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Right From The Start: Behavioral Intervention for Young Children With Autism
(Sandra Harris, Ph.D., & Mary Jane Weiss, Ph.D., BCBA, Woodbine House, 2nd edition, 2007). (Reviewed by the CT FEAT Board of Directors)

It is widely recognized that children on the autism spectrum make the greatest gains when they receive the earliest possible intensive behavioral intervention. But, even within the world of behavioral treatment, there exist varying approaches and a wide range of quality.

Written specifically for parents of newly diagnosed young children, Right From The Start provides all the essential information parents need to answer two of the most urgent questions facing them:

1) whether to seek applied behavior analysis (ABA) based treatment; and
2) how to recognize a good ABA program that fits their child’s particular needs.


The authors, professors at Rutgers University with decades of clinical experience treating children with autism, get parents quickly up to speed on all the information they need to make these critical treatment decisions. It is, by far, the single most important first book that parents of young children should read.

Decades of research have clearly established that early and intensive ABA treatment provides children with the greatest gains, up to and including recovery for some. So why do so few children receive this treatment?

Too often, parents learn about behavioral treatment after it’s too late to obtain maximum benefit from it. Also, many parents mistakenly believe that their early intervention provider or school system is providing their child with an “ABA program” which meets the quality criteria established by the research. Unfortunately, most do not.

Unlike most autism treatment books, this one is short (164 half-sized, large print pages, including dozens of helpful tables and pictures), and written in a clear, accessible style. Despite its brevity, it covers all the most important topics a parent needs to understand in assessing treatment options, including:

1) ABA treatment and the research supporting it;
2) What to teach and how to teach it, including descriptions of the most widely used ABA teaching methods;
3) The similarities and differences among the various ABA models (i.e. home-based, center-based, or school-based);
4) A description of the essential minimal components of any bona fide ABA treatment program.

The authors also delineate the key “common features of excellence” shared by all good quality ABA programs, including:

1) adequately trained and supervised staff;
2) a rich ratio of adults to children (“it is not uncommon for programs to offer a one-to-one ratio of adults to children during the first year or two of instruction”);
3) opportunities for integration with normally developing peers;
4) provisions for parental training and involvement;
5) intensity of hours (at least 25-40 hours per week);
6) a well developed and individualized curriculum.

If any of these components is missing, the program is seriously lacking.

Every parent reading this book will come away with a good handle on the sometimes arcane vocabulary of behavioral treatment methods: e.g. discrete trial instruction (DTI), Natural Environment Training (NET), Verbal Behavior, Incidental Teaching, Fluency, Errorless Learning, Pivotal Response, etc. Parents also will learn how a mix of these approaches (with different mixes for different kinds of kids) can be optimal for a given child.

The authors effectively address the most persistent myths about ABA treatment (e.g. that it’s not effective for teaching social skills), and are refreshingly candid in their discussion of possible outcomes. While recognizing that some children lose their autistic symptoms as a result of early and intensive ABA treatment, the authors also acknowledge that some small number children may not make all that much progress at all, however intense the intervention.

Ultimate outcomes are as varied as the children receiving the treatment. But all children on the autism spectrum benefit from some form of early and intensive behavioral intervention.

This is an extensively revised version of a book first published almost 10 years ago. The new edition, which takes account of all the new developments in ABA treatment during the intervening years, is much more up to date than its predecessor.

The huge outpouring of information on autism in recent years – books, web sites, listservs, etc. - has been a somewhat mixed blessing for parents of newly diagnosed children. The danger is that parents won’t read the most important stuff soon enough to provide their children with the maximum benefits of early and intensive treatment.

Their first forays into the complex world of autism treatment often leave parents feeling confused, overwhelmed and even intimidated. But with Right From the Start as their friendly, supportive, and indispensable guide, parents will navigate this journey will more success and less anxiety.

(The list price of this book is $18.95 but Amazon recently has been selling it for about $14.00)

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