**8. Screening for ASD and EIBI provision**

It is accepted in the field of autism that there now exists enough evidence to recognise the disorder at a very early age (Feldman et al. 2012; Matson, Boisjoli, Rojahn, & Hess, 2009). While many screening instruments exist for the disorder, the most thoroughly ex‐ amined of these is the BISCUIT (Matson et al., 2009; Matson, Fodstad, & Mahan, 2009; Matson, Fodstad, Mahan, & Sevin, 2009; Matson, Wilkins, Sevin, et al., 2009; Matson, Wilkins, Sharp, et al., 2009). In addition to providing clinicians with a measure of the very early signs of autism symptomology, the BISCUIT also provides a measure of emo‐ tional/behavioural disorders and comorbid psychopathology. We believe that providing EIBI to young infants showing early signs of autism, before the condition is fully mani‐ fest, will target core skills by accelerating developmental sequences, halting deteriorating behavioural repertoires, and preventing additional secondary problems. Provision of EIBI at the time when symptoms are initially detected, may in tandem, alter the course of ear‐ ly behavioural and brain development increasing the likelihood that children attain a rate of typical development (Dawson, 2008).

**2.** in Texas, USA, a total of US\$ 208,500 per child is saved by the education system

Early Intensive Behavioural Intervention in Autism Spectrum Disorders

http://dx.doi.org/10.5772/54274

587

**3.** and in Pennsylvania, USA, average savings per child are estimated even higher to range

Based on these cost-saving analyses increasing change has been shown in policy regard‐ ing the role of EIBI in early intervention. For example, the state of Ontario in Canada, has legislated to make EIBI services available for all children diagnosed with ASD (Perry & Condillac, 2003). In the USA, 32 States have passed legislation to ensure that ABAbased interventions are either state-funded or provided through medical insurance com‐ panies (Dillenberger, 2011; Market Watch, 2012). It remains to be seen whether government policy in the United Kingdom or Ireland will catch up with that of Canada and the USA and provide government funded EIBI once children are deemed at risk for or indeed presenting with this condition. Interestingly, the use of trained volunteers to deliver EIBI has been shown to produce effective outcomes (Birnbrauer & Leach, 1993) and may be an option for some parents/services to consider when cost is an issue. Many university students who train on third level post-graduate programmes in Applied Be‐ haviour Analysis could make strong contributions in a voluntary capacity, to EIBI in au‐ tism treatment, as part of their ongoing accreditation process as Board Certified Behaviour Analysts with the international certification body (Behaviour Analyst Certifica‐ tion Board®). Alternatively providing parents of children with autism with training in behavioural interventions (demonstrated by Sallows and Graupner, 2005) can result in

from US\$ 274,700 to US\$ 282,690 (see also Chasson, Harris & Neely (2007).

through the use of EIBI (see Chasson, Harris & Neely (2007);

cost-saving and important positive outcomes for children with autism.

The published studies outlined in this chapter highlight the possible positive outcomes for young children diagnosed with autism. EIBI continues to be investigated internationally as a treatment intervention for this condition and as a result of these investigations attracts many critics and controversies. In the past, some authors have criticised a behavioural approach to autism intervention with regard to "robotic" teaching and behaviour patterns that lack gen‐ eralisation to naturalistic settings (Jordan, Jones & Murray, 1998; Shea, 2004) along with the use of negative consequences in acquisition teaching and behaviour reduction (Carr, Robin‐ son & Palumbo, 1990). Others have highlighted the concerns with regard to claims of "re‐ covery"or a "cure" for autism (Offit, 2008). However, the improvements shown over the last decade in EIBI refinement and provision, particularly with regard to training and regulatory protocols with its delivery (Behavior Analyst Certification Board®, 2012) has addressed many of these issues. Indeed, professional training in behaviour analysis and behavioural

No doubt there are still many issues that continue to require analysis in the EIBI and autism field of research. We would like to draw the reader's attention to a recent publication by Matson and Smith (2008) providing an analysis of the current status of intensive behavioural

**10. Controversies related to EIBI efficacy**

intervention has never been as well regulated as it is today.

We advocate for the need to screen children for this disorder during routine health and de‐ velopmental checks. Screening in Ireland is currently haphazard and often depends on a pa‐ rent showing concern for some area of their child's development. In particular, prevention entails detecting infants at risk before the full diagnostic criteria are present and it has been recognised that early signs may emerge as soon as 9 months in infants with siblings who have ASD (Ozonoff et al. 2010; Zwaigenbaum et al. 2005). Screening these biologically "at risk" children in early infancy should allow greater access to the effective methods demon‐ strated by EIBI. We strongly believe that the availability of both standardised screening techniques and EIBI provision to such children will impact on a more promising prognosis in the long-term.
