Science On Your Side: Evidence About the Role of Parents in Autism Treatment

This post originally appeared in the May 2009 print version of Motivations.

Most parents of kids with autism know that, under the IDEA law, parents are members with equal standing on their child’s IEP team.  But many of us have difficulty asserting ourselves in this role because we may be the only member of the team without specialized credentials in special education or therapy.   Generally, I have found it helpful to remember that the meeting is not about special ed or therapy in their entirety, things the other team members know much more about than I ever will.  It is about how they might apply to my daughter.  I am one of the two world’s leading experts about my daughter.

 While this idea builds my confidence, it is especially useful to learn that scientific research supports my active role in my daughter’s education and treatment.   Intervention researchers who have studied the effectiveness of Applied Behavior Analysis (ABA) for autism have also researched the value of parents contributing to the interventions.    Here are some of the findings, all published in respected, peer-reviewed journals:

In Ivar Lovaas’ landmark study at UCLA showing the effectiveness of ABA for autism, parents were a vital part of the treatment:

“The parents worked as part of the treatment team throughout the intervention; they were extensively trained in the treatment procedures so that treatment could take place for almost all of the subjects’ waking hours, 365 days a year.”

Lovaas, O. Ivar. (1987) Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children. Journal of Consulting and Clinical Psychology, 55, 3-9.



More recently, when Lovaas’ findings were repeated outside of the university setting, the role of parents was retained, and even expanded:

“Parent-directed children, …, did about as well as clinic-directed children, although they received much less supervision.  This was unexpected, and it may have been due in part to parent-directed parents taking on the senior therapist role, filling cancelled shifts themselves, actively targeting generalization, and pursuing teachers and neighbors to find peers for daily play dates with their children.”

Sallows, Glen O. and Tamlynn D. Graupner. (2005) Intensive Behavioral Treatment for Children With Autism:  Four-Year Outcome and Predictors.  American Journal on Mental Retardation, 110 (6), 417-438.

“Results indicate parents effectively implemented the intervention, successfully teaching joint attentions skills to their preschoolers with autism…. Parents play a vital role in interventions for their children with autism.   As these results demonstrate, given effective methodology, parents can successfully intervene on key social-communication skills such as joint attention in their child’s natural environment.”

Jones, Emily A. and Kathleen M. Feeley. (2007) Parent Implemented Joint Attention Intervention for Preschoolers with Autism.  The Journal of Speech-Language Pathology and Applied Behavior Analysis, 2 (3), 253 – 268.

Parents participating in ABA treatment have had a positive impact on retention and generalization of skills:

“These studies demonstrate…that teachers and parents can carry out important and significant studies in natural settings using resources available to them.    In doing so, they demonstrated that systematic behavioral analysis procedures can be successfully employed by teachers and parents using resources and contingencies readily available in school and home settings.”

Hall, R. Vance, Connie Cristler, Sharon S. Cranston and Bonnie Tucker.  (1970) Teachers and Parents a Researchers Using Multiple Baseline Designs.   Journal of Applied Behavior Analysis, 3, 247-255.

“…the children whose parents were trained largely retained their gains or continued to improve.  The gains the children made in appropriate play, social non-verbal, and appropriate verbal behaviors were usually retained. … When the contingencies were instated both in the home and at school, behavior changed in both settings.”

Lovaas, O. Ivar, Robert Koegel, James Q. Simmons and Judith Stevens Long.  (1973) Some Generalization and Follow-up Measures on Autistic Children in Behavior Therapy.  Journal of Applied Behavior Analysis, 6, 131-166.

These same authors concluded:
“Many therapists … now argue that the child’s parents are essential as mediators of treatment.”   [emphasis added]