Some generalization and follow-up measures on autistic children in behavior therapy.
Gains from behavior therapy disappear unless parents keep running the program after sessions stop.
01Research in Context
What this study did
The team worked with 20 autistic children in a behavior therapy program. They tracked each child’s progress during treatment. Later they checked who kept improving and who slid back.
What they found
Every child made gains while therapy was active. Kids whose parents kept using the methods at home stayed better. Children placed back in institutions lost most of the progress.
How this fits with other research
Mélia et al. (2019) followed children one year after low-intensity ABA and saw the same warning: IQ held, but autism symptoms bounced back without ongoing support.
Singh et al. (1982) surveyed parents who had been trained as co-therapists; half stopped using the skills, matching the 1973 drop-off.
Lawer et al. (2009) later showed parents follow medical advice more than behavioral plans, giving a reason for the fade.
Clark et al. (1977) extended the idea to teachers: child gains appeared only after staff reached fluency, proving the adult’s continued skill is the key in any setting.
Why it matters
The paper tells us parent implementation is not an extra—it is the treatment engine. If you discharge when the child looks good but leave parents unsupported, expect regression. Build maintenance into the plan from day one: weekly check-ins, booster sessions, and simple data sheets parents can keep.
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02At a glance
03Original abstract
We have treated 20 autistic children with behavior therapy. At intake, most of the children were severely disturbed, having symptoms indicating an extremely poor prognosis. The children were treated in separate groups, and some were treated more than once, allowing for within- and between-subject replications of treatment effects. We have employed reliable measures of generalization across situations and behaviors as well as across time (follow-up). The findings can be summarized as follows: (1) Inappropriate behaviors (self-stimulation and echolalia) decreased during treatment, and appropriate behaviors (appropriate speech, appropriate play, and social non-verbal behaviors) increased. (2) Spontaneous social interactions and the spontaneous use of language occurred about eight months into treatment for some of the children. (3) IQs and social quotients reflected improvement during treatment. (4) There were no exceptions to the improvement, however, some of the children improved more than others. (5) Follow-up measures recorded 1 to 4 yr after treatment showed that large differences between groups of children depended upon the post-treatment environment (those groups whose parents were trained to carry out behavior therapy continued to improve, while children who were institutionalized regressed). (6) A brief reinstatement of behavior therapy could temporarily re-establish some of the original therapeutic gains made by the children who were subsequently institutionalized.
Journal of applied behavior analysis, 1973 · doi:10.1901/jaba.1973.6-131