The Efficacy of Intensive Behavioral Intervention for Children with Autism: A Matter of Allegiance?

Excerpt

Intervention programs based on applied behavior analysis (ABA) are currently viewed as the first line treatment for autism spectrum disorder (ASD) in early childhood (Vismara and Rogers 2010). Apart from beneficial effects on a group level, studies have consistently shown large variation in individual gains. Several factors have been suggested to explain this differential response, including child characteristics, intensity of training and level of trainer fidelity to the protocol. Despite scientific evidence, ABA treatment methods as well as goals remain controversial. The structured nature of the intervention program and use of reinforcers can be uncomfortable for parents and trainers in pre-schools. Previous psychotherapy research in adults has shown that therapist allegiance to treatment techniques is linked to the gains achieved (McLeod 2009). It is not unlikely that trainer allegiance to ABA treatment, and thus fidelity to the treatment protocol, is a crucial mediator of ABA efficacy and treatment outcome variation, respectively. …