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Randomized Controlled Trial Evaluation of ABA Content on IQ Gains in Children with Autism

An Author Correction to this article was published on 22 November 2019

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Abstract

The present study examined the content of applied behavior analytic therapy (ABA therapy) on skill acquisition and intelligence test scores of twenty-eight children with autism and related disabilities. Using a randomized controlled trial, we compared (a) traditional ABA consisting of verbal behavior techniques developed by Skinner (Verbal behavior, Appleton-Century-Crofts, New York, 1957), (b) comprehensive ABA which added techniques post-Skinner’s theory of language, and (c) waitlist control. Results obtained indicated that even though skill acquisition improved equally across both intervention groups compared to the control, highest intelligence score changes were shown for participants in the comprehensive ABA group (F: 2, 24 = 9.198, p = 0.001). With increasing emphasis on client outcomes, the present data suggest that when hours of intervention are kept constant, ABA service providers may be at an advantage by incorporating techniques that are typically considered beyond the traditional ABA ideas of Skinner’s account of language development.

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Fig. 1
Fig. 2

Change history

Notes

  1. The one participant eliminated from the comprehensive intervention group due to significant deviation demonstrated a change score of + 61 points from pre- to posttest IQ. Although no errors in administration were discovered, and no problem behavior was observed at either test administration, this participant’s data were removed to force an underestimated mean of treatment effect in the statistical analyses.

References

  • Alessi, G. (1987). Generative strategies and teaching for generalization. The Analysis of Verbal Behavior, 5, 15–27.

    PubMed  PubMed Central  Article  Google Scholar 

  • Arntzen, E., & Almas, I. K. (2002). Effects of mand-tact versus tact-only training on the acquisition of tacts. Journal of Applied Behavior Analysis, 35, 419–422.

    PubMed  PubMed Central  Article  Google Scholar 

  • Baer, R. A., & Detrich, R. (1990). Tacting and manding in correspondence training: Effects of child selection on verbalization. Journal of Experimental Analysis of Behavior, 54, 23–30.

    Article  Google Scholar 

  • Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., et al. (2018). Prevalence of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 sites, United States, 2014. Surveillance Summaries, 67, 1–23. https://doi.org/10.15585/mmwr.ss6706a1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Barnes, D. (1994). Stimulus equivalence and relational frame theory. The Psychological Record, 44, 91–124.

    Google Scholar 

  • Barnes-Holmes, Y., Kavanagh, D., & Murphy, C. (2016). Relational frame theory: Implications for education and developmental disabilities. In R. D. Zettle, S. C. Hayes, D. Barnes-Holmes, & A. Biglan (Eds.), Wiley handbook of contextual behavioral science (1st ed., pp. 227–253). Hoboken, NJ: Wiley.

    Google Scholar 

  • Belisle, J., Dixon, M. R., Stanley, C. R., Munoz, B., & Daar, J. H. (2016). Teaching foundational perspective-taking skills to children with autism using the PEAK-T curriculum: Single-reversal “I-You” deictic frames. Journal of Applied Behavior Analysis, 49(4), 965–969.

    PubMed  Article  Google Scholar 

  • Bourret, J., Vollmer, T. R., & Rapp, J. T. (2004). Evaluation of vocal mand assessment and vocal mand training procedures. Journal of Applied Behavior Analysis, 37, 129–144.

    PubMed  PubMed Central  Article  Google Scholar 

  • Carr, D., Wilkinson, K. M., Blackman, D., & McIlvane, W. J. (2000). Equivalence classes in individuals with minimal verbal repertoires. Journal of the Experimental Analysis of Behavior, 74, 101–115.

    PubMed  PubMed Central  Article  Google Scholar 

  • Cassidy, S., Roche, B., Colbert, D., Stewart, I., & Grey, I. M. (2016). A relational frame skills training intervention to increase general intelligence and scholastic aptitude. Learning and Individual Differences, 47, 222–235. https://doi.org/10.1016/j.lindif.2016.03.001.

