Does ABI / early intervention actually work??

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You know, I'm kind of skeptical and cynical as to whether applied behavioural intervention (and its variants) for people with Aspergers actually works...I mean, if they had a subject group of kids who received ABI and monitored their progress through to adulthood, then compared the outcomes with another subject group of kids who _didn't_ get early intervention therapy. Otherwise, I can't help but wonder if it's all in the name of profit, with just a bunch of smoke-and-mirrors thrown at desperate parents.

Another reason I'm skeptical of it, is that how can it work on the subject if they're at such an early age that they have little to no incentive to see all the later rewards in life, i.e. girlfriend/ wife, home and car ownership, career progression, a good circle of friends, ability to take vacation and travel to interesting places etc etc... I mean, even at the of 11-12, even NT kids aren't thinking about things like that - they're just taking it for granted that it will all fall into place later, and to a large degree they're right, because they're accumulating social skills and experience while their AS counterparts are being ostracized and left in the dust. So I suppose that incentives have to be tailored to the short-term, not the long-term so much - but clearly it depends to a certain extent on the personality of the person with AS ("When you've met one person with Aspergers, you've met one person with Aspergers!!" )

I suspect that many young kids like ages 7, 8, 9, will simply be more preoccupied with what playground to bike to, what Lego project or model airplane project to tackle, or what video game to play - any of this "ABI nonsense" must seem like a drag to them, and they wouldn't really see "the big picture". It would seem like a lower priority b/c they can't foresee the heartache and sorrow that will inevitably come with the pre-teen and teen years.

Back in the ‘80s, when I was a kid, we didn’t have labels for AS, let alone early behavioural intervention therapy. I was fortunate enough to have strong insight into my inherent differences and make great strides, only getting a diagnosis in 2001 at the age of 27, at which point I already had a girlfriend, a good job in CS/IT, and a close circle of friends. Although I still had struggles due to lacking ToM and “the big picture” in deciphering expectations, I was at least able to mitigate some of my verbal and non-verbal oddities through directed therapy and practice in front a mirror while watching movie clips. I can only hope a greater percentage of my fellow Aspergians turn out for the better as a result of ABI, and we’re not condemned to this “80% chronically unemployed or underemployed, 90% unmarried or unattached” statistic.

Depends what you mean by it 'working'.

There is no good evidence that ABA can cure autism, which is a common marketing claim by ABA proponents. However, it is definitely an effective teaching tool for many kids. Research has shown that on average, autistic kids who get ABA end up higher functioning than those who don't.

A meta-analysis (analysis of multiple studies combined) on this topic can be found here:

http://tvodigitaal.nl/100jaarPDF/tmb/PDF/free/2013septemberPeters-Scheffer.pdf#page=137

They found that on average, kids who had received ABA scored higher on IQ tests (probably not actually getting smarter, just more testable, but that's still significant), showed better receptive and expressive language and were more independent in everyday activities (things like dressing self, being toilet trained, etc), than kids in the control groups (usually some sort of eclectic and much less intensive therapy).

So, yes, ABA works. Not on every kid, mind you, but for many kids, it makes a big difference.

Unfortunately, no one's followed ABA recipients into adulthood, nor have they assessed self-esteem or many other 'internal' measures of psychological health. I suspect the story might be less positive if we looked at those things, but that remains to be seen. Even if I'm right, though, the answer isn't to toss out a treatment that is clearly so effective, but rather to tweak it a bit.

The thing about ABA is that they don't need to know why the skills are important. Their motivation is to get the treat or sticker or whatever the therapist is using as a reinforcer for the activity.

It's like training a dog. Research has shown that seeing eye dogs don't actually realize their owners are blind. However, they know that they're supposed to do X and Y and Z and if they do it, the humans will like them and do nice things for them. Similarly, most kids in ABA have no idea why it's important for them to dress themselves or use the toilet or mimic the therapist's actions or say what color a toy is. They just know that if they do what the therapist wants, the therapist will do something they want.