Abstract
The techniques of applied behavior analysis (ABA) are effective in altering the developmental trajectory of some very young children with autism. This research suggests that early, intensive treatment using the methods of ABA enables a significant number of children to enter the educational mainstream and achieve normal intellectual functioning. Both home-based and center- or school-based models have been used to deliver these services. Although discrete trial instruction is one of the most potent tools of early ABA teaching, a number of variations on this theme-the initial teaching of mands (requests), the use of an enriched environment with many items attractive to the child, and a focus on teaching the child to be highly skilled (fluent) in a behaviorall have the potential to be valuable teaching approaches.
It is possible to impact the development of some young children with autism more today than at any other time in history. The shift in our understanding and treatment of autism began around 1960 with the publication of two important works. One of these, a book by Bernard Rimland,1 offered the first plausible biologic theory of infantile autism. His book cast doubt on the then widespread notion that a defective parent-child relationship caused autism.2 The data in this debate are now clearly on the side of biology; in the past 40 years a substantial body of research has emerged suggesting that multiple biologic causes may be involved. The second major event occurred in 1966 when an article by Lovaas and colleagues3 in Science demonstrated that the principles of learning could be used to teach speech to young children with autism. Subsequent research using these principles of applied behavior analysis (ABA) has transformed our treatment of children with autism and enabled a significant number of them to enter the educational mainstream, in some cases with minimal extra support.
In this article we review the research on the benefits of ABA for the education of children with autism up to 5 or 6 years of age. We present the most common models for service delivery and discuss a few recent treatment innovations.