Dounavi, Katerina

Autism defies the entire world and has still not yet delivered all its secrets. For this reason, it is the subject matter of many different ideologies, treatments, debates and qualifications, which often do not thoroughly consider advances in international research.There are no borders in autism; it touches upon all social classes in different countries around the world.This is why the association VAINCRE L’AUTISME and its scientific committee wish to put forth the current state of international scientific knowledge on autism through the publication of this White Paper, which consolidates leading scientific research on autism from around the world.The objectives of this international and scientific document are to provide current data from science and medicine in the subject of autism, to be a document of quality and a reference, and to be informative and comprehensible for everyone. It is intended to be useful and accessible to all, from individuals and families touched by autism, to European and international governmental bodies.We intend for this document to be widely used and to be translated into different languages in order to bring about an international collective awareness of autism, as is the case for all serious conditions of public health concern worldwide.We express our heartfelt gratitude to the different researchers and clinicians who contributed to this document, which is of interest to public health and to the enhancement of the human condition without borders

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The science of Applied Behaviour Analysis as the basis for effectiveautism treatmentDounavi, K. (2018). The science of Applied Behaviour Analysis as the basis for effective autism treatment. In R.L. Hendren (Ed.), Autism Spectrum Disorder (ASD) Scientific and International White Paper: A Critical Review ofthe Evidence for the Etiology, Diagnosis and Treatment (pp. 33-34). Vaincre l'Autisme.Published in:Autism Spectrum Disorder (ASD) Scientific and International White Paper: A Critical Review of the Evidence forthe Etiology, Diagnosis and TreatmentDocument Version:Publisher's PDF, also known as Version of recordQueen's University Belfast - Research Portal:Link to publication record in Queen's University Belfast Research PortalPublisher rights© 2018 Vaincre L'Autisme.This work is made available online in accordance with the publisher’s policies. Please refer to any applicable terms of use of the publisher.General rightsCopyright for the publications made accessible via the Queen's University Belfast Research Portal is retained by the author(s) and / or othercopyright owners and it is a condition of accessing these publications that users recognise and abide by the legal requirements associatedwith these rights.Take down policyThe Research Portal is Queen's institutional repository that provides access to Queen's research output. Every effort has been made toensure that content in the Research Portal does not infringe any person's rights, or applicable UK laws. If you discover content in theResearch Portal that you believe breaches copyright or violates any law, please contact openaccess@qub.ac.uk.Download date:05. Apr. 2019VAINCRE L’AUTISME  - 2018 (ASD – TSA)IX.The science of Applied Behaviour Analysis as the basisfor effective autism treatmentKaterina DOUNAVI 33According to recent estimates, 1 in each 59 new-borns will be diagnosed with Autism SpectrumDisorder (ASD) in the USA (Centers for Disease Control and Prevention, 2018). Data in Europe arescarce and indicate that 1 in 159-333 children will receive an ASD diagnosis (European Commission,2005), with the majority of European countries not availing of direct population data. Interestingly,research in the USA has shown that prevalence may vary significantly between states of the samecountry with the number of children identified with ASD ranging from 1 in 77 in Arkansas to 1 in 34in New Jersey (Baio et al., 2018). The lack of population-based rates internationally (Kim et al.,2011), which results in estimated rates rather than real figures, firmly supports the need for furtherpopulation studies to be conducted.Individuals diagnosed with ASD share a set of characteristics at varying levels of severity:impairments in social communication skills and the presence of restricted interests and repetitivebehaviours (American Psychiatric Association, 2013). As many as 31% of all children with ASDpresent a co-occurring intellectual disability (Baio et al., 2018), while about 30% are minimally verbal(Tager-Flusberg & Kasari, 2013). When looking at adults with ASD, only 16% of them are in full-timepaid employment, with 32% reporting being in some kind of paid employment (The National AutisticSociety, 2016). Clearly, the social impact of ASD on the overall health and wellbeing of both peoplewith ASD and their families is enormous.ASD appear before the age of 3 with many signs being observable from the first year of life andothers appearing around the age of two years, including those presented in children who seem todevelop typically until approximately the age of two and then regress in previously acquired skills(Maestro et al., 2005; Zwaigenbaum et al., 2005). Research data show that a diagnosis of ASD can begiven reliably to 2-year old children (Robins, n.d.) but parents and important others may haveobserved the first signs and started worrying even before the child’s 1st birthday (Stone, Coonrod, &Ousley, 2000; Zwaigenbaum et al., 2005). Unfortunately, the formal diagnostic process takes severalmonths, with as many as half of all children with developmental delays in the USA not beingidentified until they reach school age (Glascoe & Marks, 2011). Receiving a late diagnosis poses agreat obstacle to accessing early intervention that enables children to reach their full potential (Feinet al., 2013; Howlin, Magiati, & Charman, 2009; Klintwall, Eldevik, & Eikeseth, 2015). Establishing auniversal procedure for screening and reaching an early diagnosis would therefore be extremelybeneficial. For this, a number of reliable screening and diagnostic tools have been developed, someof these based on caregivers’ reports, others requiring a clinician (Bryson, Zwaigenbaum,McDermott, Rombough, & Brian, 2008; Gray, Tonge, & Sweeney, 2008).VAINCRE L’AUTISME  - 2018 (ASD – TSA)In the last decades, a wealth of studies employing varying methodologies (i.e., systematic reviews,meta-analyses, randomised controlled trials, and single-subject research designs) have evidencedthat behavioural interventions, especially when applied early in life, can lead to optimal outcomesfor children with ASD, including significant gains in cognitive ability, social communication andadaptive behaviours (Dawson et al., 2012; Hardan et al., 2015). These behavioural strategiesemployed by well-trained educators and parents enable individuals with ASD to reach their fullpotential, promote generalisation of acquired skills and ensure cost effectiveness (Behavior AnalystsCertification Board, 2014).Applied Behaviour Analysis (ABA), the science that studies socially significant human behaviour(Cooper, Heron, & Heward, 2007), constitutes the basis of the most effective interventions forautism to date (Virués-Ortega, 2010), while lack of ABA has been shown to correlate withdependence in adulthood (Howlin et al., 2014). Some of the numerous strategies employed in ABA-based interventions are naturalistic teaching, discrete trial training, functional assessment, the use ofpictures for communication, shaping, and chaining, among other. What is common across all ABA-based interventions is that only scientifically validated teaching procedures are used for skillsacquisition and the reduction of challenging behaviours, most of which are based on reinforcement;treatment is individualised; decisions are data-driven; and continuous assessment of progress acrossdevelopmental areas determines ongoing needs and individualised learning goals. Multidisciplinarywork and collaboration across stakeholders and settings is of paramount importance (Dillenburger etal., 2014).From a human rights’ perspective, individuals with a disability including ASD should have thefreedom to make their own decisions, fully and effectively participate in society, be respected andaccepted, and enjoy equal opportunities (United Nations, 2007). Given the impact of ASD on oursociety constitutes a pressing need, an ethical response would necessarily involve universal access toevidence-based education that enables individuals to reach their potential. Evidence-based effectiveeducation for ASD is synonymous to ABA-based interventions (Keenan et al., 2015).34

The science of Applied Behaviour Analysis as the basis for effective autism treatment

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The science of Applied Behaviour Analysis as the basis for effective autism treatment

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