Should we change targets and methods of early intervention in autism, in favor of a strengths-based education?

Eur Child Adolesc Psychiatry. 2017 Jul;26(7):815-825. doi: 10.1007/s00787-017-0955-5. Epub 2017 Feb 8.

Abstract

Early intensive behavioral intervention (EIBI) and its recent variant, naturalist developmental behavioral intervention (NDBI) aim to increase socialization and communication, and to decrease repetitive and challenging behaviors in preschool age autistic children. These behaviorist techniques are based on the precocity and intensity of the intervention, face-to-face interaction, errorless learning, and information fragmentation. Once considered to be "scientifically proven", the efficacy of these approaches has been called into question in the last decade due to poor-quality data, small effects, low cost-efficiency, and the evolution of ethical and societal standards. Grounded on a reappraisal of the genetic and cognitive neuroscience of autism, we question three aspects of EIBI/NDBI: their focus on prerequisites for typical socio-communicative behaviors, their lack of consideration of autistic language development and learning modes, and their negative view of repetitive behaviors and restricted interests. We propose alternative predictions for empirical validation, based on the strengths of prototypical autistic children: (a) their non-verbal intelligence should be normally distributed and within the normal range; (b) improving access to non-communicative verbal and written auditory language material should favor their subsequent speech development and

Keywords: Autism; Autistic strengths; Early intensive behavioral intervention; Intelligence.

MeSH terms

  • Autistic Disorder / psychology*
  • Behavior Therapy / methods*
  • Child
  • Child, Preschool
  • Early Intervention, Educational / methods*
  • Female
  • Humans
  • Intelligence
  • Male