Table Of Content
The BACB also certifies Registered Behavior Technicians with a minimum of a high school diploma and 40 hours of specialized training who work only under the direct supervision of a BCBA or BCaBA. Presence of formal and or informal social validity was recorded as well as maintenance or follow-up data collection. Data was collected concerning response opportunity exceeding criterions and opportunity to fail.
Identified Studies
There was also more improvement in intellectual functioning in the intervention compared with control groups (8 studies, SMD, 0.51, 95% CI, 0.09 to 0.92). The authors did not find statistically significant differences in post-treatment scores on language ability or symptom severity or parental stress. The meta-analysis is limited by methodological limitations of the included studies; for example, only 1 study was randomized, there was no participant or parent blinding in any study and outcome assessment was blinded in only 1 study. Most of the current literature surrounding ABA-based interventions lacks investigations into the QoL of children with ASD and instead focuses on aberrant behaviors (Reichow et al., 2018; Whitehouse et al., 2020). A recent meta-analysis found that, upon analyzing five articles of higher scientific credence, none conducted investigations into the changes with respect to QoL for the children or parents (Reichow et al., 2018).
Limitations of the Current Review
A qualified and trained behavior analyst (BCBA) designs and directly oversees the program. They customize the ABA program to each learner's skills, needs, interests, preferences and family situation. Each time the person uses the behavior or skill successfully, they get a reward. The reward is meaningful to the individual – examples include praise, a toy or book, watching a video, access to playground or other location, and more.
Screen Process and Study Selection
These are termed “comparison records” for the purpose of coding and synthesis. As seen in Tables S2 and S3 in Appendix 3, further detail was extracted regarding the category of techniques or interventions compared and the relative effectiveness of each. During the process of coding, articles containing multiple concurrent or consecutive studies were separated into discrete rows, and will hereafter be treated as self-contained studies in this review. In all figures and further text, all coded rows are referred to as “study records.” Once separated, researchers identified and excluded (1) functional analyses or studies focused on their use, (2) preference assessments or studies focused on their use, and (3) predictive studies. Study records were coded independently by two researchers and then discussed to obtain agreement, or referred to a third researcher to obtain agreement. During coding, any further study records found to satisfy the exclusion criteria were excluded.
Moreover, as the children and youth who participated in ABA-based and other interventions become adults, the long-lasting effects of these interventions should be investigated more thoroughly. As the understood spectrum of ASD and the diagnostic tools for ASD have changed drastically over the decades in which the investigated articles were published, the represented population may have also changed throughout the years, potentially influencing the acceptability of study findings (Reichow et al., 2018). Furthermore, the initial objective for this scoping review included searching across all NDD/D, not just ASD. Thus, the ASD MeSH term of “autistic disorder and autism spectrum disorder” may have potentially resulted in missed studies that included only AS or PDD-NOS diagnoses. That said, as this review was intended to find the scope of the research surrounding the impact of ABA on children and youth with ASD over a time frame of 23 years and across all available research, the authors believe all of the applicable scope was covered within reason.
Therefore, large longitudinal prospective studies comparing ABA-based and different interventions treating children and youth with ASD are needed. With a holistic view of all of the scientific evidence behind ABA, governments will be able to more accurately compare any existing and emerging interventions to the well-established norm of ABA. Until a SoC is established, all interventions for children and youth with ASD must be held to the existing standard set by ABA to be considered effective.
What is Applied Behavior Analysis?
Last but not least, we give a heartfelt thank-you to Dr. Patrick Myers for taking the time to review our work. The infrequent use of generalization seen in the Between-Groups Comparison section could be a result of the greater use of validated tools in this section of records (Cohen et al., 2006; Remington et al., 2007). Measurement tools such as VABS incorporate measures of generalization into the scale, and though not often specified as an independent measure of generalization, multiple environmental locations for the interventions (e.g., home and school) or multiple individuals interacting with the participants may have been measured. The 5-year impact factor (IF) characteristics were determined by removing duplicate journals prior to calculation. The lowest impact journal had an IF of 0.71 and the highest had an IF of 9.92. Most of the reviewed study records were from the Journal of Applied Behavior Analysis (55%).
Data Availability
When a behavior is followed by something that is valued (a reward), a person is more likely to repeat that behavior. In the study records reviewed, 33% had one or two participants, whereas 31% of the publications had three participants, and 13% had four. Study records with 5 to 9 participants accounted for 11% of the total and 13% had more than 10 participants.
Adaptive behavior treatment with protocol modification is intended to focus on the treatment of specific destructive behaviors such as gesturing or aggression. As ever in the scientific process, interventions and treatments need consistent and replicative investigations under stringent protocols to ensure the continued efficacy and generalizability of a given intervention. Department of Health and Human Services (1999), ABA is the gold standard treatment for ASD, and is funded almost exclusively across North America.
The median number of participants was 3, whereas the mean number of participants was 8.12. In addition, some qualitative characteristics were explored as well, such as observations about the types of methods used in the interventions encountered, the degree of mastery and generalization measures, and how targeted the interventions and measurement tools were. Prior to coding, researchers categorized outcome measures, measurement scales or strategies, and intervention categories observed during the extraction process into tables in an effort to mitigate potential inconsistencies in coding. For example, in the Comparisons of ABA Techniques section, categories were broadly defined as Teaching, Stimulus Characteristics, Reinforcement, Subject/Setting Characteristics, and Comparisons of ABA Interventions.
Scoping reviews differ from systematic reviews in that they provide an overview of existing evidence regardless of the quality (Tricco et al., 2016), and may not formally assess study rigor (Arksey & O’Malley, 2005). Of the 267 CCD data collected, social validity was collected formally or informally in 43 studies (16.1 %); all of which reported positive feedback. Of the 267 CCDs noted, the majority were conducted within schools (45.7 %), followed by clinics or hospitals (16.1 %), home (13.5 %), across the day (9.4 %), at another institution (7.5 %), at an unknown location (4.9 %), and work (3.0 %). The individual responsible for implementing the CCD was most frequently the experimenter or therapist (47.9 %), followed by a teacher or staff (27.3 %), parent (19.1 %), other staff or agency (7.5 %), unspecified (6.4 %), self (4.5 %), and a peer (2.2 %). More than one individual was involved with implementation in 40 individual CCD interventions (15.0 %). Of the 127 references found, 19 were removed as they were book chapters or discussions that did not contain original research data, 1 article concerned animal behavior, and 1 was not written in English.
Another type of focused treatment is family adaptive behavior treatment guidance, which is tended to provide instruction to a parent, guardian, or other caregiver in the treatment protocols designed to reduce maladaptive behaviors and increase generalization of acquired skills. Multiple-family group adaptive behavior treatment guidance is intended for the same purpose, but the goal is to train a group of parents, guardians, or caregivers together. These types of family-oriented therapies are recommended in HRSA guidelines (Maglione, 2012).
“ABA” (applied behavior analysis) programs are one of the evidence-based types of behavioral interventions that may be available for your child. More than 20 studies have established that intensive and long-term therapy using ABA principles improves outcomes for many but not all children with autism. “Intensive” and “long term” refer to programs that provide 25 to 40 hours a week of therapy for 1 to 3 years. These studies show gains in intellectual functioning, language development, daily living skills and social functioning. Studies with adults using ABA principles, though fewer in number, show similar benefits. Many records from the current search investigated the effectiveness of different ABA methods or variables in delivery.
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