Dear Dr. Klass,
We would like to thank you for your article, “Early Treatment for Autism Is Critical, New Report Says.” Your article highlighted the 2020 American Academy of Pediatrics comprehensive clinical report on autism. We wholeheartedly agree with you that behaviorally-based programs are important for helping children with autism and their families. Applied Behavior Analysis (ABA) is a behaviorally-based framework for delivering a range of evidence-based teaching and behavior support strategies. ABA has a strong evidence-based for individuals on the autism spectrum. In an ABA-based program, professionals individualize the program for the child with autism by identifying specific behaviors to change, with an emphasis on decreasing behaviors that interfere with learning and negatively impact the child’s quality of life, and increasing behaviors that will lead to greater independence, such as daily living, communication, and safety skills. Your article brought up a critical point related to autism and intervention, which is the importance of understanding an individual’s behavior thoroughly, particularly before medications are introduced. Medication cannot cure autism, nor does it teach new skills. By contrast, an individualized program driven by evidence-based practice tailored to the child’s strengths and needs can teach new, functional life skills and significantly increase quality of life.
We were thrilled to see that you emphasized the importance of early identification and intervention. It has been shown that early and intensive behaviorally-based interventions can promote positive outcomes for individuals with autism. Greater understanding of autism within our community as a whole, but particularly within the pediatric and medical sector, is important to ensure families receive an early diagnosis and access to information about early intervention. But support needs extend beyond early intervention, and many individuals on the spectrum will need support from a range of professionals across different stages of life. As you highlighted in your article, access to good support across the lifespan is important, particularly around periods of transition such as the transition from school to adulthood. As mentioned in your article, at any point in time, a process of shared decision making should be promoted, in which the professional, family, and person with autism work together to plan and evaluate the intervention.
We appreciate your transparency when discussing the current state of the science with respect to the genetic causes of autism. While there is some promising research in this area, the degree to which an understanding of genetic causes will lead to safe, effective, and ethical interventions for autism is unknown. Overall, your article paints a well-balanced picture of the great advances that have been made within the field of autism detection and intervention, and the areas of great need that lie ahead.
We at ASAT have also reviewed the 2020 American Academy of Pediatrics report and wrote a summary and appraisal, which can be found on our website: Part 1 and Part 2. We hope you will consider sharing these resources with your readers.
Eilis O’Connell, BCBA
Dr Erin Leif, BCBA-D
Association for Science in Autism Treatment