    Article  Google Scholar 

  • Cassidy, S., Roche, B., & Hayes, S. C. (2011). A relational frame training intervention to raise intelligence quotients: A pilot study. The Psychological Record, 61, 173–198.

    Article  Google Scholar 

  • Cassidy, S., Roche, B., & O’Hora, D. (2010). Relational frame theory and human intelligence. European Journal of Behavior Analysis, 11(1), 37–51.

    Article  Google Scholar 

  • Cohen, H., Amerine-Dickens, M., & Smith, T. (2006). Early intensive behavioral treatment: Replication of the UCLA model in a community setting. Developmental and Behavioral Pediatrics, 27(2), 145–155.

    Article  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York, NY: Routledge Academic.

    Google Scholar 

  • Colbert, D., Dobutowitsch, M., Roche, B., & Brophy, C. (2017). The proxy-measurement of intelligence quotients using relational skills abilities index. Learning and Individual Differences, 57, 114–122. https://doi.org/10.1016/j.lindif.2017.03.010.

    Article  Google Scholar 

  • Colbert, D., Tyndall, I., Roche, B., & Cassidy, S. (2018). Can SMART training really increase intelligence? A replication study. Journal of Behavioral Education, 27(1), 509–531. https://doi.org/10.1007/s10864-018-9302-2.

    Article  Google Scholar 

  • Dawson, G. (2011). Behavioral interventions in children and adolescents with autism spectrum disorder: A review of recent findings. Current Opinion in Pediatrics, 23, 616–620.

    PubMed  Article  Google Scholar 

  • Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., et al. (2010). Randomized, controlled trial of an intervention of toddlers with autism: The Early Start Denver Model. Pediatrics, 125(1), 17–23. https://doi.org/10.1542/peds.2009-0958.

    Article  Google Scholar 

  • Dixon, M. R. (2014a). PEAK relational training system—Direct training module. Carbondale, IL: Shawnee Scientific Press.

    Google Scholar 

  • Dixon, M. R. (2014b). PEAK relational training system—Generalization module. Carbondale, IL: Shawnee Scientific Press.

    Google Scholar 

  • Dixon, M. R. (2015). PEAK relational training system—Equivalence module. Carbondale, IL: Shawnee Scientific Press.

    Google Scholar 

  • Dixon, M. R. (2016). PEAK relational training system—Transformation module. Carbondale, IL: Shawnee Scientific Press.

    Google Scholar 

  • Dixon, M. R., Belisle, J., Munoz, B. E., Stanley, C. R., & Rowsey, K. (2017). Teaching metaphorical extensions of private events through rival-model observation to children with autism. Journal of Applied Behavior Analysis, 50(4), 744–749.

    PubMed  Article  Google Scholar 

  • Dixon, M. R., Belisle, J., Stanley, C. R., Rowsey, K. E., Daar, J. H., & Szekely, S. (2015). Toward a behavior analysis of complex language for children with autism: Evaluating the relationship between PEAK and the VB-MAPP. Journal of Developmental and Physical Disabilities, 27(2), 223–233.

    Article  Google Scholar 

  • Dixon, M. R., Belisle, J., Stanley, C. R., Speelman, R. C., Rowsey, K. E., Kime, D., et al. (2016). Establishing derived categorical responding in children with disabilities using the PEAK-E curriculum. Journal of Applied Behavior Analysis, 50(1), 134–145.

    PubMed  Article  Google Scholar 

  • Dixon, M. R., Whiting, S., Rowsey, K. E., & Belisle, J. (2014). Assessing the relationship between intelligence and the PEAK relational training system. Research in Autism Spectrum Disorders, 8(9), 1208–1213.

    Article  Google Scholar 

  • Dymond, S., & Alonso-Alvarez, B. (2010). The selective impact of Skinner’s Verbal Behavior on empirical research: A reply to Schlinger (2008). The Psychological Record, 60, 355–360.

