There are many factors contribute to the long-term treatment outcome of a child with Autism. Some of these factors can be controlled and some cannot.

Cognitive Ability  (49%)
Research has shown that children starting at the same age, with the same intensity, consistency of treatment, same treatment choice, treatment outcomes are sometimes different. This, we believe, is due to the individual cognitive ability of the child. Some children may learn vary fast and others may learn slower. Some children may find it difficult to learn abstract concepts, while others may become fluent in all areas. These outcomes are better understood looking at the outcome research.

Treatment Age (12%)
It has been well documented that children with ASD benefit the most in the early years. Early intervention is critical to ensure the maximum progress. This is not to say that older children do not benefit from treatment; they do, however as children get older the developmental gaps become wider and more difficult to catch up. Thus, it is recommended that intervention be done as early as possible.

Quality of Treatment (13%)
It is critical to ensure that the treatment your child receives is of a high quality. There is tremendous variablity in the quality of ABA services. Providers may claim to provide ABA services without the proper training or quality control.

Professional and well-qualified treatment therapists should receive ongoing extensive training and supervision by experts in the field. Your program should be as good as the person who designs the curriculum and the people that implement it.

Treatment Intensity (13%)
Children with autism face the formidable challenge of not only trying to catch up the developmental gaps that already exist but also they need to keep up their learning pace with their peers to ensure that the gaps do not widen. As an example of a child who has a 2-year delay in language may only learn one year of language in a year. This would be very ideal as it represents a lot of progress. However, the two-year delay still exists because the child is older and his peers have acquired another year of knowledge. In order to actually catch up, the student needs to learn more than one year of language in a year. If the student caught up 1.5 years of language every year, it would then take him or her 4 years to finally catch up with their peers level.

This then presents a real challenge. Given the multitude of deficits that often present in Autism, it is critical that all areas are taught intensively and systematically. It is not unlike taking a child and training him or her to become an Olympic swimmer. Spending one hour a week on one of the deficit areas that is 2 years behind is unlikely to yield the results we may wish for. Research has consistently shown that a high volume of hours (often an average of 30 hours per week) is necessary to maximize a child’s learning progress. This is often not the case in Asia where budgets and finances dictate what the treatment should be rather than what the research shows to be effective.

Consistency (13%)
In order to maximize program progress, it is critical that the whole treatment team provides service in a consistent approach. If the student is doing sign language in the morning and using pictures to communicate in the afternoon, it is likely to result in confusion on the part of the student. If a number of practitioners are working together, it is then essential that they meet regularly to formulate a comprehensive plan so that the treatment can be consistent. This is also true for the consistency between parents and the treatment team. Parents need to be involved and develop knowledge and expertise in treatment so as to help their child learn and generalize skills.

There is much debate and disagreement about whether it is possible for a child to recover from a diagnosis of autism. There is also varying views on what constitutes recovery. The first use of the term “Best Outcome” was in the seminal research study by Dr Ivar Lovaas. This term was used to describe a group of children that no longer carried the diagnosis when tested by an independent diagnostician, had normal IQ’s, were placed in mainstream classrooms with no supports and were indistinguishable from their peers. Later studies have also used these criteria to define outcome of children in their treatment programs. It is possible that children reaching this best outcome criteria may still have some quirks or have some very minor deficits that would not be able to be observed by a layman. These children might go on to university, have good careers and may get married.

Unfortunately, there has also been great misuse of the term and parents can be mislead by certain providers to believe that all children will attain this kind of outcome if you just do the right kind of treatment or take the right doses of medications. The research on ABA certainly does not show that this is the case. The current research shows that just under 50% of children who receive very intensive (30 hours per week) of ABA services at a young age will attain this kind of best outcome.

Proponents of ABA do not claim that it cures autism. Nobody knows the underlying causes of autism at this point. To claim to be able to cure the disorder would also be claiming that the underlying cause had been dealt with. Treatment providers claiming to cure autism or to be able to know the causes of autism should be treated with extreme caution as currently there is no scientific evidence to support these claims.

Autism Partnership firmly believes that best outcome is possible for many children with early intervention. However, we also believe strongly that for those who do not attain the best outcome, early intervention can have a profound effect on their quality of lives. Many of the children who do not meet the best outcome can have jobs, relationships, contribute to society and have happy meaningful lives. This is our objective for all the children we treat.