Here at Applied Behavioral Strategies, our mission is to improve the quality of life through effective intervention. One way we hope to do that is by reviewing research articles for our readers. Today’s article is titled,”Six Developmental Trajectories Characterize Children With Autism”. Christine Fountain served as the lead author along with Alix S. Winter and Peter S. Bearman. The journal called Pediatrics published the study. The original paper is available online now, and will come out in paper in May, 2012.
This paper has received quite a bit of press lately so we thought that we could shed some light on the study for our readers. We want to point out that the National Institutes of Health (NIH) funded the study as part of their early career awards for new scientists.
The authors noted that the purpose of the study was to “describe the typical longitudinal developmental trajectories of social and communication functioning in children with autism and to determine the correlates of these trajectories”. In reader terms that means that this is not an experimental study but rather a correlational study. The authors did not apply any treatments, they merely looked for patterns and relationships in existing data.
The authors examined data from a group of children in California. They analyzed data from the age of diagnosis until the children turned 14. The California Department of Developmental Services (DDS) provided the data set to the authors. This is important because the data are most likely skewed as every parent does not necessarily register their child with the state. For example, parents who are living in the state illegally are not likely to register their children. Additionally, it is highly unlikely that wealthy families took the time to register their children (think Hollywood, movie stars, secrets). Finally, parents who are not connected to community resources, may not find out that such a service exists. Thus, we must look at this study as extremely limited in validity because the sample is biased from the start.
The authors analyzed data from 6, 975 children. The authors also noted if any of the children had a diagnosed intellectual disability. The diagnoses were all completed by California DDS psychologists.
The authors examined the birth records of the children paying attention to several factors:
- maternal age at birth
- maternal education
- maternal race and ethnicity
- place of birth
- child’s gender and birth weight
- and whether Medi-Cal (California’s Medicaid program) paid for the birth (a loose indicator of Socio-economic Status
A somewhat standardized measure was used to identify the functioning level of the child. The measure was also completed the DDS staff an it was completed annually. The measure included several questions about social skills, several questions about communication skills, and several questions about adaptive behavior. These items were used to examine improvement or change over time.
It is important to note that the authors did not contact the children or their parents at any point in this study. Additionally, the authors did not attempt to document what types of intervention the children received to address the autism. This is incredibly important
because some interventions have been proven to have long-term effectiveness for children with autism. If children were receiving this intervention, the data in the study would be impacted. If you are interested in reading about the effective intervention, you can read this, or this, or even this.
- Many of the children showed substantial improvement over time.
- Some children changed quickly and greatly while others remained “flat lined” or experienced little growth over time.
- Children who appeared to be “high functioning” at the beginning tended to improve more rapidly.
- The most rapid development occurred before age 6 (note: this is consistent with the original studies on ABA).
- The authors then identified a group of “bloomers” that started out fairly low at first but then improved at a rapid pace appearing similar to the higher functioning individuals
- The authors reported that the repetitive behaviors remained fairly stable over time across groups.
- Sadly, the lower functioning group tended to be non-white, Medi-Cal recipients, with mothers who were younger and foreign-born.
- And not surprisingly, the higher functioning group tended to be born to older, more educated, white mothers, and they were less likely to be a Medi-Cal recipient.
This peer-reviewed published paper is an absolute joke. It is horrifying (and embarrassing) to think that a person with advanced training in research would publish a disgrace of a paper. The authors failed to consider the fact that these children were most likely receiving intervention paid for by DDS. The Center for Autism and Related Disorders has 12 offices in California and they regularly provide ABA services to children using funds from DDS. Why was this important point not mentioned?
Even more disgraceful is the fact that this study was funded by the NIH! Clearly, our tax-payer dollars are not being used to fund important research. Why did the authors ask important research questions like:
- How much intervention were the bloomers receiving compared to the other groups?
- What type of intervention if any were the children of non-white, low-income, and uneducated mothers receiving?
- Does more intervention lead to better outcomes?
We must help educate the public that ABA intervention works. Children do not outgrow autism and they do not magically “bloom” like spring flowers. Their growth is the result of hard-working parents, teachers, and therapists. Please get the facts straight.
Of course, if you have a topic that you would like for us to review, please let us know by posting in the comments below or you may always reach us at info at applied behavioral strategies dot com