House of Commons calling for a National Autism Strategy and Virtual Experts has lost no time in positioning itself as a potential recipient of funding resources in connection with the motion as one of their press releases shows:

A private members motion put forth by New Brunswick Liberal MP Andy Scott calling for the federal government to develop a national autism strategy was passed on December 5. On December 7, the United States senate unanimously passed a bill authorizes nearly a billion dollars in spending for autism research and programs.”

http://ww1.prweb.com/releases/2006/12/prweb489594.htm#

I think it is unfortunate that Dr. Holden has chosen to publicly endorse and enthusiastically support Autism Pro in such a high profile environment as the Canadian Senate Committee studying autism funding given that she is still conducting a research study using Autism Pro.

Dr Holden is currently undertaking a research trial consisting of 46 families across Ontario, including 63 adult care providers and 52 children aged 2 to 9, using AutismPro. The study is being done in partnership with Autism Ontario and Autism Spectrum Disorder – Canadian American Research Consortium (ASD – CARC) out of Queen’s University. Participants have been provided with a one year subscription to the program.”

http://ww1.prweb.com/releases/2006/12/prweb489594.htm#

It is difficult to see how Dr. Holden, despite her expertise, will be able to remain detached and objective in her conduct of the study given that she has already publicly endorsed the program which she is using in the study. Technology is glamorous and we live in an era when information technology increasingly dominates our lives and decision making. This blog site itself would have been unimaginable a few short years ago. Maybe Autism Pro will provide real solutions to autistic children. I am sure that there will be tremendous pressure exerted on government to provide more funding to Autism Pro than it has already received from organizations such as the New Brunswick Innovation Foundation. Since resources are not unlimited choices will be made about which options receive funding, to what extent, and which do not. Hopefully the decisions will be made carefully and not on the basis of trendiness, glamour or high pressured PR campaign. Autism Pro press realeases constantly tout parental support for the program. As a parent my experience makes me much more cautious. My experience tells me that autism intervention is a very personal face to face matter.

For now, anyway, this parent is not convinced – I am still not Pro Autism Pro.

January 25, 2007 Posted by | autism, autism disorder, evidence based, internet, national autism strategy, senate, technology, therapy | Leave a comment

Jason Oldford Testifies Before the Canadian Senate Committee Studying Autism Funding In Canada

Jason Oldford is a person with autism who served on the Board of Directors of the Autism Society of New Brunswick for several years where he played a key role. On December 6, 2006 Jason Oldford testified before the Standing Senate Committee on Social Affairs, Science and Technology which was meeting to consider the inquiry on the issue of funding for the treatment of autism in Canada. Jason’s testimony was recorded in Hansard:

Jason Oldford, as an individual: I am honoured to address this committee. I was diagnosed with autism in 1974 when not much was known about it. I will tell you a bit about myself. I will not take long. I have quite a few things to say about funding for treatment.

I still have a few weaknesses with my autism. Eye contact is one of them. My social skills are not perfect. They are not up there with a typical person either.

On the plus side, my language developed normally. I was able to read by the age of three. I know trivial matters that other people would not dream of knowing. I tend to interpret things literally sometimes.

I have two university degrees and I attended public school with all the other children. I was not put in a special education class.

The reason I accepted the invitation to appear before this committee was to tell you what I would like to see. I would like to see severely autistic people become more like me, or more like others like me, to become more high-functioning. It can happen. I believe it.

There are about 100,000 people affected by some form of autism across Canada. When their parents received the diagnosis, immediately the research started looking for a treatment. They came across this ABA, applied behavioural analysis. It is the only evidence-based treatment that is available. The only drawback is that it is expensive. They cannot afford it. For that reason, they go to the respective provincial governments and try to get them to do it. It has not worked out the way they planned.

Autism is a life-long disorder. There is no cure. There are several treatments. Only one is evidence-based. There is no cure.

The key is early intervention, early diagnosis, and early detection. If treatment is started immediately upon diagnosis, or soon thereafter, within three or four years a child could enter school and perhaps not need ABA. He could go on, get a high school diploma, get university degrees, and be able to contribute to society.

I was pleased yesterday when I heard that the House of Commons had passed motion M-172, for a national autism strategy. I turned 36 yesterday. That news would rank up there with one of the best birthday presents I could receive.

