ABA for treatment of Autism Spectrum Disorders: Applied Behaviour Analysis (ABA) is the application of the principles of behaviour to issues that are socially important in order to produce practical change. Or at least that’s what it says in our training manuals! That doesn’t quite capture it for me. To me, ABA is a way of looking at life. ABA is a way for children who have previously had ceilings and labels put on them and been given dim prospects, to exceed expectations. ABA is something that brings out true potential and gives families experiences of their child they didn’t think they would get to have. ABA is an incredible box of tools, and in this chapter I invite you to look inside…

  1. Set goals. Think short-term (3 months), medium-term (6 months) and long-term (the whole year).
  2. Attend workshops. You are just as valuable a team member as any other in your child’s treatment programme.
  3. Communicate to your supervisor what is important to you as a parent and for your family.
  4. Receive parent training. The better equipped you are, the more consistency you can create between home and centre, and the faster your child will progress.
  5. Stay in the loop. Make sure you are receiving our newsletters and following our Facebook page.
  6. If you haven’t already, explore biomedical intervention. Most, if not all, children on the spectrum are suffering from underlying biomedical conditions. Children who are feeling well are more receptive to education and ABA instruction.
  7. Follow recommendations. These recommendations are made in your child’s best interests and stem from decades of research and experience.
  8. Stay positive. Your child is in the best possible hands and has a real shot at making huge gains.

The Centre for Disease Control in the United States released the latest autism prevalence statistics this year. 2018 saw an increase in the prevalence statistics of autism from 1 in 68 just two years ago to 1 in 59. This is a 15% increase, which is astronomical.

One might be inclined to think this number must be an over-estimation. Quite the contrary – at sites where researchers had full access to school records, higher numbers were recorded. This suggests that the new numbers reflect a persistent underestimation of autism’s true prevalence.

Other interesting findings were that:

  • The gender gap in autism has decreased. In 2012, boys were 4.5 times more likely to be diagnosed than girls. By 2014, this had decreased to a ratio of 4:1. This appears to reflect improvement in identification of autism in girls, many of whom do not fit the stereotypical picture of autism seen in boys.
  • White children are still more likely to be diagnosed with autism than children from other racial groups, but this gap has also decreased and reflects improved awareness and screening in ‘minority communities’ in the US.
  • Disappointingly, there has been no overall decrease in the age of diagnosis, with most children still being diagnosed after age 4, even though autism can reliably be diagnosed by age 2. This is important because research and experience shows that early intervention leads to the best outcomes.
  • The change in diagnostic criteria (from the DSM IV TR to the DSM 5, which did away with diagnoses such as Asperger’s Syndrome and moved to a catch-all diagnosis of Autism Spectrum Disorder) caused only a slight decrease in prevalence estimates.
  • The US still lacks any reliable estimate of autism’s prevalence among adults. South Africa

Awareness in South Africa is increasing, which is good in terms of the safety of our children and in terms of families accessing treatment earlier, but we cannot stop there. What is really needed is financial support for Applied Behaviour Analysis, declared by the US surgeon general to be a medical necessity for children on the autism spectrum, and greater acceptance of children with autism in general education schools, with trained facilitators where necessary.

What is Methyl-B12 (B12)?

B12 (cobalamin) is a vitamin “family” with five unique family members that each do different things.  Out of the B12 family, only methyl-B12 has the ability to activate the methionine/homocysteine biochemical pathway directly which results in more “fuel” to the brain.

B12 works with folic acid to make all the cells in the body.  It plays a key role in methylation.  Methylation makes ALL of the cells in our body.  It is the process of adding genetic material to cells.  After conception, the cells in the womb that will later become the fetus are DEMETHYLATED.  The process of development depends on methylation.

Increasing evidence is revealing the role of methylation in the interaction of environmental factors with genetic expression in playing a role in developmental issues like autism and ADHD.  Differences in maternal care during the first 6 days of life in a mammal can cause different methylation patterns in some genes.  Methylation has also been shown to impact inflammation after a child leaves the womb.  We know that autism and ADHD are linked to inflammation.  Now we are discovering that inflammation, autism and ADHD are linked to impaired methylation.

Methylation is responsible for:

  • RNA and DNA (genetic material responsible for every function in the body)
  • Immune system regulation
  • Detoxification of heavy metals and other harmful substances
  • Making GLUTATHIONE (the body’s main detoxification enzyme responsible for removing mercury, lead, cadmium, arsenic, nickel, tin, aluminum and antimony)
  • Production and function of proteins
  • Regulating inflammation

What connects B12, methylation, glutathione and Autism Spectrum Disorder?

