ABA IN THE NETHERLANDS

1. ABA IN THENETHERLANDS 31.01.2013 Dr. Jacqueline J. Schenk School of Pedagogical & Educational Sciences Erasmus University Rotterdam The Netherlands

2. Outline • Diagnosis and prevalence • Demand for behavioural interventions for people (of all ages) with autism in the NL • Recent change in health care and education • ABA-based services in the NL: study results • ABA training and education in the NL • Conclusions

3. Diagnosis of Autism

4. The Netherlands Diagnosed autism is more common in an IT-rich region, such as Eindhoven (Philips, ASML, IBM and ATOS Origin) Roelfsema et al. (2011) J Autism Dev Disord

5. Why this increase? • Early diagnosis and screening • More (scientific) knowledge of predictors • and early warning signals • Worldwide • Boys: 1:54, girls: 1:252 • The Netherlands: 1:100 on average..

6. After the diagnosis…..in NL ? ?

7. After the diagnosis (anecdotal) • Bereavement groups • Psycho-education • Parent groups for support • Random/inappropriate professional advice regarding effective behavioural interventions

8. Time to collect some data… • 10 ABA (-ish) organisations • Questionnaire (structural characteristics) • Mission; claimed intervention characteristics staff:child ratio; educational background of staff; no. of hours per child (av/range); number of trainers per child; educational context; materials; admission & exclusion criteria, parent involvement etc. • Behavioural observations on site • To validate (or not) characteristics of interventions

9. Used in the NL (in theory) • DTT (Discrete Trial Training) • PRT (Pivotal Response Treatment) • Sonrise • Verbal Behavioural Intervention • TEACCH (Treatment and Education of Autistic and Handicapped Children) • CGT (Cognitive Behavioural Therapy) • PECS (Picture Exchange Communication System) • Bits and pieces from all of the above • (Neidt & Schenk, Wetenschappelijk Tijdschrift voor Autisme, June 2012)

10. In reality? • All had the same mission (i.e. optimal development) • Similar in 1:1 training, all private, all working many hours, all working in isolation • Huge differences in structural characteristics • Educational background of staff • Supervision and IRR procedures • No of staff working with each child • No of children attending the service (range 1-75, av. 20) • Criteria for mastery • Parental involvement • (Neidt & Schenk, Wetenschappelijk Tijdschrift voor Autisme, June 2012)

11. Recent developments • Parents increasingly demand ABA based interventions at all levels of (pre) education • Increasing number of organisations offering “ABA” services of variable quality and cost (!) • “ABA” services approach us to carry out effectiveness studies

12. WHY? • Parents appear to read more than professionals • Schools now responsible for EO • “ABA “ services will not be paid by health care system if they don’t provide evidence for effectiveness • Teachers working in inclusive schools lack knowledge and training on “behaviour”

13. Compared to many other countries in Europe, we are very behind

14. Education & training in NL • 8 Dutch universities • 8/8 offering Psychology, Pedagogical and/or Educational sciences at BA and MSc level • 0/8 offering ABA training

15. Conclusions… • Hardworking professionals and parents of children with autism, but… • Eclectic use of early behavioural ABA-based interventions • Lack of professional academic training and ABA consultancy opportunities • Lack of funding despite the conclusion by Ministry of health (Gezondheidsraad, 2009) about its effectiveness and need for evidence-based practice

16. The STAMPPP Project • Simple Steps in Dutch !-> Parental testimonies, animations, demonstrations, and textural material to teach ABA principles to Dutch parents, professionals, students etc. • Maximises learning opportunities for children with autism • Enables parents to become proficient in delivering home programs for their children • Facilitates the coordination of child learning opportunities at home and school

17. THANK YOU! schenk@fsw.eur.nl