    Article  Google Scholar 

  • Dymond, S., & Rehfeldt, R. A. (2000). Understanding complex behavior: The transformation of stimulus function. The Behavior Analyst, 23(2), 239–254.

    PubMed  PubMed Central  Article  Google Scholar 

  • Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2002). Intensive behavioral treatment at school for 4- to 7-year-old children with autism. A 1-year comparison controlled study. Behavioral Modification, 26(1), 49–68.

    Article  Google Scholar 

  • Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2007). Outcome for children with autism who began intensive behavioral treatment between ages 4 and 7: A comparison controlled study. Behavior Modification, 31(3), 264–278.

    PubMed  Article  Google Scholar 

  • Giofre, D., Borella, E., & Mammarella, I. C. (2017). The relationship between intelligence, working memory, academic self-esteem, and academic achievement. Journal of Cognitive Psychology, 29, 731–747. https://doi.org/10.1080/20445911.2017.1310110.

    Article  Google Scholar 

  • Gresham, F. M., & Witt, J. C. (1997). Utility of intelligence tests for treatment planning, classification, and placement decisions: Recent empirical findings and future directions. School Psychology Quarterly, 12(3), 249–267. https://doi.org/10.1037/h0088961.

    Article  Google Scholar 

  • Hayes, J., & Stewart, I. (2016). Comparing the effects of derived relational training and computer coding on intellectual potential in school-age children. British Journal of Educational Psychology, 86(3), 397–411.

    Article  PubMed  Google Scholar 

  • Hayes, S. C. (2018). ACT randomized controlled trials since 1986. Retrieved May 10, 2019, from https://contextualscience.org/ACT_Randomized_Controlled_Trials.

  • Hayes, S. C., Barnes-Holmes, D., & Roche, B. (2001). Relational frame theory: A post-Skinnerian account of human language and cognition. New York: Plenum.

    Book  Google Scholar 

  • Healy, O., Barnes‐Holmes, D., & Smeets, P. M. (2000). Derived relational responding as generalized operant behavior. Journal of the Experimental Analysis of Behavior, 74(2), 207–227.

    PubMed  PubMed Central  Article  Google Scholar 

  • Keith, T. Z., Fehrmann, P., Harrison, P. L., & Pottebaum, S. M. (1987). The relation between adaptive behavior and intelligence: Testing alternative explanations. Journal of School Psychology, 25(1), 31–43. https://doi.org/10.1016/0022-4405(87)90058-6.

    Article  Google Scholar 

  • Landa, R. J., & Kalb, L. G. (2012). Long-term outcomes of toddlers with autism spectrum disorder exposure to short-term intervention. Pediatrics, 130, 186.

    Article  Google Scholar 

  • Lovaas, O. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3–9.

    PubMed  Article  Google Scholar 

  • McEachin, J. J., Smith, T., & Lovaas, O. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal of Mental Retardation, 97(4), 359–372.

    PubMed  Google Scholar 

  • McKeel, A., & Matas, J. (2017). Utilizing PEAK relational training system to teach visual, gustatory, and auditory relations to adults with developmental disabilities. Behavior Analysis in Practice, 10(3), 252–260.

    PubMed  PubMed Central  Article  Google Scholar 

  • McKeel, A. N., Dixon, M. R., Daar, J. H., Rowsey, K. E., & Szekely, S. (2015). Evaluating the efficacy of the PEAK relational training system using a randomized controlled trial of children with autism. Journal of Behavioral Education, 24(2), 230–241.

    Article  Google Scholar 

  • Meyers, C. E., Nihira, K., & Zetlin, A. (1979). The measurement of adaptive behavior. In N. R. Ellis (Ed.), Handbook of mental deficiency: Psychological theory and research (2nd ed.). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Mullen, S., Dixon, M. R., Belisle, J., & Stanley, C. R. (2017). Establishing auditory-tactile-visual equivalence classes in children with autism and developmental delays. The Analysis of Verbal Behavior, 33(2), 283–289.

