By Vince LaMarca, M.A., BCBA, Editor
Lovaas Institute - Indianapolis

I read with interest the article from the Associated Press concerning autism and insurance laws http://ap.google.com/article/ALeqM5iT3S7GDQdN8H8DfSkpTf58lqVCKAD93U0F7O0

As a behavior analyst for the Lovaas Institute in Indianapolis for the past 9 years, I have seen behavior therapy move from a treatment (prior to the insurance mandate of 2001) that I typically provided to families of doctors, lawyers, and businessmen, to a treatment that I now provide to a variety of families including teachers, retail store employees, and police officers. 
 
Let’s be clear. The autism mandate has allowed the most effective treatment for children with autism to become accessible to families at all income levels.

I would make three clarifications to the Associated Press article, though.  I understand that reporters, in an attempt to remain unbiased, try to present both sides of an argument.  However, it is unfortunate when one side of the argument contains misleading information. 
 
First, Tristam Smith has already submitted a correction to the comment that evidence for behavior therapy with older children is “sparse” when in fact it is readily available (http://www.lovaas.com/blog/). 
 
Second, the article states that “The most rigorous studies [of behavior therapy] show mixed results.”  However, the article mentions ONE rigorous study that shows mixed results (e.g., Smith, 2000) while failing to mention the MANY OTHER rigorous studies that show clear evidence that behavior therapy is profoundly effective (e.g., Lovaas, 1987, Sallows, 2005, Howard, 2006). http://www.lovaas.com/research.php.  In 2001, National Research Council’s Educating Children with Autism noted that behavior therapy, in particular the UCLA Young Autism Project, had “the most rigorously controlled early intervention research published to date (Lovaas, 1987). http://www.nap.edu/openbook.php?record_id=10017&page=170.  While the report went on to note some of the limitations of the research, many of those limitations have been overcome with new research that has been published since 2001.  (Another relevant point of interest concerning the research council’s report appears in the section on adaptive behavior.  It reads, “There is substantial data, particularly with older children and adolescents, that behavioral interventions, particularly those with attention to generalization, can result in improved adaptive behavior in children with autism..”  http://www.nap.edu/openbook.php?isbn=0309072697&page=114
 
Finally, the Associated Press article states that “Another study in preschoolers, published in 2005, showed little difference between an intensive ABA-based program run by therapists and less-intensive therapy from parents.” What the article fails to mention is that the “less intensive” therapy in this article (Sallows, 2005) http://www.lovaas.com/research.php was still behavior therapy, still included frequent and ongoing oversight from qualified behavior analysts, still included therapists who passed rigorous quality control measures, and still included 35-40 hours of weekly therapy.
 
I urge all families of children with autism in every state to do what we have done here in Indiana – make the services proven effective for individuals with autism affordable for everyone through insurance funding.  The financial impact to the system is minimal (less than 1% of the cost of insurance, according to the article) while the benefit to many children with autism is immeasurable.  Ask any of the families for whom I have worked.