31.01.2013

Dr. Jacqueline J. Schenk

School of Pedagogical & Educational SciencesErasmus University Rotterdam

The Netherlands

ABA ABA IN THEIN THE

NETHERLANDSNETHERLANDS

OutlineOutline• Diagnosis and prevalenceDiagnosis and prevalence• Demand for behavioural interventions for Demand for behavioural interventions for

people (of all ages) with autism in the NLpeople (of all ages) with autism in the NL• Recent change in health care and educationRecent change in health care and education• ABA-based services in the NL: study resultsABA-based services in the NL: study results• ABA training and education in the NLABA training and education in the NL• ConclusionsConclusions

Diagnosis of AutismDiagnosis of Autism

The NetherlandsThe Netherlands

Diagnosed autism is more common in an IT-rich region, such as Eindhoven (Philips, ASML, IBM and ATOS Origin)Roelfsema et al. (2011) J Autism Dev Disord

Why this increase?Why this increase?• Early diagnosis and screening• More (scientific) knowledge of predictors and early warning signals• Worldwide • Boys: 1:54, girls: 1:252• The Netherlands: 1:100 on average..

After the diagnosis…..in NL

??

•Bereavement groups•Psycho-education•Parent groups for support•Random/inappropriate professional advice regarding effective behavioural interventions

After the diagnosis (anecdotal)

• 10 ABA (-ish) organisations• Questionnaire (structural characteristics)– Mission; claimed intervention characteristics

staff:child ratio; educational background of staff; no. of hours per child (av/range); number of trainers per child; educational context; materials; admission & exclusion criteria, parent involvement etc.

• Behavioural observations on site – To validate (or not) characteristics of interventions

Time to collect some data…

• DTT (Discrete Trial Training)DTT (Discrete Trial Training)• PRT (Pivotal Response Treatment)PRT (Pivotal Response Treatment)• SonriseSonrise• Verbal Behavioural InterventionVerbal Behavioural Intervention• TEACCH (Treatment and Education of Autistic and TEACCH (Treatment and Education of Autistic and

Handicapped Children)Handicapped Children)• CGT (Cognitive Behavioural Therapy)CGT (Cognitive Behavioural Therapy)• PECS (Picture Exchange Communication System)PECS (Picture Exchange Communication System)• Bits and pieces from all of the aboveBits and pieces from all of the above(Neidt & Schenk, (Neidt & Schenk, Wetenschappelijk Tijdschrift voor AutismeWetenschappelijk Tijdschrift voor Autisme, , June 2012June 2012))

Used in the NL (in theory)Used in the NL (in theory)

All had the same mission (i.e. optimal development)All had the same mission (i.e. optimal development) Similar in 1:1 training, all private, all working many Similar in 1:1 training, all private, all working many

hours, all working in isolationhours, all working in isolation Huge differences in structural characteristics Huge differences in structural characteristics

Educational background of staffEducational background of staff Supervision and IRR proceduresSupervision and IRR procedures No of staff working with each childNo of staff working with each child No of children attending the service (range 1-75, No of children attending the service (range 1-75,

av. 20)av. 20) Criteria for masteryCriteria for mastery Parental involvementParental involvement

(Neidt & Schenk, (Neidt & Schenk, Wetenschappelijk Tijdschrift voor AutismeWetenschappelijk Tijdschrift voor Autisme , , June 2012June 2012))

In reality?In reality?

Recent developmentsRecent developments• Parents increasingly demand ABA based interventions at all levels of (pre) education• Increasing number of organisations offering “ABA” services of variable quality and cost (!)• “ABA” services approach us to carry out effectiveness studies

WHY?WHY?• Parents appear to read more than professionals• Schools now responsible for EO• “ABA “ services will not be paid by health care system if they don’t provide evidence for effectiveness• Teachers working in inclusive schools lack knowledge and training on “behaviour”

Compared to many other Compared to many other countries in Europe, countries in Europe, we are very behindwe are very behind

8 Dutch universities8 Dutch universities8/8 offering Psychology, 8/8 offering Psychology, Pedagogical and/or Educational Pedagogical and/or Educational sciences at BA and MSc levelsciences at BA and MSc level0/8 offering ABA training0/8 offering ABA training

Education & training in NL

ConclusionsConclusions……• Hardworking professionals and parents Hardworking professionals and parents

of children with autism, but… of children with autism, but… • Eclectic use of early behavioural ABA-based Eclectic use of early behavioural ABA-based

interventionsinterventions• Lack of professional academic training and ABA Lack of professional academic training and ABA

consultancy opportunitiesconsultancy opportunities• Lack of funding Lack of funding despite despite the conclusion by the conclusion by

Ministry of health (Gezondheidsraad, 2009) Ministry of health (Gezondheidsraad, 2009) about its effectiveness and need for evidence-about its effectiveness and need for evidence-based practicebased practice

The STAMPPP ProjectThe STAMPPP Project• Simple Steps in Dutch !-> Simple Steps in Dutch !-> Parental testimonies,

animations, demonstrations, and textural material to teach ABA principles to Dutch parents, professionals, students etc.• Maximises learning opportunities for children with

autism• Enables parents to become proficient in delivering

home programs for their children• Facilitates the coordination of child learning

opportunities at home and school

THANK YOU!

schenk@fsw.eur.nl