Autism/ADHD News stories, Technology, breakthroughs, treatments

Applied behavior analysis is autism treatment of choice, experts say
November 28, 2010 at 3:02 PM

Applied behavior analysis is autism treatment of choice, experts say

Posted Saturday, Nov. 27, 2010 0 Comments  Print Share Share Buzz up! Reprints



FORT WORTH -- When Ethan Groblebe started receiving treatment at the Child Study Center 11 months ago, he wouldn't eat anything but cookies or chips.

"That was breakfast, lunch and dinner -- seven days a week," said Duy Le, co-director of autism services at the center. "Now, we're able to get him to eat fruit. Yesterday, he had a sandwich."

Ethan, who is autistic, also no longer resists getting his hair cut or putting on sunscreen. The 7-year-old boy doesn't scream as often, is potty-trained and can say three-word sentences.

Five days a week, several hours a day, Ethan undergoes an intensive type of therapy at the Child Study Center near downtown Fort Worth called applied behavior analysis, or ABA.

The therapy is a recognized treatment for autism -- a developmental brain disorder that inhibits a person's ability to communicate and interact socially. Experts say ABA is an evidence-based science that uses repetitive commands and positive reinforcement to rewire the way an autistic child thinks and behaves.

On a recent morning, Melinda Lopez, a behavior analysis lead tutor at the center, was patiently putting Ethan through his paces.

"Ethan, arms up," she said, raising her arms in the air.

"Arms up," Ethan replied, imitating her.

"Very good," Lopez said. "Put your arms up, arms up."

Ethan imitated her again.

"Good, you get a penny for following instructions," Lopez said.

For the next 30 minutes, Ethan and Lopez worked together on simple tasks such as clapping, waving and sitting. When he responded appropriately, he received a gummy bear, a high-five or a penny. When he received a predetermined number of pennies, he was allowed to briefly play with a toy of his choice -- a video game.

Each day from 9 a.m. to 3:45 p.m., Ethan and more than two dozen other autistic children work one-on-one in this manner, learning skills that most children easily pick up as babies or toddlers. Each child's behavior is documented, charted on a graph, and analyzed to determine progress and what changes should be made.

On this day, behavior analysis lead tutor Hannah Fisher was working with German O'Campo, 5, whose language skills were severely delayed when he came to the center 14 months ago. Since then, he has made great strides in identifying everyday objects.

"What's this?" she asked, showing him a picture.

"Chair," German replied.

"What's this?" she asked, showing him another picture.

"Microwave," he responded.

"Very good, give yourself a penny," Fisher said

Later, he was wearing a Star Wars costume -- his reward for earning enough pennies.

While there is no cure for autism, experts say children who receive ABA early are capable of making substantial gains in IQ, language and behavior.

But the therapy is not cheap. It costs about $260 a day at the Child Study Center, where children attend from one to five days a week, depending on their needs and resources.

For many families, the cost is offset by a program offered by the Texas Department of Assistive and Rehabilitative Services, which contracts with six autism centers statewide, subsidizing the cost of ABA for autistic children ages 3 to 8. But the waiting list is long.

And many insurance companies don't cover ABA. The state mandates fully funded insurance agencies to cover it, but self-funded insurance plans aren't subject to state law and often don't cover it on the grounds that it is "experimental" or "educational."

"I disagree with that," said Dr. Joyce Elizabeth Mauk, CEO of the Child Study Center. "Even the state Legislature has identified it as a medical treatment. It's probably the most studied and most scientifically validated form of treatment for autism."

In Ethan's case, ABA has worked wonders. He no longer just points at what he wants and says "Ma" but now uses words to communicate.

And for parents of autistic children, Le said, those kinds of milestones are priceless.

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