However, the lay impression persists that there are “negative” reviews in the literature. But let’s look at what the “negative” reviews do say. The following is one of the most skeptical recent publications in the scientific literature. But see one of their concluding statements.

“There is little question now that early intensive behavioral intervention is highly effective for some children. However, gains are not universal, and some children make only modest progress while others show little or no change, sometimes after extremely lengthy periods in treatment.” (page 36).

Howlin, P., Magiati, I., & Charman, T. (2009). Systematic review of early intensive behavioral interventions for children with autism. American Journal on Intellectual and Developmental Disabilities. 114. 23-41. (The authors are professors at the Institute of Psychiatry, King’s College (London, UK) and University College, London, Institute of Child Health).

Other “negative” reviews may exclude the majority of ABA research, by applying highly restrictive criteria for what qualifies as evidence.

For example, there is the Comparative Effectiveness Review published by the AHRQ in 2011. But, while this report has also been cited as “negative,” see their main conclusions regarding ABA and EIBI interventions.

“Evidence supports early intensive behavioral and developmental intervention, including the University of California, Los Angeles (UCLA)/Lovaas model and Early Start Denver Model (ESDM) for improving cognitive performance, language skills, and adaptive behavior in some groups of children.” (page vi).

“Evidence suggests that interventions focusing on providing parent training and cognitive behavioral therapy (CBT) for bolstering social skills and managing challenging behaviors may be useful for children with ASDs to improve social communication, language use, and potentially, symptom severity. (page vi).

The “negative” qualifiers of these conclusions are stated as:

“All of these studies need to be replicated, and specific focus is needed to characterize which children are most likely to benefit.” (page vi).

“Information is lacking on modifiers of effectiveness, generalization of effects outside the treatment context, components of multicomponent therapies that drive effectiveness, and predictors of treatment success.” (page vi).

In comparison to the above comments, these are the clearly negative conclusions about traditional biomedical treatments that are currently widely covered by insurance policies:

“No current medical interventions demonstrate clear benefit for social or communication symptoms in ASDs.” (page vi).

“Little evidence is available to assess other behavioral interventions, allied health therapies, or complementary and alternative medicine.” (page vi).

Warren, Z., Veenstra-VanderWeele, J., Stone, W., Bruzek, J.L., Nahmias, A.S., Foss-Feig, J.H., Jerome, R.N., Krishnaswami, S., Sathe, N.A., Glasser, A.M., Surawicz, T., & McPheeters, M.L. (April, 2011). Therapies for Children With Autism Spectrum Disorders. Comparative Effectiveness Review No. 26. (Prepared by the Vanderbilt Evidence-based Practice Center under Contract No.290-2007-10065-I.) AHRQ Publication No. 11-EHC029-EF. Rockville, MD:Agency for Healthcare Research and Quality. Available at:

The AHRQ report reached these positive conclusions about ABA and EIBI despite excluding a large number of studies, including all studies published prior to 2000. Yet the AHRQ report still found 78 studies of behavioral interventions, which included 34 studies of EIBI that met their criteria for inclusion.

Other “negative” reviews cited are typically proprietary reports published privately. For example, the Kaiser Blue Cross report did not offer positive statements (Rothenberg & Samson, 2009). However in their methodology, they limited their analysis to only 16 studies, out of the hundreds available, and concluded that more research needs to be done. Interestingly, unlike the AHRQ review, this report did not comment on the comparable lack of data for psychotropic medications, yet insurance companies readily cover such treatment.