**7. A 'new idea'**

The Federal U. S. Office of Personnel Management responsible for all federal government employees concluded that ABA-based interventions should be covered not only for educa‐

based on ample scientific and empirical evidence, ABA therapy qualifies as a

In Canada, ABA-based interventions are supported, for example by the Ontario Department of Education Policy/Program Memorandum [73] that support[s] incorporation of ABA methods into school boards' practices. . . The use of ABA instructional approaches may also

The Maine Administrators of Services for Children with Disabilities confirmed their support

Despite this general endorsement of evidence-based behaviour analytic interventions across most of the English speaking world, the highly controversial approach taken by governments across the UK and Ireland is to support an 'eclectic' approach. There are no clear guidelines as to what an 'eclectic' approach entails and not a single study is published anywhere to show the effectiveness of an eclectic approach being equal or superior to ABA-based interventions [14]. In fact, [21] and [39] findings show clearly that ABA-based interventions are superior to an eclectic approach. Individually tailoring behavioural interventions to match child charac‐

Yet in the UK, the National Institute for Clinical Excellence's [64] response to stakeholders, who asked for ABA-based interventions to be included in the NICE guidelines for the

In the review of evidence, the Guideline Development Group found no evidence to support

NICE clinical guidelines are based on the best quality evidence and are developed according to rigorous and robust methodologies. The developers were unable to identify high quality evidence of effectiveness of the ABA approach in managing

This view is informed mainly by relatively few, but well rehearsed anti-ABA arguments that continue to circulate misinformation and misleading anti-ABA propaganda. As [33] points out:

The most concerning issue affecting the quality of practices and policies in the helping professions is the play of propaganda, which misleads us regarding what is a problem, how (or if) it can be detected, its causes, and how (or if) it can be remedied. Propaganda is defined as encouraging beliefs and actions with the least

ABA, and therefore could not make a recommendation about ABA. (pp. 5& 8)

It is important to note that ABA is frequently perceived to be synonymous with discrete trial teaching. However, ABA is comprised of a broad scope of empirically

medical treatment, rather than purely educational. [5], p. 1)

derived behavioural principles used in interventions. (p. 25)

be effective for students with other special education needs. (p. 1)

tional but also for medical reasons:

254 Autism Spectrum Disorder - Recent Advances

in the Report of the Autism Task Force [6]

teristics is key to effectiveness [82].

They also asserted that:

management of children with ASD, was the following:

children and young people with autism. (pp. 5 & 8)

Anti-ABA propaganda generally comes from people not trained in the science (e.g., [41, 47]. Censorship comes in the form of excluding behaviour analysts from review bodies [14] or ignoring data presented to review panels [68]. As a consequence of this exclusion, ABA remains a 'new idea' in the UK, despite its extensively documented history and evidence base accessible in the English language.

The German philosopher Alfred Schoppenhauer (1788-1860) recognised that:

All new ideas pass through three stages. First, they are ridiculed. Second, they are violently opposed. Third, they are accepted as being self-evident.

This is true for the evolution of the arguments by ABA opponents [15]. First, they ridicule ABA as' one approach for autism', while promoting the rather ill-defined eclectic approach. Of course, one could argue that the eclectic approach is one approach as it precludes any other approach, such as the dual approach taken in Germany, where psychotherapists are trained in either behaviour therapy and psychotherapy, and the service user has the choice which service they prefer to use [17]. In reality then, eclecticism is 'one approach' to autism inter‐ vention. When opponents of ABA state that they do not want one approach for all, they cannot at the same time say that they promote the one approach called 'the eclectic approach'.

There are of course further problems with eclecticism.


On the other hand as mentioned earlier, ABA is not 'one approach to autism' [16], it is the application of the scientific discipline of behaviour analysis.

ABA aims to discover and understand the underlying principles of behaviour with the function of a particular behaviour considered in the design of behaviour change interventions. Interventions are designed for the individual, recognizing that the function of behaviour varies based on complex combinations of variables. [6], p. 25) There is nothing wrong with using one approach, if this 'one approach' is science [15]. Countless procedures have been developed from the science of behaviour analysis, many specifically for ASD, e.g., Discrete Trail Teaching (DTT); Pivotal Response Training (PRT); Natural Environment Training (NET); Verbal Behaviour Approach (VB); while other proce‐ dures have been developed for more general applications, e.g., Functional Analysis and Functional Assessment; Preference Assessments; shaping, forward chaining, backward chaining; differential reinforcement of low or zero rate and/or incompatible or alternative behaviours; Time-out from Positive Reinforcement (TOR); etc. . Some of these procedures have been combined into comprehensive packages for autism, such as Early Intensive Behavioural Interventions (EIBI) or Early Start Denver Model (ESDM), while others are used more gener‐ ally, e.g., Programmed Instruction, Generative Instruction; Peer Tutoring; Habit Reversal Training; etc. Given that the science of behaviour analysis underpins all of these programmes/ procedures and continuous data-based decision making is part and parcel of ABA, new procedures and progammes are developed continuously to meet the individual or group needs of service users.

ABA has been further ridiculed and accused of intending to change the person, while others pride themselves for accepting the person for who they are [69, 80]. In fact, the targets of ABAbased interventions are socially relevant behaviours, linked to cultural and personal norms and preferences [4]. The curricula are agreed with individuals with ASD and/or their caregiv‐ ers. They are generally based on wide-ranging target behaviours, including life skills, such as dressing, toileting, attending; social skills, such as playing or imitation; academic skills, including attending, reading, drawing, writing, and maths, and work/employment based skills, including interviewing or team work.

Basically, the aim of ABA is to enhance all skills necessary to lead a fulfilled life for individuals who would otherwise be limited in the quality of life they experience. These are the same aims that most parents have for all of their children, irrespective of a diagnosis. As such, ABA does not intend to 'change the person', but to enhance skills and help individuals to break down barriers to learning and achieve their full potential. After all, enhancing skills development increases choice.

Once a new idea can no longer be ridiculed, the second point Schoppenhauer made comes to play: the new idea is opposed. In the case of ABA, this refers to statements such as there is no evidence to support ABA and therefore no recommendation can be made [64]. We have outlined the wealth of evidence in favour of ABA-based interventions earlier in this chapter. Given that behaviour analysts commonly are not included in review bodies, at least in Europe, this mountain of evidence generally is excluded from reviews [68].

When the evidence can no longer be denied, the opposition turns to the behaviour analytic scientists themselves, stating that research conducted by behaviour analysts is biased and therefore not to be taken seriously. The idea, that it is objectionable that scientist conduct scientific research in their own subject area is rather intriguing. Given that it is against ethical guidelines of all social and health care as well as education professionals to work outside their own area of expertise [90], clearly, multidisciplinary practice and interdisciplinary research teams in ASD, should routinely include behaviour analysts, not least because others are not qualified to make authoritative statements about behaviour analysis [16].

Once ridicule and opposition are not longer tenable, the third point of Schoppenhauer's concept of the evolution of a new idea comes to play, when finally, new ideas are considered self-evident. Intriguingly, this is now starting to happen with regards to ABA. There is evidence of a claim that all teachers and psychologists use ABA techniques. However, being able to conduct one or two behavioural techniques [16] clearly does not equate to training in applied behaviour analysis to international standards [3]. For example, clinical psychology training typically includes (under Psychological Therapies) 'competency in two evidencebased therapeutic approaches including CBT and one other (e.g. psychodynamic, systemic, social constructionist)' [76]. Other professionals commonly receive no training in behaviour analysis and either none or very little training in ASD [19].