    PubMed  PubMed Central  Article  Google Scholar 

  • Murphy, C., Barnes-Holmes, D., & Barnes-Holmes, Y. (2005). Derived manding in children with autism: Synthesizing Skinner’s verbal behavior with relational frame theory. Journal of Applied Behavior Analysis, 38(4), 445–462.

    PubMed  PubMed Central  Article  Google Scholar 

  • O’Hora, D., Palaez, M., & Barnes-Holmes, D. (2005). Derived relational responding and performance on verbal sub-tests of the WAIS-III. The Psychological Record, 55, 155–175.

    Article  Google Scholar 

  • O’Hora, D., Palaez, M., Barnes-Holmes, D., Rae, G., Robinson, K., & Chaudary, T. (2008). Temporal relations and intelligence: Correlating relational performance and performance on the WAIS-III. The Psychological Record, 58, 569–584.

    Article  Google Scholar 

  • O’Toole, C., & Barnes-Holmes, D. (2009). Three chronometric indices of relational responding as predictors of performance on a brief intelligence test: The importance of relational flexibility. The Psychological Record, 59, 119–132.

    Article  Google Scholar 

  • Rehfeldt, R., Dillen, J. E., Ziomek, M. M., & Kowalchuk, R. K. (2007). Assessing relational learning deficits in perspective-taking in children with high functioning autism spectrum disorder. The Psychological Record, 57, 23–47.

    Article  Google Scholar 

  • Rehfeldt, R. A., & Root, S. L. (2005). Establishing derived requesting skills in adults with severe developmental disabilities. Journal of Applied Behavior Analysis, 38, 101–105.

    PubMed  PubMed Central  Article  Google Scholar 

  • Reichow, B., & Wolery, M. (2009). Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA young autism project model. Journal of Autism and Developmental Disorders, 39(1), 23–41.

    PubMed  Article  Google Scholar 

  • Roane, H. S., Fisher, W. W., & Carr, J. E. (2016). Applied behavior analysis as treatment for autism spectrum disorder. The Journal of Pediatrics, 175, 27–32.

    PubMed  Article  Google Scholar 

  • Rosales, R., & Rehfeldt, R. A. (2007). Contriving transitive conditioned establishing operations to establish derived manding skills in adults with severe developmental disabilities. Journal of Applied Behavior Analysis, 40(1), 105–121.

    PubMed  PubMed Central  Article  Google Scholar 

  • Rowsey, K. E., Belisle, J., & Dixon, M. R. (2015). Principal component analysis of the PEAK relational training system. Journal of Developmental and Physical Disabilities, 27(1), 15–23.

    Article  Google Scholar 

  • Rowsey, K. E., Belisle, J., Stanley, C. R., Daar, J. H., & Dixon, M. R. (2017). Principal component analysis of the PEAK Generalization Module. Journal of Developmental and Physical Disabilities, 29(3), 489–501.

    Article  Google Scholar 

  • Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-year outcome and predictors. American Journal on Mental Retardation, 110(6), 417–438.

    PubMed  Article  Google Scholar 

  • Sattler, J. M., Dumont, R., & Coalson, D. L. (2016). Assessment of children: WISC-V and WPPSI-IV. San Diego: Jerome M. Sattler, Publisher.

  • Sautter, R. A., & LeBlanc, L. A. (2006). Empirical applications of Skinner’s analysis of verbal behavior with humans. The Analysis of Verbal Behavior, 22, 35–48.

    PubMed  PubMed Central  Article  Google Scholar 

  • Schriebman, L. (2000). Intensive behavioral/psychoeducational treatments for autism: Research needs and future directions. Journal of Autism and Hearing Research, 14, 5–13.

    Google Scholar 

  • Sigafoos, J., Doss, S., & Reichle, J. (1989). Developing mand and tat repertoires in persons with severe developmental disabilities using graphic symbols. Research in Developmental Disabilities, 10, 183–200.

    PubMed  Article  Google Scholar 

  • Skinner, B. F. (1957). Verbal behavior. New York: Appleton-Century-Crofts.

