David Celiberti, PhD, BCBA-D, Nicole Stewart, MSEd, BCBA, Katie Daly, MA, BCBA, LBA, and Erin Leif, PhD, BCBA-D
Association for Science in Autism Treatment

One way that ASAT supports dissemination of science-based treatment is through our Media Watch efforts. ASAT’s Media Watch team monitors mainstream media for published information about autism and autism treatments. Understanding that every media contribution has the potential to reach thousands of consumers and service providers, we highlight accurate media depictions of scientifically sound interventions. We also respond to inadvertent promotions of fad, ineffective, or potentially harmful treatments, including those that only showcase testimonials as evidence of effectiveness.

Readers can review our 200+ published letters as models of professional interaction with journalists and media outlets. You will find that we have a long history of following media representations related to autism treatment, including the behavior analytic treatment of autism. Although we address the full array of treatments for autism, we aim to help consumers and providers alike better appreciate the research basis, relevance, and scope of applied behavior analysis (ABA) in many of our letters. In fact, approximately half of our Media Watch letters address ABA, and focus on topics such as misconceptions surrounding ABA, its extensive research basis, appropriate understanding and application of basic principles of behavior, and professional and ethical standards in ABA, as well as the role and offerings of the Behavior Analysis Certification Board (BACB). Many of our letters relate to ABA outside of the United States, such as in Israel, the UAE, Australia, Ireland, and Canada to name a few.

The journalism community is at the forefront of sharing information about treatments for individuals with autism and their families. It is imperative that media representation continue to shine light on issues pertaining to the needs of individuals with autism, and how we as a community can support future efforts for effective, science-based treatment. In our ongoing effort to respond to media representation of the behavior analytic treatment of autism, we have compiled a list of several dozen letters we have written over the recent years. These are organized topically below:

Helping readers appreciate the vast research support for ABA: These responses to the media focus on highlighting how much research exists to support ABA and how this body of research is based on the work of hundreds of individuals worldwide that spans many decades. This important clarification is most needed when the media equates ABA to other forms of treatments that are not scientifically validated, suggests that ABA is new or experimental, or questions whether ABA is even an appropriate treatment for autism.

Showcasing positive outcomes of ABA: Research demonstrates that ABA can help individuals with autism learn new skills and become more independent. It is important for media professionals and members of the public to understand the individualized nature of ABA – no two ABA programs are the same! The types of skills addressed within an ABA intervention, and the strategies used to teach new skills and address challenging behavior, are tailored to the individual. These Media Watch articles commend journalists for sharing stories of individuals and families who have experienced the benefits of participating in ABA intervention.

Correcting misconceptions about ABA: Despite the vast evidence-base (in the form of scores of peer reviewed journal articles) and support from organizations such as the United States Surgeon General and the American Academy of Pediatrics (Hyman et al., 2020), misconceptions still remain about the use of ABA in the treatment of autism. Misconceptions include: a) a lack of understanding of ABA as a treatment option; b) a misunderstanding of one aspect or principle of ABA such as reinforcement; and c) assertion that ABA only applies to young children, to name a few. These Media Watch articles seek to educate journalists and the public about the science of ABA as it is applied to autism treatment. It is imperative that we first share a mutual understanding of the data and evidence before making decisions about treatment options.

Mentioning ABA as an alternative to the non-evidence-based intervention showcased in the article: Parents and family members affected by autism will likely be dismayed to learn that there are over 500 “treatments” touted for autism, the vast majority with little to no evidence to support its use. While not all these treatments are harmful (though some may be!), utilizing them is costly in terms of precious time, finance, and resources. It also distracts from participation in intervention that is evidence-based. From our experience, this represents one of the most recurring themes within the media representations of autism: a non-evidence-based treatment celebrated as a viable treatment. Here are letters about biomedical interventions being touted as treatments in which we urge consideration of evidence-based treatment and, more often than not ABA, to the author:

Below are letters focusing on non-medical interventions touted as treatment. Again, we urge consideration of evidence-based treatment and ABA to the author:

Fortunately, in some cases, our letters highlight the journalist’s significant concerns about non-evidence-based intervention discussed in their story and we captured these opportunities to remind readers about the relevance of evidence-based treatment and/or evidence base of ABA.

