|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
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
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
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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