Short answer:   Dr. S. Jill James (who has recently received a NIH – National Institute of Health – grant for her research) has shown that children with ASD have impaired methylation and decreased levels of glutathione.  Supporting and/or repairing the underlying impairment and deficiency translates into increased social, cognitive and language development.

Long answer: Dr. S. Jill James has also shown that children with ASD have 80% less glutathione in their cells and that 90% of children have defects in their methylation.  This means that children with autism cannot effectively fuel the brain and detoxify heavy metals and other harmful substances from their system.

The brain is the only part of the body that has depends entirely on B12 to detoxify.  As the the brain is over-burdened with toxic substances, the “wheels” of methylation slow, severely impacting development.

B12 works closely with folic acid. A precursor folic acid molecule must interact with the enzyme MTHFR (methylenetetrahydrofolic acid) to become 5-methyltetrahydrofolic acid (5-MTHF).

5-MTHF gives the methyl group (the “M” part) to B12 so it can become methyl-B12.  Unfortunately, many children have a defect in this enzyme.  In a recent study by Dr. S. Jill James, 90% of children with ASD were found to have methylation defects.

What connects MB12 and ADHD?

Dr. Richard Deth is a Ph.D and neuropharmacologist at the Northeastern University.  His area of  research is focused on impaired methylation and oxidative stress in neurological and neuropsychiatric disorders, including autism, ADHD, schizophrenia, and Alzheimer’s disease

Dr. Deth discovered the link between dopamine, methylation and attention which has helped Defeat Autism Now doctors understand why B12 is crucial to treatment of ADHD.  Children with ADHD have difficulty bring methyl inside cells to support methylation and therefore development – especially in the areas of attention and focus.

What are the benefits of MB12 treatment?

Enhancement in executive function:

  • Awareness
  • Cognition
  • Appropriateness
  • Eye contact
  • Responsiveness
  • Normalized behaviours and interaction

Promotion of speech and language:

  • Spontaneous language
  • More complex sentences
  • Increased vocabulary

Improvements in socialization, understanding and expressing emotion:

  • Initiation and interactive play
  • Understanding and feeling emotions
  • Affection and tolerance to touch

Undesired effects to B12 therapy are a good sign of treatment success.  They are not uncommon and include: 

  • Hyperactivity
  • Self Stimulating Behaviour
  • Increased mouthing of objects
  • Sleep disturbances – which can be managed with other treatments
  • Aggression, hitting and biting – caused by frustration due to increased awareness

*Side effects can be mild to severe and are considered transient which means they will pass as  treatment progresses*

  • MB12 is a treatment, not a cure.  However, many children using MB12 combined with other biomedical and non-biomedical therapies make incredible developmental gains and in a small percentage of children, have had their ASD label removed.
  • Parents should understand that the maximum results from MB12 therapy occur over years, not months, not weeks. Initial results will be obvious within the first 3-5 week period of time; but MB12’s power is in continued use.

Why is MB12 most effective when injected into the bum?

According to Dr. Neubrander (www.drneubrander.com), “Only the subcutaneous injectable route of administration into the adipose tissue of the buttocks will produce the remarkable results parents want to see!”

All forms of administration work to some degree, and some better than others. Injection has been shown to be, by far, the most effective route of administration.  It is through injection that the most dramatic strides in development are seen.

MB12 injection into the buttocks area allows MB12 to surround the cells and stay in the system continually.  Oral, transdermal or intranasal forms cause the MB12 levels to fluctuate up and down.  All cobalamins are absorbed in the last portion of the small intestine, the terminal ileum. Dr. Wakefield and Dr. Krigsman and Dr. Buie have shown through their research that an extremely high percentage of children on the autistic spectrum have an inflammatory bowel condition that affects this region of the intestinal tract. This makes injection a better choice than depending on the digestive tract for absorption.

Dr. Sonya Doherty, N.D., FMAPS (Cand.)

With a prevalence of 1 in every 59 children, autism spectrum disorder (ASD) has become increasingly commonplace. In turn, the growing autism advocacy community has been extraordinarily effective in engendering the political will to enact laws intended to ensure that individuals with ASD have access to needed therapies such as applied behavior analysis (ABA), empirically proven to be the most effective method for treating the developmental delays and challenging behaviors most commonly associated with ASD. Left untreated, the cost of autism per capita is estimated at $3.2 million.

