Thursday, May 30, 2019

DIRFloortime is Evidence-Based…Even if the ABA Industry Propaganda Tries to Say Otherwise


In recent years as research studies on DIRFloortime have continued to be published in peer-reviewed professional journals, I have seen a steady decline in the questions about the evidence-base for DIRFloortime.  However, there are many in the ABA industry in particular who continue to make false statements about DIRFloortime.  This happens even more so when ICDL has an event where many attend or we are advocating for parent choice and increased access to DIRFloortime for families.  We have seen it most recently with attempts to block health insurance coverage for DIRFloortime and following courses and conferences around the world including the recent conference in Moscow. 

If anyone objectively reviews a program for its evidence-base, one would look for a combination of case studies, group design studies, randomized controlled trial studies, and systematic reviews.  To be clear and simple, DIRFloortime has all of these.  There are research studies of each type of research design noted published in peer-reviewed journal articles.  I am not going to go through a laundry list of citations, but you can read a quick review by clicking here and look a longer list by going to www.icdl.com/research.

While there are many amazing and caring professionals in the ABA community for which I have much respect, there is also a group of strategically savvy ABA industry advocates that will promote ABA and demote approaches they see as competition in whatever way possible.  Even though I am not a fan of ABA, I understand their desire to promote what they believe works.  I do the same thing.  But, the methods they often employ and the work to demote anything else is where I get very frustrated.  In many ways, this ABA industry advocacy has utilized a propaganda campaign that uses many well established propaganda techniques including spreading false information under the guise of an apparent authority (i.e. “National Autism Center”) and instilling fear.  It is hard to see any reason why this happens besides the promotion of the ABA industry which is driven by financial motivations.  While ICDL promotes DIR Floortime, it is done within the context of advocating for family choice.  We believe families should have a choice in the interventions that are available and accessible to them, whether they pay privately, use health insurance, or are being supported by a government funded program. 

I know “propaganda” is a strong word, however it is hard to understand it any other way when you begin to look at what is happening.  For example, in response to our conference in Moscow, an organization called the Association for Autism Regions in Russia complained to the Ministry of Education and posted their objection to the use of DIRFloortime stating it is not science-based.  In their post, they attached a letter from Dr. Elena L. Grigorenko as their primary source to support their claim.  Dr. Grigorenko went on to cite the Association for Science in Autism Treatment which cites the National Autism Center as a key source in their articles.  Both of these organizations work to promote ABA.  They would probably cloak it as promoting science-based interventions, but look at the facts.  Look at who is behind the organizations and their goals.  The organization that is behind the National Autism Center is the May Institute.  On the May Institute website the opening line on the about page states, “May Institute is a nonprofit organization that is a national leader in the field of applied behavior analysis…”  In much of their promotion of their 144 different programs in 7 different states, they present this as services that are “evidence-based” or “science-based” yet they are self-declaring themselves as a leading ABA organization.  Even on the National Autism Center website they openly state in the first lines on the about page the following, “The National Autism Center is May Institute’s Center for the Promotion of Evidence-based Practice.  May Institute is a nonprofit organization that is a national leader in the field of applied behavior analysis…”  How can an organization that cites they are a “leader in the field of ABA” ever be considered to be objective.  As an ABA service provider and industry advocate, it is in their best financial interest to not have more innovative and effective approaches emerge.  They have gone so far as to create a contrived National Autism Center that published a biased “Standards Project” that seems to have a goal of bolstering ABA and scaring people about other approaches.  While I do not know the Russia-based Association for Autism Regions well enough to make any judgments on their work, it does not take much peeling back of the facts to see that much of what they are presenting to their government on their opposition to DIRFloortime is based on propaganda created by ABA industry advocates.  This is very concerning.  Bottom line, if you see any site that states that they only provide “science-based” autism services, be very cautious as this is a common cloak for the ABA industry to state they are only providing ABA. (I'll address fruther the problems with how the term "science" is used in a future blog.) 

