by caitlin labarbera aba 553 assessing autism interventions the appeal of unvalidated treatments
TRANSCRIPT
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BY CAITLIN LABARBERA
ABA 553 ASSESSING AUTISM INTERVENTIONS
The Appeal of Unvalidated Treatments
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Introduction
With the rise of autism and other developmental disabilities there is a new claim for a cure around every corner.
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Introduction
With all these new “fad” treatments, we as professionals need to be able to identify interventions that are both validated and
plausible.
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Validated Treatments
Scientifically Valid Treatments Involve Increasing skills in specific areas Improving functioning in every day
situations Contain controlled studies Consistent with previous knowledge
Treatments with solid scientific support: Applied Behavior Analysis Psychotropic Medication
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Unvalidated Treatments
Pseudoscientific Treatments
Interventions that are considered to have little to no scientific basis
Appealing because they are advertised as Cures Fast and Easy “Deeper” Benefits Natural
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How can you determine if a treatment is both validated and plausible, or if it is
just another fad?
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Red Flags
Tristram Smith gives us several key pointers on picking out Scientifically Valid Treatments while weeding out
Pseudoscientific Interventions.
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CureMiracle
Breakthrough
Revolution
HEALING
Remedy
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We found a cure…
Popular interventions that “found a cure” included:
Facilitated Communication Auditory Integration Training Gentle Teaching
All were found to be infective and some proved to create problems instead of eliminating them.
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Important Sounding but Vague Benefits
Enhanced Learning
Increased Focus
Improved Body Awareness
Reduced Tactile Defensiveness
A Greater Well-Being
A Better Sense of Self
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Important Sounding but Vague Benefits
Lack scientific evaluations
Lack controlled studies
Benefits are so vague that testing them would be difficult if not impossible.
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http://www.youtube.com/watch?v=8JdDU0Ql8EI
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Controlled vs. Uncontrolled Studies
ABA and Psychotropic Medication – Scientifically rigorous and controlled studies
Unvalidated treatments – Make no distinction between rigorous and nonrigorous studies Uncontrolled Lack objective measures
Megavitamin Therapies
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Technology
Technology has extraordinary uses in science but having technology in a treatment does not mean that the treatment is ligament.
Is the technology used reliable and does it support the study?
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Criticisms of Validated Treatments
Criticism may be used to justify implementing their own interventions
Using criticism to hide one of their own faults
“Criticisms of one treatment or its practitioners do not constitute evidence for the effectiveness of another treatment (Smith 2005) .”
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Subjective Evidence
Unvalidated interventions tend to rely on Testimonies from parents Case studies Surveys Popularity Longevity
These things cannot be substitute for a controlled study
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http://www.youtube.com/watch?v=3qR6aDkVjYY
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Example: Diets – Eliminating Dairy and Wheat.
Is it really the diet? Parents desire to see gains Protein deficiency Spending more time with child Deprivation – Motivation Other environmental changes
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Core Deficits
Once the deficit is corrected there will be global improvements in functioning
Two believed deficits include: The lack of ability to form reciprocal relationships Problem in processing or sensory input
Proposing that changes in one behavior will by itself lead to changes in other behaviors goes against a large body of research on humans and other organisms in both clinical and laboratory settings (Detterman&Sternberg,1995).
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Natural Therapies
“Natural Therapies” Special diets to eliminate food additives Cut out wheat a dairy Chelation therapy Antifungal medications Shunning vaccinations
“Natural” does not mean safe or effective.
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Treatment Combinations
Treatments are often combined in hopes to accelerate and maximize treatment
Some treatments encourage combinations Megavitamins
Reality - combining treatments have no effect and can even reduce effectiveness of treatments.
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Experimenting
Implementing a new treatment First, make only one treatment change at a
time Second, Identify specific target behaviors Use objective measures to obtain a baseline Finally, monitor changes in the target
behavior on an on going basis with objective measures obtained by raters who are blind to treatment.
• HYMAN AND LEVY (2000)
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http://www.youtube.com/watch?v=qbhkX2oBmJY
What would be appealing?How many red flags can you pick out?
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Evaluating Treatments
Treatments that are both validated and plausible
Treatments that are Unvalidated and implausible
Should be Widely Used
Should be Avoided
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Reference
Jacobson, J. W., Foxx, R. M., & Mulick, J. A. (2005). Controversial therapies for developmental disabilities, fad, fashion, and science in professional practice. Lawrence Erlbaum.
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http://www.youtube.com/watch?v=s6Svp81lPhQ