[Feature Article] Sin Chew Newspaper: Using Applied Behavioral Analysis To Treat Autism

On the 5th of April, our director, Jochebed Isaacs, was featured in the Sin Chew Newspaper, speaking about an introduction to autism.

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Using Applied Behavioural Analysis To Treat Autism

Published in: Sin Chew Newspaper

Published on: 5th April 2016

April 2nd is World Autism Awareness Day. According to statistics, 1 out of 68 children are affected by autism. Over the years, scientists have indicated that autism might be caused by environmental, biological or genetic factors, but until now, the exact cause of autism is still unknown. Applied Behavioural Analysis (ABA), which is the most empirically valid treatment for autism, has shown successful outcomes in treating children with autism.

Best practices in both the United States and the United Kingdom support early intervention. A child can be diagnosed as young as 18 months of age. Once he or she is diagnosed, an individualised curriculum is important. According to statistics, 50% of children with autism can catch up to typical learning development and integrate into society successfully with at least 30 therapy hours per week in a centre or home setting.

The director of Early Autism Project (EAP) Malaysia, Jochebed Isaacs, says, "The display of one or two symptoms of autism, or a 5-minute interview by a doctor is not enough to give a diagnosis of autism for your child. In fact, most parents do not understand the diagnosis evaluation given.

A professional and comprehensive diagnosis can take up to 2 to 3 hours, which includes observation of the child and a thorough interview with his or her parents. Here are some red flag behaviours for parents to watch out for:

  1. No babbling or cooing by 12 months
  2. No gestures (finger point, wave, grasp) by 12 months
  3. No single words by 16 months
  4. No 2 word phrases by 24 months
  5. Any loss of language skills at any age

Others red flag behaviours include:

  1. Does not point to show interest in something.
  2. Does not respond when name is called.
  3. Does not show interest in other children.
  4. Does not bring objects to adults.
  5. Does not look at objects when adults point to them.
  6. Does not imitate adult’s movements.

On another note, parents can do a self-screening for your child using the M-CHAT-R. Lastly, parents need to refer to a clinical psychologist, psychiatrist, neurologist or developmental paediatrician to receive a more thorough assessment for autism.

The golden standard assessment tool for autism is the Autism Diagnosis Observation Schedule (ADOS). However, there is very little expertise in this field in Malaysia. Hence, Jochebed suggested to use The Diagnosis and Statistical Manual of Mental Health (5th Edition) (DSM-5) as the golden standard for diagnosis.

In addition to that, Jochebed also mentioned that our country does not have any regulatory standard for the autism diagnosis. She is worried that the fresh graduates who lack in experience might claim that they have the ability to diagnose a child with autism. In fact, Jochebed said that "experienced expertise is indeed important to diagnose a child on autism spectrum, especially for the verbal children."

Many people think that all people with autism are geniuses. Jochebed explained that only 10 percent of the autism population are savants, which means they have extraordinary skills in areas such as art or music that we don’t normally find in others. Last but not least, autism is a spectrum disorder, which means people are mildly, moderately or severely affected.

Categorization of Autism

Jochebed explained that previously, based on the The Diagnosis and Statistical Manual of Mental Health (4th Edition) (DSM-IV), autism is under the category of Pervasive Developmental Disorder (PDD). This also included Asperger syndrome, pervasive developmental disorder-not otherwise specified (PDD-NOS) and childhood disintegrative disorder.

Specialists encountered difficulties in differentiating mild autism from Asperger disorder over the years. People with Asperger disorder do not possess cognitive and communication difficulties. They only possess some behaviour and deficits in social skills. Moreover, the possibility of people diagnosed with Asperger was very rare, and most of the time, they were diagnosed autism or social phobia instead.

After years of research, the American Psychological Association decided to abolish the label of Asperger and summarised it under the Autism Spectrum Disorder by December 2012. Autism Spectrum Disorder is then further categorised as mild, moderate or severe autism. As a clinical psychologist, Jochebed said that this categorisation was much clearer and helpful for the accurate diagnosis and intervention.

However, she stated that if the individual has been diagnosed with Asperger disorder, he or she can continue with the treatment without further diagnosis.

For more information, please visit the official site of Early Autism Project, Malaysia, www.autismmalaysia.com.