The other part of this that amazes me about this savvy group of ABA industry advocates is that they are promoting old science and trying to squash innovation.  The more recent science and research on autism, including very compelling brain research, clearly indicates that autism is not simply a disorder of behavior as the ABA industry often presents (for example, the Association for Science in Autism Treatment and the May Institute both refer to Autism as a “neurobehavioral” disorder).  Autism is clearly a neurodevelopmental condition that results in neurodiverse individuals that often perceive and interact with the world in different ways than neurotypical individuals do.  This can include many individual differences that can be amazing strengths and others that can be distressing and disabling.   Understanding Autism as a behavioral disorder is not only short-sighted, it is simply wrong and science continues to tell us this more and more clearly. 

So, please don’t be misled or allow others to be misled by the ABA industry’s propaganda efforts that seek to undermine access of DIRFloortime to families by falsely claiming DIRFloortime is not evidence-based.  It is simply wrong. DIRFloortime is supported by a solid and growing evidence-base.  The days when ABA advocates could say “ABA is the only evidence-based intervention for Autism” are long gone. Families should no longer be stuck with only one choice. 

6 comments:

  1. I feel grateful for your willingness to write about this. Thank you for making it comprehensive and clear. So important. Our family is so grateful for DIR and it remains threaded into our fabric. Unfortunate, yet not surprising, that greed can drive some to prevent others from getting what they need. I believe, however, that there is more good in the world than bad; we simply need to spread the word. Thank you, again, for these words.

    ReplyDelete
  2. Dr, Chris (Plauche Johnson originally discredited Floortime in a paper she wrote, based on a not so great relationship with Dr. Greenspan. This paved the way for no insurance for DIR.

    ReplyDelete
  3. "Look at who is behind the organizations and their goals." Yes, let's also look at who is behind your organization and goals. The ICDL was founded by Dr. Greenspan to promote DIR/Floortime, then you write hit pieces on ABA to promote your garbage, for profit, intervention. You are literally doing exactly what you claim many well respected organizations are doing. Shameful.

    ReplyDelete
    Replies
    1. I know that my blog is upsetting to some. But, there are some things I’d like to correct regarding your comment. ICDL was created 29 years ago to redefine the world’s understanding of child development and developmental disabilities. While there is still work to do, most of the world has such a better understanding of the child development process since we started 29 years ago. The most frustrating area that is lagging behind is in the specific field of autism. Many are stuck in a behaviorally-based understanding of autism which is, at a minimum, not complete. ICDL is a not-for-profit and while we do promote developmental perspectives, we never advocate against families having access to ABA. We advocate for family choice. This is very different than many of the ABA industry advocates. Also, I am making a distinction between the ABA industry advocates and the many wonderful and caring ABA practitioners. As I noted in my blog, I am not a fan of ABA as I think it is too narrow in scope and practice, but it does not mean I am advocating against families having access. Good and caring people can choose to use ABA. My hope though is that they have a full range of knowledge about autism and autism interventions and are not led to believe the ABA industry’s propaganda to discredit non-ABA approaches. Finally, I stand by the fact that entities like the National Autism Center are contrived entities that are wholly run by “national leaders in ABA.” The claims that DIRFloortime does not have evidence to support it are simply wrong. There are solid research studies showing DIRFloortime works. Thank you for your comment.

      Delete
    2. Darcy, The MayInstitute in its decades long painfully transparent conflict of interests and the ergregiously bogus "Standards Project" is, par excellence bar none, quite remarkably proficient in its attempts to deceive, distort and dissuade countless generations of families with its false claims of, "ABA the Only Scientifically Proven Treatment..." So please spare me the stench of your sympathies.The evidentiary non-behavioral Neurodevelopmental biopsychosocial foundations which strongly supports DIR/Floortime began to gain enormous and indisputable validation with the paradigm shift (with no agenda whatsoever)which began in the mid 1990's. Enter little phrase that perhaps eludes you, "Affect Developmental Neuroscience" If you want to talk "Real Science" in contrast to anitiqated and ineffective if not potentially damaging and regressive applied behavioral based methodologies, let's begin here, shall we? https://www.youtube.com/watch?v=lY7XOu0yi-E&t=6s https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079208/

      Delete
  4. DIRFloortime/Dr. Greenspan has gained quite a population in counseling therapy territory. An expert in Therapy play commented that DIRFloortime's relational therapy is as effective as Therapy play.

    ReplyDelete

Thank you for your comment. -Jeff