Although ABA was first shown to be effective in the late 1980s, private insurance coverage routinely excluded ABA on the basis that it was educational or investigational. This prompted the autism community to pass autism insurance reform bills state-by-state to mandate coverage of ABA. This past summer, North Dakota became the 48th state to announce a plan to mandate insurance coverage of ABA, leaving Tennessee and Wyoming as the only remaining states to allow state-regulated plans not to cover medically-necessary treatment for children with ASD.

Despite the enormous success of advocates in securing insurance coverage of ABA, nearly all of the state autism mandates do not apply to Medicaid. Four years ago, though, the Centers for Medicare & Medicaid Services (CMS)  published an informational bulletin clarifying that treatment for ASD is a covered service under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, Medicaid’s pediatric benefit for children and adolescents. In the intervening years since the bulletin was issued, more than half of state Medicaid agencies have added coverage of ABA under EPSDT.

Given the high prevalence of ASD and the fact that Medicaid and CHIP cover over a third of children in the US, the CMS clarification and subsequent compliance of a majority of the states created critical, long-overdue access to ASD treatment. Approximately 20 states, however – including populous states such as Texas and New York – exclude ASD treatment, specifically ABA, for children in Medicaid.

Even in states that now cover ABA for Medicaid beneficiaries, significant barriers deprive these children of the treatment they need. In most instances, such barriers violate both the EPSDT mandate and the federal Mental Health Parity and Addiction Equity Act (MHPAEA). Simply stated, MHPAEA provides that limits on mental health services, including autism treatment, can be no more restrictive than limits on substantially all other medical/surgical services. Most states have contracted with managed care organizations (MCOs) to administer their autism treatment benefits, and CMS has made it clear that MCOs must comply with MHPAEA. MHPAEA has been a critical complement to the state autism insurance reform laws that mandate coverage in 48 states, and it is playing an equally important role as states design their autism benefits for children with Medicaid coverage.

Despite clear guidance from CMS to ensure access to autism treatment for children with Medicaid coverage and separate guidance that such treatment is protected by MHPAEA, thousands of children with ASD continue to struggle to access the services and supports they need. By allowing barriers to medically-necessary treatment to persist, states fail to maximize the potential of these children to become adults who live and work independently. Because of the high prevalence of ASD, it is not hyperbolic to suggest that thousands of children in our country are in danger of being left behind.

By Julie Kornack, Center for Autism and Related Disorders

Read More: https://ccf.georgetown.edu/2018/10/01/children-struggle-to-access-autism-treatment-in-medicaid/


This document summarizes medical and scientific evidence for effectiveness of applied behavior analysis (ABA) as a treatment for autism spectrum disorder. It includes:

  • Peer-reviewed literature
  • Findings, studies or research conducted by or under the auspices of a federal government agency or a nationally recognized federal research institute
  • Clinical practice guidelines that meet Institute of Medicine criteria
  • Reports by other professional and governmental associations
  • Expert analysis by autism researchers
  • Legal rulings by courts of law
  • Decisions by Regulatory Agencies

Documents listed in the first three categories (peer-reviewed literature, findings from federal government agencies or research institutes, and clinical practice guidelines meeting Institute of Medicine criteria) meet the requirements from Oregon Administrative Rules (OAR) 836-053-1325 for medical, scientific, and cost effectiveness evidence for use by Independent Review Organizations in External Review decisions to determine whether a treatment is medically necessary, or is an experimental / investigational treatment.

A Behaviour Intervention Plan (BIP) is a step-by-step guide on managing challenging behaviour. All significant role-players in a child’s life should have access to the BIP and should be trained on the BIP. This may include parents, domestic helpers, extended family, teachers, or other professionals. A parent-friendly BIP can be drawn up by the supervisor upon request, too.