The provinces worry about resources and having to live within their means. I understand the provinces have to live within their means. That is where the federal government comes in and helps out. If the federal and provincial governments put their heads together and work this thing out, a solution can be reached in the autism treatment situation we have in this country, in every province and territory.

There is a concern about having autism treatment funded under medicare. I am in favour of that. Ultimately, it is up to the provinces and territories. Each one has its respective medicare plan. Should any provinces decide not to fund this treatment under medicare, not only do I think they are making a mistake, I think they should find some place in their respective budgets to fund that treatment.

You also come to the issue of education. We need therapists certified in ABA. We need people in our schools trained to deliver ABA to autistic students. We need enough so that there are no waiting lists.

I have heard stories about people who have tried to get into speech and occupational therapy; some have told me were on a waiting list for months or years. Others are still on waiting lists. That is a problem that needs to be addressed and solved.

ABA is an expensive treatment. You have probably heard the figure $60,000 per year per child. It is derived from 52 weeks a year at 40 hours a week at $30 an hour.

Parents put themselves on the verge of bankruptcy when they have to pay for that treatment out of pocket. I certainly understand the situation they are in. I am amazed they can cover the treatment they need for their child and still pay the bills. How they do it, I do not know. Somehow, they get it done.

Early intervention, detection and diagnosis, can lead the way to a child’s achieving his or her full potential, to become productive in society. If Ottawa and the provinces work together, we could have a solution.

As was mentioned, ABA is not perfect. According to studies, only 47 per cent of those tested were indistinguishable, but 47 per cent is a lot better than zero.

If provinces and the territories and the federal government all work together on this, it will lead to solutions. None of the world’s problems was ever solved by arguing; none of the world’s problems was ever solved by doing nothing; none of the world’s problems was ever solved by worrying.

If Ottawa can get together with the provinces and territories and come away with a solution — and I am confident that they can; I am confident that they can accomplish this — just think of how many children will not be in group homes or institutions. Think of how many children will be able to contribute to society if they get this treatment. With the provinces and Ottawa working together, I know that can happen.

..

Mr. Oldford: Yes, I was recommending federal leadership with the federal government and the provinces agreeing on something to fund evidence-based treatments. The bill that was passed yesterday talked about evidence-based standards. That is good. It talks about developing innovative funding methods, and that is good too. I read an explanation that said that that means that the provinces, territories and federal government discuss how to fund evidence-based treatment.

The only evidence-based treatment that currently exists is ABA, but there may be more to come. Judging by what I have read, I think that sooner rather than later ABA will have company in the evidence-based treatments category. If any other evidence-based treatments were to come up I would support those, too, especially if they cost less than ABA does.

The governments must agree on how to fund a treatment that is proven to be scientifically validated and evidence-based.

Mr. Oldford: I agree with every word that Ms. Harrisson. I do not have any statistics on the number of adults that are autistic, that are in group homes or that are in institutions. I would say that a small number of autistic adults are in group homes or in institutions. I could be wrong, but I do not think there are that many.

When you read about autism, you read about autistic children. Autism is diagnosed during childhood. Some of the higher functioning types of autism can be diagnosed in adolescence or even adulthood.

Adults still need treatment. In the last session one of the things they discussed was age restrictions. I do not think there is any need to have them; they are discriminatory. Once a child turns five or six years old and still needs treatment, they should not be cut off. They should still get the treatment. If someone is diagnosed as an adult and needs treatment, they should get the treatment.

Getting back to housing, as I mentioned earlier, whoever works with autistic people in group homes and institutions has to have the proper training and has to know how to deal with autism. If they do not, it is not a good situation. There is also a need for proper housing for people with autism, not just in my home province of New Brunswick, but in every province across Canada.

The Chairman: Do most people with ASD live at home with parents or do many live on their own?

Mr. Oldford: I would say a good number of them live with their parents. I lived with my parents until this past July when my brother and I bought a house. I would think that most autistic people do live at home.

That brings us to another issue: employment. When they become adults, most people with autism are either unemployed or underemployed, which is the reason they live with their parents or in group homes. They do not make enough money to be self-sufficient. It is a bad situation. That should be discussed, too, when they discuss the treatment issue.

..

Senator Munson: There seem to be more and more diagnoses of autism; one in 166 is the new figure. With these diagnoses, we either pay now or later, and pay big later. We will have the statistics on homes like this if this keeps up this way. Do you agree?

