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Can Applied Behavior Analysis (ABA) Cure Autism?

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Updated March 27, 2009

Question: Can Applied Behavior Analysis (ABA) Cure Autism?
I've read stories about intensive ABA "recovering" autistic children, but I've also heard that there is, as yet, no cure for autism. Which is true?
Answer: The following answer was supplied by researchers at the Lovaas Institute:

SHORT ANSWER

Both are true.

LONG ANSWER

In 2000, Dr. Lovaas wrote a paper entitled “Clarifying Comments on the UCLA Young Autism Project.” In it, he discussed the difference between the use of the word “cure” and “recovered.”

He states, "The term 'cure' implies removal of the original cause of the problem and because the cause of autism is unknown, claiming a cure would certainly be unjustified and unethical. In contrast, it is possible to enable a child with autism to achieve normal functioning without finding a cure for autism, just as it is possible for a physician to recover patients to normal functioning without having found a cure for their illness. Hodgkin’s disease is a case in point."

The term “recovered” was used in Table 3 of the Lovaas 1987 research article and within the text. Children included in this outcome group tested within the normal range for IQ and successfully completed first grade in a regular education classroom without an aide. Further, on the basis of testing, “the recovered children showed no permanent intellectual or behavioral deficits and their language appears normal.”

Whether or not the term “recovered” should be used to describe the children who obtained the best outcomes in the 1987 study continues to be debated. On one hand, Dr. Lovaas himself cautioned in the study that “…questions can be asked about whether the children truly recovered from autism” adding that “…certain residual deficits may remain in the normal functioning group that…can only be isolated on closer psychological assessment, particularly as these children grow older” (p. 8). On the other hand, in the 1993 follow up study, these same children were reassessed at 13 years of age. The recovered children were put through a more lengthy series of tests, including an examination of areas likely to be difficult for children with autism of average intelligence (compulsive or ritualistic behavior, empathy for and interest in others, a sense of humor). The study found that 8 out of 9 of the children continued to be successful in regular education classes and were indistinguishable from their peers on all of the tests that were conducted.

New testing measures continue to be developed. Recent examples include the ADOS -- Autism Diagnostic Observation Schedule -- and the Theory of Mind test. Ongoing evaluations will continue to support or clarify the use of the term “recovered.” For example, the 48% of children in the best outcome group from the 2005 replication research were tested using the Autism Diagnostic Interview-Revised, and parent and teacher rating scales were intended to look for “residual signs” of autism. Further, a follow-up evaluation with these tests is planned for the 29% of children in the best outcome group from the 2006 replication research. Finally, the children in the 1987 study have been followed into adulthood and an evaluation of their current status should be published in the near future.

Sources:

Cohen, Howard, Amerine-Dickens, Mila, Smith, Tristram. (2006). Early Intensive Behavioral Treatment: Replication of the UCLA Model in a Community Setting. Journal of Developmental & Behavioral Pediatrics, 27 (2), 145-155.

Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3-9.

Lovaas, O. I. (2000). Clarifying Comments on the UCLA Young Autsim Project. University of California, Los Angeles. Department of Psychology.

McEachin, J. J., Smith, T., & Lovaas, O. I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97 (4), 359-372.

Sallows, Glen O. & Graupner, Tamlynn D. (2005). Intensive Behavioral Treatment for Children with Autism: Four-Year Outcome and Predictors. American Journal on Mental Retardation,110 (6), 417-438.

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