1. ABA in the Netherlands 31.01.2013 Dr. Jacqueline J. Schenk
School of Pedagogical & Educational Sciences
Erasmus University Rotterdam
The Netherlands

2. Outline Diagnosis and prevalence
Demand for behavioural interventions for people (of all ages) with autism in the NL
Recent change in health care and education
ABA-based services in the NL: study results
ABA training and education in the NL
Conclusions

3. Diagnosis of Autism

4. The Netherlands
The two control regions were selected because they have similar size populations and a similar socioeconomic class. Schools in each region were asked to provide the number of children enrolled, the number having a clinical diagnosis of ASC and/or two control neurodevelopmental conditions (dyspraxia and ADHD). The participating schools in the three regions provided diagnostic information on a total of 62,505 children. The researchers found school-reported prevalence estimates of ASC in Eindhoven was 229 per 10,000, significantly higher than in Haarlem (84 per 10,000) and Utrecht (57 per 10,000), whilst the prevalence for the control conditions were similar in all regions.
Diagnosed autism is more common in an IT-rich region, such as Eindhoven (Philips, ASML, IBM and ATOS Origin)
Roelfsema et al. (2011) J Autism Dev Disord

5. Why this increase? Early diagnosis and screening
More (scientific) knowledge of predictors
and early warning signals
Worldwide
Boys: 1:54, girls: 1:252
The Netherlands: 1: on average..

6. After the diagnosis…..in NL? ?

7. After the diagnosis (anecdotal)
Bereavement groups
Psycho-education
Parent groups for support
Random/inappropriate professional advice regarding effective behavioural interventions

8. Time to collect some data…
10 ABA (-ish) organisations
Questionnaire (structural characteristics)
Mission; claimed intervention characteristics staff:child ratio; educational background of staff; no. of hours per child (av/range); number of trainers per child; educational context; materials; admission & exclusion criteria, parent involvement etc.
Behavioural observations on site
To validate (or not) characteristics of interventions

9. Used in the NL (in theory)
DTT (Discrete Trial Training)
PRT (Pivotal Response Treatment)
Sonrise
Verbal Behavioural Intervention
TEACCH (Treatment and Education of Autistic and Handicapped Children)
CGT (Cognitive Behavioural Therapy)
PECS (Picture Exchange Communication System)
Bits and pieces from all of the above
(Neidt & Schenk, Wetenschappelijk Tijdschrift voor Autisme, June 2012)

10. In reality? All had the same mission (i.e. optimal development)
Similar in 1:1 training, all private, all working many hours, all working in isolation
Huge differences in structural characteristics
Educational background of staff
Supervision and IRR procedures
No of staff working with each child
No of children attending the service (range 1-75, av. 20)
Criteria for mastery
Parental involvement
(Neidt & Schenk, Wetenschappelijk Tijdschrift voor Autisme, June 2012)

11. Recent developments
Parents increasingly demand ABA based interventions at all levels of (pre) education
Increasing number of organisations offering “ABA” services of variable quality and cost (!)
“ABA” services approach us to carry out effectiveness studies

12. WHY? Parents appear to read more than professionals
Schools now responsible for EO
“ABA “ services will not be paid by health care system if they don’t provide evidence for effectiveness
Teachers working in inclusive schools lack knowledge and training on “behaviour”

13. Compared to many other countries in Europe, we are very behind

14. Education & training in NL
8 Dutch universities
8/8 offering Psychology, Pedagogical and/or Educational sciences at BA and MSc level
0/8 offering ABA training

15. Conclusions…
Hardworking professionals and parents of children with autism, but…
Eclectic use of early behavioural ABA-based interventions
Lack of professional academic training and ABA consultancy opportunities
Lack of funding despite the conclusion by Ministry of health (Gezondheidsraad, 2009) about its effectiveness and need for evidence-based practice

16. The STAMPPP Project
Simple Steps in Dutch !-> Parental testimonies, animations, demonstrations, and textural material to teach ABA principles to Dutch parents, professionals, students etc.
Maximises learning opportunities for children with autism
Enables parents to become proficient in delivering home programs for their children
Facilitates the coordination of child learning opportunities at home and school

17. THANK
YOU!