**11. Conclusion**

intervention for young children with autism. We believe that this paper provides an excel‐ lent summary of the criticisms provided on EIBI and we will highlight these here. Firstly, many of the studies providing analysis of EIBI outcomes fail to report the severity of ASD across participants and groups. This makes it difficult to decipher which children will show greatest susceptibility to the intervention. Those with greater severity of symptoms may show slower progress or less gains. It has been reported that a milder degree of autism is related to better prognosis (e.g., Bartak & Rutter, 1976) and therefore it is essential that varia‐ bles at intervention onset include such a measure. Secondly, Matson and Smith (2008) high‐ light the fact that researchers often do not take into account the additional, co-morbid, problems that present with autism (e.g., ADHD symptoms or anxiety disorders). Psychopa‐ thological problems can co-occur with the condition and may exacerbate the challenges and deficits for many children. The impact this can have on treatment susceptibility is underre‐ ported and often not addressed in treatment research. For example, only two studies in our review provided outcome measures of co-morbid psychopathology (Birnbrauer & Leach, 1993; Fava, 2011). Matson and Smith (2008) provide a strong argument for the assessment of psychopathology before, during, and after EIBI, to determine ongoing changes in child pro‐ files or to address any required adjustments to the delivery of EIBI (e.g., increasing or de‐ creasing the duration of intervention, removing skills acquisition teaching from artificial environments, less emphasis on massed trial instruction etc.). Perhaps not enough attention has been given to these issues in EIBI research. The young age of onset of EIBI and the inten‐ sity of the intervention may have undesired side effects such as anxiety, stress, "burn out" or indeed refusal to participate. Other controversial issues involving EIBI include parent and sibling involvement which can often induce stress and family strain when highly intensive intervention is provided within the family home. The negative side effects of this kind of in‐

Unfortunately, like any professional practice or therapeutic intervention, there will be those who claim to provide EIBI without adhering to the scientific demonstrations of what is, and is not, effective within an intervention protocol. We have heard of anecdotal accounts of the applications of behavioural interventions in autism treatment that are outdated and often lack individualisation. Treatment fidelity is often a major problem in the field and often au‐ thors fail to demonstrate or report adherence to effective and current practice in many of the published studies on EIBI. Such problems can lend support to a negative view of the use of

An analysis of changes in adaptive functioning of young children has become an added fo‐ cus of EIBI studies in more recent years. Traditionally, studies tended to focus on changes in intellectual and social functioning and language and communication abilities. Some authors have criticised EIBI for overly focusing on cognitive skills with 1:1 teacher/student ratios and a focus on desk-top instruction and intensive "drills" (e.g., Shea, 2004). Increasingly, EI‐ BI curricula and instructional protocols have grown to ensure inclusion of adaptive skills teaching and acquisition of novel skills in natural environments. Studies evaluating out‐ comes of EIBI have also focused more on adaptive functioning changes as a result of the in‐ tervention. In 2002, Eikseth et al. reported greater increases in adaptive functioning in a

tensive intervention certainly warrant separate analysis.

588 Recent Advances in Autism Spectrum Disorders - Volume I

EIBI with young children with autism diagnoses.

EIBI as an approach to autism treatment is one of the most intensively analysed interven‐ tions in paediatric clinical psychology (Matson & Smith, 2008).

Substantial objective evidence for EIBI has been demonstrated at an experimental, descrip‐ tive and meta-analytic level of analysis (Reichow, 2012). We support the contention of many authors in the field of autism treatment, that EIBI prevails by adhering to a principle of evi‐ dence-based practice, incorporating standardised objective measurement of outcomes along with implementation of robust experimental design. This robust demonstration of effective‐ ness is driving policy change on the international stage and some authors (e.g., Dawson, 2008) suggest that one of the most important goals of investigations in the domains of au‐ tism and behaviour analysis research, is to become more effective communicators of scientif‐ ic findings to the general public/government bodies/advocacy groups/related professionals, not only to harvest their support, but to ensure the dissemination of accurate and effective intervention to so many who require it.