A good BIP consists of the following:

  1. Operational definition. This is a detailed description of what the behaviour looks like. It may include examples and non-examples. It must contain measurable, observable behaviours – wording like “…intending to…” is not acceptable because you cannot directly observe and measure intent. It must specify what counts as one instance of the challenging behaviour in order to ensure consistency in tracking between different observers.
  2. Function. This is the reason the behaviour is occurring. If the function is not accurately identified before the BIP is drawn up, the BIP is likely to be ineffective. Any challenging behaviour that continues to occur is meeting a need or a want for the child; otherwise it would not continue to occur. A BIP designed to address the function ensures that the child learns pro-social and safe ways to get their needs met.
  3. Antecedent modifications. This lists and describes everything you can do to decrease the likelihood of the challenging behaviour occurring. It often involves teaching the child skills or providing them with supports such as timers.
  4. Replacement behaviour. This describes what skills we are teaching the child to engage in so that they no longer need to engage in the challenging behaviour.
  5. Consequence manipulation. This lists and describes everything you can do when the challenging behaviour occurs to manage it in the moment and to decrease how often and how intensely it happens in the future.
  6. Measurement method. The most common ways we measure challenging behaviour are rate (how often the behaviour is occurring on average per hour) and duration (how long the behaviour lasts; especially useful for behaviours like tantrums). It is important to measure the behaviour so that we know for sure that the behaviour is decreasing over time.

Consistency is absolutely key, so that more you know about and can implement your child’s BIP, the better! Implementing a BIP can be hard work at first, partly because the behaviour sometimes temporarily gets worse before it gets better, and partly because our interventions sometimes don’t align with what comes naturally to people outside of the field of ABA. Please hang in there! Stay in touch with your supervisor for support because sticking to the BIP will be SO worth it in the end. BIPs and the resulting decrease in problem behaviour leads to a happier family life, a happier child, and a child who is better equipped to navigate life!

Jenna White

Senior Clinical Director

Introduction: I have undertaken this review of the case against Dr. Andrew Wakefield because the issues involved are far more consequential than the vilification of one doctor. The issues, as I see them, involve (a) collusion of public health officials to deceive the public by concealing scientific evidence that confirms empirical evidence of serious harm linked to vaccines – in particular polyvalent vaccines; (b) the “willful blindness” by the medical community as it uncritically fell in line with a government dictated vaccination policy driven by corporate business interests.

Public health officials and the medical profession have abrogated their professional, public, and human responsibility, by failing to honestly examine the iatrogenic harm caused by expansive, indiscriminate, and increasingly aggressive vaccination policies. On a human level, the documented evidence shows a callous disregard for the plight of thousands of children who suffer irreversible harm, as if they were unavoidable “collateral damage”.

All of the documented evidence and testimonies submitted to the General Medical Council, upon which GMC issued its guilty verdicts against Dr. Wakefield and his two co-defendants in 2010, were subsequently forensically assessed by the UK High Court in March 2012, in the appeal of Professor John Walker-Smith, the senior clinician and senior author of the Lancet case series. The High Court determined that the verdicts of professional misconduct and ethics violations were unsupported by the evidence.

Indeed, the adjudicated evidence refutes the case against Dr. Wakefield; the documents and testimonies demonstrate that there is no evidence whatsoever, to support the charges of professional misconduct, much less the accusation of fraud. The accusation of fraud was hurled by the Editor-in-Chief of the BMJ, a medical journal whose corporate ownership is intertwined with the vaccine manufacturing Behemoths, Merck – with whom BMJ signed a partnership agreement in 2008 – and GlaxoSmithKline which provides additional financial support to BMJ. Among their numerous vaccine products, Merck and GSK manufacture the MMR vaccine.

My commentary is buttressed with details from the High Court decision (2012); transcripts of testimony before the General Medical Council (2007- 2010); documents and testimony that have been judicially adjudicated; the sworn deposition of the Deputy Editor of the BMJ with internal BMJ emails(2012); internal correspondence by CDC officials and CDC-commissioned scientists (2000-2009, some uncovered in 2011; new documents obtained in July 2017); the suppressed finding of CDC’s first large-scale epidemiological study (1999) and a transcript of the closed door meeting of the Epidemic Intelligence Service at Simpsonwood (2000); a transcript of the closed meeting of the US Institute of Medicine Committee on Immunization Safety Review (2001); the U.S. Grand Jury criminal indictment of Dr. Poul Thorsen (2011); transcripts of the UK Joint Committee on Vaccination and Immunisation (1988); a confidential report Re: Infanrix hexa submitted by GlaxoSmithKline to the European Medicines Agency (2012) documenting sudden infant deaths; Cochrane Collaboration MMR reviews (2003, 2005, 2012); HHS Inspector General investigation report – CDC advisory panel corruption (2009); CDC scientists letter of complaint about “rogue interests” “questionable and unethical practices” (2016).