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Published in: European Child & Adolescent Psychiatry 7/2017

Open Access 01-07-2017 | Original Contribution

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

Author: Laurent Mottron

Published in: European Child & Adolescent Psychiatry | Issue 7/2017

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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 (c) decrease their problematic behavior; (d) lateral tutorship should increase the well-being of children and parents to a greater extent than personalized, face-to-face interventions by professionals; (e) admission to regular, but supervised daycare centers, combined with parental support and on-site crisis solving, represents a more cost-effective educational intervention than EIBI/NDBI.
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Metadata
Title
Should we change targets and methods of early intervention in autism, in favor of a strengths-based education?
Author
Laurent Mottron
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
European Child & Adolescent Psychiatry / Issue 7/2017
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-017-0955-5

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