Mr. Oldford: I would have to agree with that. I have heard people fighting for treatment telling the governments that, as you said, Senator Munson, the governments can pay now or pay later. We understand this treatment is expensive, but if you pay for it now, look at the return you will get on your investment. The people with autism will get out in the real world and get jobs, and that will stimulate the economy. Or you can pay later, which means they will go into group homes and it will cost the taxpayers a lot of money in the long run to keep them there.

..

Mr. Oldford: We do need more autism awareness. As Mr. Hooker has mentioned, many people look at us as low-functioning people because they view autism that way. They see it on television and read about it in the papers. They think, “Boy, I am glad I do not have a child like that.” Even in the most severe cases, autism is not the end of the world.

One way to promote awareness is through columns in newspapers and television appearances, as Mr. Hooker said. I would add that perhaps more people with autism spectrum disorder could be invited to speak at conferences. One of the measures that the government announced last week in its autism strategy was that there would be a national autism symposium next year. At that national symposium I would like nothing better than to see people with autism being invited to speak.

Mr. Oldford: Education is required for teachers and employers. However, as for team work, people with autism prefer to work alone. Sometimes when you put people with autism into a team setting they can become a bit temperamental and a bit hot under the collar. It could be because the other team members do not agree with the suggestions, or for other reasons. On the school front, there have been stories about even the most high-functioning students becoming aggressive. It is not their nature but it happens when they are frustrated at not being able to communicate their feelings appropriately. In many cases, teachers will send those students to the principal’s office, put them on detention, suspend them from school or send them home for the day, which is an inconvenience these days for parents because in most families, both parents work outside the home.

Employer and teacher education is needed when it comes to autism and how to deal with it. They need to know how to deal with situations that arise that could be caused by the autism.

Mr. Oldford: Sometimes I do find myself in a situation of the type you mentioned. More often than not, it is advising parents of autistic children. Basically, all I give them is words of encouragement. I am in no position to tell them how to raise their children.

There is quite a large autistic population, even in a small province like New Brunswick. The only advice I give them is just do not give up the fight.

January 23, 2007 Posted by | aba, ASNB, autism, autism disorder, autism education, employment, evidence based, health care, New Brunswick, residential care, treatment | Leave a comment

School Inclusion Can Be Abuse

School inclusion ‘can be abuse’. That is the title of a BBC on line story which includes a report on a recent study of the British inclusive education system prepared for that country’s National Union of Teachers “The Costs of Inclusion” by John MacBeath, Maurice Galton, Susan Steward, Andrea MacBeath and Charlotte Page, published by University of Cambridge Faculty of Education. Professor John MacBeath of Cambridge was interviewed and stated that placing some students in a mainstream classroom could be seen as a form of abuse:

Physically sitting in a classroom is not inclusion. Children can be excluded by sitting in a classroom that’s not meeting their needs.” The typical secondary school timetable – rushing from physics, to history then French, say – was for some children as bewildering as being “on another planet”. “You might call it a form of abuse, in a sense, that those children are in a situation that’s totally inappropriate for them.” Professor MacBeath also indicated that the report is not “anti-inclusion” , just that mainstream classroom inclusion is not appropriate for all students, particularly those with complex needs.

The BBC story and the “Costs of Inclusion” report can be found at:

http://news.bbc.co.uk/2/hi/uk_news/education/4774407.stm

http://www.teachers.org.uk/resources/pdf/CostsofInclusion.pdf

I have personally argued against placement of all autistic children in mainstream classrooms as has the Autism Society New Brunswick which asks that the school system look at what works for each individual child. If a child does not learn in, and is overwhelmed by, a mainstream classroom then he or she should not be placed in that environment. A quieter environment is necessary for some autistic children who also require more individualized instruction. Flexibility in choice of learning environment is needed. Some autistic children are capable of learning in a mainstream classroom. Some are not. It is critically necessary to examine the evidence and see what works for the individual child. Failure to place an autistic child in the right learning environment because of a rigid adherence to the philosophy of mainstream classroom inclusion for all may constitute abuse.

http://news.bbc.co.uk/2/hi/uk_news/education/4774407.stm

January 16, 2007 Posted by | autism, autism education, education, evidence based, inclusion, philosophy | 3 Comments