The metaanalysis you link does not show the effectiveness of ABA therapy. The studies included are without a control group. If the post therapy IQ is higher than the pre-therapy IQ, that's only to be expected, as the children are older and have matured. The therapy is enormously expensive (several years of many hours per week!) and as you correctly say, many if not most kids below 4 are on the waiting list. It would be the easiest thing in the world to do a really large randomized controlled study with a waiting list control group. If correctly done experimental studies according the usual medical standards are rare among the published material on ABA, and "naturalistic" studies abound, maybe most of the methodologically better studies that were done went into the drawer as the results were not to the liking of the therapist lobby.
I don't care what kind of therapy that kids get, but they do need therapy at an early age. Floortime or ABA, it's all the same to me. It's clear that quality and quantity of hours spent working with young autistic children has a positive impact on their development.
Families need that diagnosis as soon as possible to get access to the type of therapy that works for them and their child. And some parents might choose to skip therapy entirely, but that's their choice. However, I think this is problematic. Special ed kindergarten teachers tell me that they can tell instantly which autistic kids had therapy before starting school, and which ones didn't.
My son didn't have ABA therapy or any intensive services for autism when he was a toddler, because he wasn't diagnosed with autism until age five. I wish we had better medical help earlier.
The one thing that may help parents of very young children with highly concerning autism symptoms is a referral to genetics. Most of the time, genetics won’t find anything, but if parents are “lucky” enough to draw a genetic diagnosis, it cuts the red tape. That wasn’t possible when your son was young, but these days a genetic screening is cheap and easy enough that insurance will usually pay for it.
It’s about 1 in 8 kids. They’re discovering new genes all the time; my daughter’s mutation wasn’t discovered until 2012. Kids with genetic diagnoses usually get the same access to ABA, early intervention, etc. as kids with who have ASD as a primary diagnosis.
How do those statistics break down if you separate autistic kids with an intellectual disability from those without? I find it’s a strong confusing confounding issue that kids with both of those are often classified just as “autistic” because the ID is considered part of it but obviously things like employment will be significantly affected.
The metaanalysis you link does not show the effectiveness of ABA therapy. The studies included are without a control group. If the post therapy IQ is higher than the pre-therapy IQ, that's only to be expected, as the children are older and have matured. The therapy is enormously expensive (several years of many hours per week!) and as you correctly say, many if not most kids below 4 are on the waiting list. It would be the easiest thing in the world to do a really large randomized controlled study with a waiting list control group. If correctly done experimental studies according the usual medical standards are rare among the published material on ABA, and "naturalistic" studies abound, maybe most of the methodologically better studies that were done went into the drawer as the results were not to the liking of the therapist lobby.
I don't care what kind of therapy that kids get, but they do need therapy at an early age. Floortime or ABA, it's all the same to me. It's clear that quality and quantity of hours spent working with young autistic children has a positive impact on their development.
Families need that diagnosis as soon as possible to get access to the type of therapy that works for them and their child. And some parents might choose to skip therapy entirely, but that's their choice. However, I think this is problematic. Special ed kindergarten teachers tell me that they can tell instantly which autistic kids had therapy before starting school, and which ones didn't.
My son didn't have ABA therapy or any intensive services for autism when he was a toddler, because he wasn't diagnosed with autism until age five. I wish we had better medical help earlier.
The one thing that may help parents of very young children with highly concerning autism symptoms is a referral to genetics. Most of the time, genetics won’t find anything, but if parents are “lucky” enough to draw a genetic diagnosis, it cuts the red tape. That wasn’t possible when your son was young, but these days a genetic screening is cheap and easy enough that insurance will usually pay for it.
I don’t think most kids show genetic markers for autism, unless they have a rare gene mutation.
It’s about 1 in 8 kids. They’re discovering new genes all the time; my daughter’s mutation wasn’t discovered until 2012. Kids with genetic diagnoses usually get the same access to ABA, early intervention, etc. as kids with who have ASD as a primary diagnosis.
The system can't keep up - and once someone manages to get a diagnosis, the next system has done real evil.
https://cepr.net/report/pocketing-money-meant-for-kids-private-equity-in-autism-services/
I despair.
Thanks, Nora, for this link. Super interesting.
How do those statistics break down if you separate autistic kids with an intellectual disability from those without? I find it’s a strong confusing confounding issue that kids with both of those are often classified just as “autistic” because the ID is considered part of it but obviously things like employment will be significantly affected.