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Future research may allow therapists to know in advance which type of applied behavior analysis (ABA therapy) is most likely to work for any given child with autism.

This study of six children was designed to see if it is possible to predict which type of ABA therapy will work for which child with autism.

The authors were able to predict which children would respond to pivotal response training, but not which ones would respond to discrete trial training. The authors note that all children were first exposed to pivotal response training and then to discrete trial training and this may have influenced the results. Children who liked toys were more likely to respond to pivotal response training than children who did not like toys.

The study, published online today in the journal Pediatrics, examined an intervention called the Early Start Denver Model, which combines applied behavioral analysis (ABA) teaching methods with developmental 'relationship-based' approaches.

The five-year study took place at the University of Washington (UW) in Seattle and was led by Dawson, then a professor of psychology and director of the university's Autism Center, in partnership with Rogers. It involved therapy for 48 diverse, 18- to 30-month-old children with autism and no other health problems.

At the conclusion of the study, the IQs of the children in the intervention group had improved by an average of approximately 18 points, compared to a little more than four points in the comparison group. The intervention group also had a nearly 18-point improvement in receptive language (listening and understanding) compared to approximately 10 points in the comparison group. Seven of the children in the intervention group had enough improvement in overall skills to warrant a change in diagnosis from autism to the milder condition known as 'pervasive developmental disorder not otherwise specified,' or PDD-NOS. Only one child in the community-based intervention group had an improved diagnosis.

The view of the behavior analyst should be that the subject is always right. If the child isn't learning, you need to know why. It's not that the child is defective, it's that the approach isn't working. The therapist needs to ask, "what do I need to do to teach this child?" ...Being autistic shouldn't stop children from learning. It has nothing to do with their ability to learn. They just don't learn typically. That's the problem we have. You can't use "autism" as way to explain behaviors: it is the behaviors. Why do the behaviors occur? We don't always know. But that doesn't mean we can't teach children with autism language and social interaction. They don't need us to have fun -- they can create their own reinforcers. The therapist has to find a reinforcer that's better than what the child can do on his own. That "better thing" should always have a social component.