Why is the intensity of treatment so important?
Mental Health: A Report of the Surgeon General states, "Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior." The research of Ivar Lovaas and his colleagues at the University of California (Lovaas, 1987), calls for an early intensive, one-on-one child-teacher interaction for 40 hours a week.
The graph below illustrates the learning gap that occurs over time between a neurotypical child and a child with ASD. The yellow line represents the steady developmental progress from birth through 18 years of age in the average child. At 18 years of age, this child is expected to graduate from high school, begin to live life independent of his or her parents, and become a contributing member of society. The green line represents the developmental progress of a child with ASD. There are three important points illustrated by this graph.
1. The children in each situation make steady developmental progress, but the rates of progress vary. Children with developmental delay usually make steady developmental progress, but they do things at a different age than other children.
2. The end point of achievements for a child who is developmentally delayed is often different from that of the average child. Exactly what will be achieved in adulthood can vary dramatically within the developmentally delayed population as it does within the "average" population. Rate of progress during the first five to seven years of life generally provides a good deal of information about approximately where a child fits in on this illustrative graph.
3. The learning gap between these children dramatically increases as time goes on. Because in the beginning years of life the developmental differences between these two children may not be apparent, many children do not get the intense treatment necessary. As a result they begin to quickly fall further and further behind and now have to catch up to peers who are continuously learning new information every day. Therefore if we teach children with ASD at the same rate as typical children, this gap will continue to increase. In order to decrease the gap we need to teach these children at a faster, more intense rate than typical developing children are learning.