For many years the outlook for autistic individuals has generally been considered to be poor, with, most requiring lifelong protection and supervision. However three decades of scientific research and extensive clinical experience have convincingly demonstrated that intensive, early, behavioural intervention can significantly improve the functioning of autistic children, and recent studies have shown that quite dramatic and lasting improvements can result.
A groundbreaking study by Dr. Ivar Lovaas (1987) showed that with intensive, early, behavioural treatment 47% of treated children made such substantial improvements that they were able to attend regular schools, without the assistance of integration aides. These children achieved normal intellectual and educational functioning and could not be distinguished from their peers. A follow-up study several years later showed that the gains they made persisted into adolescence (McEachin, Smith and Lovaas 1993). A study done in Australia, at Murdoch University (Birnbrauer, Leach 1993), also showed encouraging results, with substantial gains made by almost half the children involved.
The treatment utilised the principles of Applied Behaviour Analysis (ABA) , a scientific method of enhancing appropriate and useful behaviours and reducing problematic ones. Every skill is broken down into small, discrete steps and taught in a precise and systematic way (discrete trial training). This approach was applied by Lovaas in an intensive manner, with therapists working one-to-one with children at home, many hours per week.
The treatment program focuses on all the skills a person needs to be able to function successfully and to enjoy life to its fullest. Language, social skills, play skills, academic skills and self-help skills are all addressed. Children are actively taught, for example, how to pay attention, imitate, use communicative language which is appropriate for the child (e.g. verbal or through picture communication), show and receive affection, and relate to other children - things that most children do not formally need to be taught. Even spontaneity can be taught!
The overall therapy experience for the child is designed to be a positive and enjoyable one, and most importantly - fun! Although the best outcomes seem to occur in those children who start treatment when very young (under 4 years of age) this form of therapy can still be effective for older children and children of all levels. Outcomes will vary, and not all children will make major gains. However, meaningful improvements can be achieved in many important and useful areas, and all can benefit.
At present, embarking on intensive ABA therapy is not easy. There are no established centres in Australia which run such programs. It is a time-consuming and often costly exercise, as families must employ experienced professionals to set up and supervise their programs, recruit assistants to work with their child, and play an active role in the progress of the program itself. Costs can be reduced by the use of volunteers, and some families have found various sources of funding assistance.
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