    Book  Google Scholar 

  • Smith, T., Eikeseth, S., Klevstrand, M., & Lovaas, O. I. (1997). Intensive behavioral treatment for preschoolers with severe mental retardation and pervasive developmental disorder. American Journal on Mental Retardation, 102(3), 238–249.

    PubMed  Article  Google Scholar 

  • Sternberg, R. J. (1997). The concept of intelligence and its role in lifelong learning and success. American Psychologist, 52(10), 1030–1037.

    Article  Google Scholar 

  • Sturmey, P. (2002). Mental retardation and concurrent psychiatric disorder: Assessment and treatment. Current Opinion in Psychiatry, 15, 489–495.

    Article  Google Scholar 

  • Weschler, D. (2012). Weschler preschool and primary scale of intelligence (4th ed.). San Antonio, TX: Pearson.

    Google Scholar 

  • Weschler, D. (2014). Weschler intelligence scale for children (5th ed.). San Antonio, TX: Pearson.

    Google Scholar 

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Correspondence to Mark R. Dixon.

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First author receives small royalties from sales of the PEAK curriculum. Remaining authors declare they have no conflict of interest.

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Appendix

Appendix

Therapist: Rater 1: Rater 2: Date:
Preparation checklist
Instructions: For each item, evaluate if the therapist has met expectations as outlined in the item description. A score of 0 suggests that the therapist has not met expectations and is reserved for when the therapist fails to complete the step entirely. A score of 1 suggests that the therapist has completed the item; however, greater performance is expected. A score of 2 suggests that the therapist has met expectations for the given item
Item Score
1. Has determined appropriate stimuli to use as reinforcers using a preference assessment method 0 1 2
2. Has program sheets with appropriate stimuli indicated on the program sheets 0 1 2
3. Has written the date and randomized the stimulus presentation order on the data sheets 0 1 2
4. Has arranged the environment in a way that minimizes distractions to conduct training 0 1 2
5. Has all necessary stimuli, as specified in the participant’s program, to conduct training 0 1 2
 Total score /10
 Percentage score /100%
Implementation checklist
Instructions: The implementation checklist is designed to evaluate implementation fidelity for any number of consecutive trials. We recommend that at least five trials be evaluated. For each trial, provide a tally indicating whether the step was completed correctly or incorrectly. Note that, for each trial, a step can only be performed either correctly or incorrectly, and the total number of tally marks for each step (i.e., correct + incorrect) should equal the number of trials that have been assessed. Also, only a single tally mark may appear in steps 3 and 4 for each trial as these items are incompatible with one another (i.e., the participant either demonstrates the correct response or an incorrect response)
Train trials Test trials
Step Correct? Incorrect? Step Correct? Incorrect?
1. Clearly presents the discriminative stimulus    1. Clearly presents the discriminative stimulus   
2. Allows appropriate time for participant response    2. Allows appropriate time for participant response   
3. If participant response is correct, provides reinforcement    3. Does not provide reinforcement when participant response is correct   
4. If participant is incorrect, provides appropriate prompt    4. Does not provide prompt when participant response is incorrect   
5. Quickly progresses to the next trial    5. Quickly progresses to the next trial   
Total    Total   
Percentage correct (Train + Test)   Notes
Preparation fidelity: (percentage score preparation checklist)  
Implementation Fidelity: (percentage correct implementation checklist)  
  1. Developed by Jordan Belisle, M.S., BCBA, Southern Illinois University; Mark R. Dixon, Ph.D., BCBA-D, Southern Illinois University
  2. jbelisle@siu.edu; mdixon@siu.edu

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Dixon, M.R., Paliliunas, D., Barron, B.F. et al. Randomized Controlled Trial Evaluation of ABA Content on IQ Gains in Children with Autism. J Behav Educ 30, 455–477 (2021). https://doi.org/10.1007/s10864-019-09344-7

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Keywords

  • Language acquisition
  • Relational frame theory
  • Verbal behavior therapy
  • PEAK