Academic journal article The Behavioral Development Bulletin

An Evaluation of the Role of Reinforcement-Based Interventions in Determining the Effectiveness of 'Eclectic' Approaches for Teaching Children with Autism Spectrum Disorders

Academic journal article The Behavioral Development Bulletin

An Evaluation of the Role of Reinforcement-Based Interventions in Determining the Effectiveness of 'Eclectic' Approaches for Teaching Children with Autism Spectrum Disorders

Article excerpt

There have been numerous studies regarding the effectiveness of early teaching interventions for Autism Spectrum Disorders (ASD; e.g., Eldevik, Eikeseth, Jahr, & Smith, 2006; Lovaas, 1987; Ozonoff & Cathcart, 1998; Reed, Osborne, & Corness, 2007; Rogers, 1998; Sallows & Graupner, 2005). Much current debate has centered on Applied Behavior Analysis (ABA) as an intervention. This approach has been outlined in a variety of sources (e.g., Lovaas, 1981; Lovaas & Smith, 1989). The outcome-effectiveness of this intervention reported by Lovaas (1987) was remarkable; children undergoing this approach made gains of up to 30 IQ points, and just under half of these children were not noticeably different from normally-developing children after three years of the intervention. The gains noted for a group of children receiving a high intensity intervention (40 hours/week) were much more pronounced than in those children undergoing the same treatment for less time per week (10 hours/week or less). The relatively high intensity of the program (i.e., 40 hours/week) has been taken as axiomatic to the success of the program by many adherents to this approach (see Lovaas, 1987; Mudford, Martin, Eikeseth, & Bibby, 2001). Although some studies have replicated the relative benefits of high intensity programs (e.g., over 30 hours/week) compared to low intensity programs (e.g., Smith, Eikeseth, Klevstrand, & Lovaas, 1997; Smith, Annette, & Wynn, 2000), other studies have shown that gains are made with less than 30 hours per week (Sheinkopf & Siegel, 1998).

Irrespective of the empirical strength of outcome intervention studies for ABA approaches, alternatives to ABA interventions for ASD are widely employed. For example, Humphrey and Parkinson (2006) cited twenty-four different types of approach that are currently in use for children with ASD. These approaches include: 'interactive methods', such as the Option approach, or music therapy; 'communicative interventions', such as the Picture Exchange Communication System (PECS), or facilitated communication; and the 'integration approach', which combines a range of different strategies to produce interventions, such as Alternative Program for Preschoolers and their Parents (LEAP), or the Walden preschool program.

In fact, the majority of schools across the United Kingdom use an 'eclectic' approach for intervention for children with ASD (see Jordan, Jones, & Murray, 1998). The term 'eclectic intervention' will be used here to refer to the use of a combination of different intervention approaches (see Reed, Osborne, & Corness, 2007). Eclectic interventions do not follow a specific ethos, or strategy, as do many 'brand name' approaches, but rather they combine different aspects of existing strategies. For example, an approach might combine two approaches, such as TEACCH with ABA (e.g., Farrell, Trigonaki & Webster, 2005), or it could use more methods, such as speech therapy, occupational therapy, physiotherapy, and portage (e.g., Drew, Baird, Baron-Cohen, Cox, Slonims, Wheelwright, Swettenham, Berry & Charman, 2002). Such combinations of interventions do not necessarily derive from an assessment of the data on the outcome effectiveness of the individual components of the eclectic approach, nor from the established effectiveness of any such combinations. This may not be regarded as ideal in a scientific sense, but it is a common approach to the development of intervention (often thought of as potentially effective, see Jordan et al., 1998) and often tailored to suit the training and abilities of the staff delivering the interventions within an education authority.

Some positive results have been documented for many of the strategies employed within an eclectic intervention. For example, within the eclectic intervention studied by Akstinas (2006), PECS was included, and improvements in speech and social behavior, as well as a reduction in problematic behavior, was evident for some participants (Charlop-Christy, Carpenter, Le, LeBlanc, & Kellet, 2002). …

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