Highlighting ABA’s place in early intervention: ABA has many applications, among them being intensive, early intervention. Studies have consistently demonstrated that most children who receive ABA during early intervention consistently have significant improvements in communication and language outcomes (e.g., Fuller et al., 2019; Makrygianni et al., 2018). These Media Watch letters aim to emphasize the role that ABA plays in early intervention, which is necessary to allow parents to make informed decisions at a critical stage in their child’s development.

Highlighting ABA’s application with adolescents and young adults: In addition to ABA’s application in early intervention, ABA can be widely used to teach skills and safely address interfering behaviors for adolescents and adults (e.g., Watkins et al., 2017, Wong et al., 2015). Initially, ABA focused heavily on the early childhood population. As that population has aged, there has been a slow and necessary shift to development of support systems for adolescents and adults with autism. It is important to keep these opportunities for services at the forefront of the conversation. The following Media Watch letters focus on the application of ABA across the lifespan.

Sharing concerns about access/funding for ABA: Despite increasing autism awareness globally, access to effective, science-based treatment is far from guaranteed. Unfortunately, even if an individual is able to access an array of treatment options, funding this treatment represents another major obstacle for many families. We appreciate members of the media writing about the challenges faced by autism families in securing treatment for their loved ones. The following Media Watch letters respond to articles which both call attention to the lack of funding options for ABA treatment and provide suggestions to those facing these daunting challenges.

Showcasing the expansion of services in underserved communities and regions: Sadly, there are many underserved communities and regions that may not adequately benefit from evidence-based practice. One of our many objectives is to help families avoid wasting valuable time and resources on unsubstantiated treatments, particularly those prematurely or erroneously touted as “cutting edge.” In some of our Media Watch letters, we highlight the emergence of programs in regions that have been historically underserved and acknowledge current efforts to provide ABA-based interventions. If emerging programs are not utilizing ABA, we recommend that program development and expansion incorporate ABA.

Authors’ Note: We are grateful to Barbara Jamison, Renee Wozniak, Elizabeth Zink, and Jane Barbin, along with all of our Media Watch writers, who have helped create such an extensive library of letters.

References

Fuller, E. A., & Kaiser, A. P. (2019). The effects of early intervention on social communication outcomes for children with autism spectrum disorder: A meta-analysis. Journal of Autism and Developmental Disorders, 1-18.

Hyman, S. L., Levy, S. E., & Myers, S. M. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145(1).

Makrygianni, M. K., Gena, A., Katoudi, S., & Galanis, P. (2018). The effectiveness of applied behavior analytic interventions for children with Autism Spectrum Disorder: A meta-analytic study. Research in Autism Spectrum Disorders, 51, 18-31.

US Surgeon General (2000). Surgeon General’s Report on Mental Health – subsection on Autism. http://www.surgeongeneral.gov/

Watkins, L., O’Reilly, M., Ledbetter-Cho, K., Lang, R., Sigafoos, J., Kuhn, M., … & Caldwell, N. (2017). A meta-analysis of school-based social interaction interventions for adolescents with autism spectrum disorder. Review Journal of Autism and Developmental Disorders, 4(4), 277-293.

Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., Brock, M. E., Plavnick, J. B., Fleury, V. P., & Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45(7), 1951-1966. https://doi.org/10.1007/s10803-014-2351-z

Citation for this article:

Celiberti, D., Stewart, N., Daly, K., & Leif, E. (2021). Media representations of the behavior analytic treatment of autism: Highlighting a decade of ASAT’s efforts to promote accuracy. Science in Autism Treatment, 18(4).

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