Dear Dr. Kevin Pelphrey:
We are writing in response to your article, “Robots, Apps, and Brain Scans: New Tools to Help the Autistic Child.” Your article highlights some of the deficits that may be associated with autism spectrum disorder (ASD), which is important for furthering the understanding of the complex facets of the disorder for the general public. Within the article, you describe tools for educating neuroptypical peers about social deficits in ASD, as well as some of the new technology for teaching individuals on the spectrum.
The social apps, mentioned in the article, appear to have a place in the education of neurotypical peers regarding the social challenges of individuals with ASD and, hopefully, will encourage their peers to include them in future social events. These may be great tools for increasing social awareness in the general public. However, we also want to keep in mind that as wonderful as these apps appear to be, until there is scientific support for their effectiveness they should be used only as a possible supplement to interventions with established scientific support such as intensive and comprehensive applied behavior analysis (ABA) treatment for individuals with ASD. The science of applied behavior analysis has over 40 years of research to support its effectiveness and it has been recommended by various state and federal agencies, including the New York State Department of Health and the U.S. Surgeon General. Intensive behavioral intervention (IBI) based on the principles of ABA has been recognized as an effective treatment for individuals with autism spectrum disorder (Remington et al., 2007). While educating the larger community is key for developing acceptance and understanding of autism spectrum disorder, it is not a replacement for intensive treatment for the individuals with ASD. Today, technology may serve as an amazing resource to support individuals receiving evidence-based treatment, and we are pleased to see that you are exploring ways to incorporate technology into existing evidence-based interventions.
Your research utilizing robots is also extremely interesting and sounds very promising. As you are likely aware, the demonstration of generalization of newly acquired skills can be very difficult for many individuals on the autism spectrum (Charlop-Christy & Carpenter, 2000). Future studies including robot interaction will be necessary in order to determine if the skills that they have learned through their interaction with the robots could be generalized to human interaction, as this is crucial in order to increase meaningful social interactions and overall quality of life. We are excited to see this line of research and eagerly await the results in order to determine how effective technology and technological advances will be for this population.
As an additional note, there are some concerns when using general statements about sensory issues often described when discussing individuals with ASD, such as, “Children with autism often feel overwhelmed or anxious in the presence of loud music, bright lights, or strong smells.” To date there is little empirical evidence to support these conclusions. While it is commonly known, and actually part of the diagnosis for ASD, that there are differences in their reactions to sensory input (i.e., under-reactions and/or over-reactions) the relationship to other diagnoses such as “anxiety” has not been supported in the literature to date. Thus, it is important to be factual, limit overgeneralizations, assumptions, and personal biases when evidence is lacking.
Ensuring that communities are aware of the challenges and strengths of individuals with autism spectrum disorder is essential. Moreover, educating the larger community about ways in which technology can be used to support these individuals and involving peers in this endeavor is promising. Hopefully, your article will help to generate awareness of the potential for incorporating technology into a comprehensive treatment package rooted in evidence-based treatment such as applied behavior analysis.
Sincerely,
Anya K. Silver, MA, BCBA and Tracie Lindblad M.Sc., Reg. SLP (CASLPO), M.Ed., BCBA
Association for Science in Autism Treatment
References
Charlop-Christy, M. H., & Carpenter, M. H. (2000). Modified incidental teaching sessions: A procedure for parents to increase spontaneous speech in their children with autism. Journal of Positive Behavior Interventions, 2, 98–112
Reichow, B., & Volkmar, F. R. (2010). Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework. Journal of Autism and Developmental Disorders, 40, 149-166.
Remington, B., Hastings, R. P., Kovshoff, H., Degli Espinosa, F., Jahr, E., Brown, T., et al. (2007). Early intensive behavioral intervention: Outcomes for children with autism and their parents after two years. American Journal of Mental Retardation, 112, 418-438.
