Efficacy of Behavioral Interventions for Young Children with Autism Spectrum Disorders: Public Policy, the Evidence Base, and Implementation Parameters

Abstract

The complex and extensive deficits associated with Autism Spectrum Disorders, in concert with the substantial increase in prevalence over the last three decades, combine to present a challenge to individuals, families, communities, and government that has few parallels. This challenge is complicated by debate among service providers concerning appropriate treatment approaches and the evidence for efficacy. Within this backdrop, numerous healthcare reform initiatives have included coverage for Autism Spectrum Disorders, both enhancing and complicating the role of public education in the mix of provision of appropriate services. Basic principles of limited resources and expenditure accountability require that standards of care and evidence-based procedures be established and agreed upon. While this approach is common in health insurance policies and procedures, it is less so in public education. The purpose of this review is to provide impetus toward guidelines for comprehensive treatment services, as well as individual skill/behavior interventions, with respect to required service provider characteristics, setting, and “dosage” (number of hours per week for a designated time period). Quantitative analysis will permit progress in review panel deliberation for both insurance reimbursement and public services allocation by having appropriate comparisons with which to evaluate progress reported versus progress expected given the specific intervention program being provided.