Last Monday I went to a talk given by Professor Richard Hastings, who discussed the evidence surrounding Early Intensive Behavioural Interventions (EIBI). He talked through some of the latest research demonstrating the effectiveness of this intervention for children with autism. I will briefly discuss some of his findings and will hopefully get you questioning why this is not being brought into schools as soon as possible, and how much research does it take before it is brought into practice.
Firstly, an intervention is a focused teaching experience used to teach individuals a new skill or reduce unwanted behaviour. EIBI requires a comprehensive schedule of 35+ hours a week, 52 weeks per year – this usually continues for 2 years or more. Lovass (1987) was the first psychologist to test this against the typical programme for children with autism, and found that 47% of children in the EIBI group achieved “normal intellectual and education functioning”, compared to 2% of children in the control groups. Although Lovass produced significant effects, common critiques of the study are the method used to assign subjects to control groups, the criteria for subject selection and the intellectual level of the subjects, and the choice of outcome measures (Schopler, 1989). In response to this critique the study was replicated a number of times and each found a significant effect, which suggests that EIBI is effective (MacEachin, Smith, & Lovaas, 1993; Smith, Green, & Wynn, 2000; Sallows, Graupner, Tamlynn, 2005; Cohen et al., 2006). However, a recent meta-analysis that reviewed all studies on EIBI and recovered the individual data from the children who participanted. This meant that they were able to analyse the effectiveness of the behavioural intervention at an individual level, and not only look at group means. They found that the EIBI group had significantly better outcomes than those for the control and comparison groups (Eldevik, Hastings, Hughes, Jahr, Eikeseth, & Cross, 2010).
The most interesting finding from this meta-analysis, was the improvement of both IQ and what’s called ABC gains, which is a measure of personal and social skills. This can be measured using the Vineland-II Adaptive Behaviour Scale (Sparrow, Cicchetti, Balla, 2005). What this means is that children with autism who go under this behavioural intervention will be more likely to have these important gains and therefore function within society with greater ease. This also means a better quality of life for the family, as they will be able to communicate more easily with their child and the child is more capable, than they were prior to the intervention, of performing everyday tasks by themselves. So, why is it not being implemented on a large scale?
Well, a large concern is the cost of funding this kind of intervention. The figures behind current specialist education are already very large and as there have been huge cuts to the education system, unfortunately, spending more money is impossible. EIBI involves paid tutors, Applied Behavioural Analysts (ABA), ABA supervisors and 35 hours or more of EIBI (Eldevik, Hastings, Hughes, Jahr, Eikeseth, & Cross (2010) – a lot of time and money. However, the main cost for the government when concerning the current specialist programme for children with intellectual and developmental disabilities is due to particularly difficult children being sent to residential facilities. One argument for the EIBI method is that it will reduce the number of children being sent into residential homes and will be able to stay with their family. This means that the cost could end up as equivalent to the current amount already being spent, or even cheaper (Jacobson, Mulick, & Green, 1998).
Ultimately, I hope you can see from the research i’ve discussed that EIBI is an incredible intervention that allows children with autism to develop to the best of their abilities, which should in itself outweigh the overall cost it may be to the government. However, it is unclear as to whether this would be an issue until it is implemented nationwide.
psuca2 
The EIBI topic is a topic I find very interesting, however when I was studying this for learning module one of my biggest concerns was how practical it was. The amount of hours the intervention requires is a lot, the average child spends around 30 hours a week in school (6 hours a day, 5 days a week). So if the intervention is an additional time outside the class that is very intrusive, even if it is for the benefit for the child. This study I have found focuses on training the parents extensively for them to be able to carry on the the effects of the IBI without the need for the presence of a therapist all the time. I believe this is great because this helps keep up the great effects of the training beyond the time in therapy, cutting costs in the long run.
References
1. http://www.children.gov.on.ca/htdocs/English/topics/specialneeds/autism/ibi.aspx
2. http://rsaffran.tripod.com/consultants.html
3. http://www.scovautism.com/Version_anglaise/Documents_SCOVA/ABA_Announces/Service%20IBI%20A_vm_JM.pdf
I agree with Jessicaaro above; while this is clearly an extremely useful programme to those suffering with autism, is the scale of the programme too large for families in this day and age? Not only would the children miss out on school time, it would also most likely cut into the parents careers and means they may have to miss it. Employers can be pretty stingey with maternity leave as it is. While charities try to help prevent this, the problem still persists. I can’t think of a company that would allow one of their employees to miss a few hours each day for two years, despite the help it gives to a child. They are just more likely to fire them and employ someone else.
http://mediacentre.dh.gov.uk/2012/03/14/6-8-million-to-benefit-patients-through-charities/