Behavior Analysis in Practice

, Volume 12, Issue 3, pp 503–513 | Cite as

You Get What You Pay For: Three Years of Applied Behavior Analysis in Hong Kong With Relative Cost

  • Jeremy H. GreenbergEmail author
  • Tsoi-Yi Chung
Research Article


There are decades of research literature that support the effective application of applied behavior analysis (ABA) in schools that have students with special needs, including autism spectrum disorder. Students ranging in age from preschool through secondary have benefited from ABA and its effectiveness. In light of the global economic downturn over the last decade, the costs of services for children with special needs has been analyzed and scrutinized across many levels of bureaucratic systems. Through its evidence-based methods, its focus on relevant outcome data, and its systematic measurement practices, ABA has offered many educational stakeholders the best way forward for one of modern society’s biggest behavioral health problems. The present study replicates a cost-benefit analysis and shows the outcomes of instruction in terms of cost in dollars. We reviewed 3 years of outcome data from an international school for students with special needs in Hong Kong. Special instruction with ABA was provided in individual, group, and inclusive classroom settings using learn units as the basic unit of instruction. A cost-benefit analysis showed the relative dollar amounts of the learn unit and instructional objectives, adjusted for inflation and compared across previous studies.


Applied behavior analysis Autism Cost-benefit analysis Learn units Inclusion 


Compliance with Ethical Standards

Conflict of Interest

Jeremy H. Greenberg declares that he has no conflict of interest with the research data in the present paper. Tsoi-Yi Chung declares that she has no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. Albers, A. E., & Greer, R. D. (1991). Is the three-term contingency trial a predictor of effective instruction? Journal of Behavioral Education, 1(3), 337–354.CrossRefGoogle Scholar
  2. Anderson, S. R., & Romanczyk, R. G. (1999). Early intervention for young children with autism: Continuum-based behavioral models. The Journal of the Association for Persons With Severe Handicaps, 2(3), 162–173.CrossRefGoogle Scholar
  3. Bate, A., Barber, S., Powell, T., Parkin, E., Long, R., Bolton, P., . . . Kennedy, S. (2017). Early intervention (Briefing Paper No. 07647). London: Parliament, United Kingdom. Retrieved from
  4. Bushell, D., & Baer, D. M. (1994). Measurably superior instruction means close, continual contact with the relevant outcome data. Revolutionary! In R. Gardner III, D. M. Sainato, J. O. Cooper, T. E. Heron, W. L. Heward, J. Eshleman, & T. A. Grossi (Eds.), Behavior analysis in education: Focus on measurable superior instruction (pp. 3–10). Pacific Grove, CA: Brooks/Cole Publishing.Google Scholar
  5. Chasson, G. S., Harris, G. E., & Neely, W. J. (2007). Cost comparison of early intensive behavioral intervention and special education for children with autism. Journal of Child and Family Studies, 16(3), 401–413.CrossRefGoogle Scholar
  6. Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (2nd ed.). Upper Saddle River, NJ: Merrill.Google Scholar
  7. Greenberg, J. H. (2007). Effects of teachers’ verbal mastery and application of research-based tactics on instruction and estimated costs to students with pervasive developmental disorders. Dissertation Abstracts International, 68(06), UMI No. 3266585.Google Scholar
  8. Greenberg, J. H., & Greenberg, J. C. (2014). It takes two to tango: Inclusive schooling in Hong Kong. Global Education Review, 1(1), 44–55.Google Scholar
  9. Greenberg, J. H., & Martinez, R. C. (2008). Starting off on the right foot: One year of behavior analysis in practice and relative cost. International Journal of Behavioral Consultation and Therapy, 4(2), 212.CrossRefGoogle Scholar
  10. Greer, R. D. (1994). The measure of a teacher. In R. Gardner III, D. M. Sainato, J. O. Cooper, T. E. Heron, W. L. Heward, J. Eshleman, & T. A. Grossi (Eds.), Behavior analysis in education: Focus on measurably superior instruction (pp. 283–320). Pacific Grove, CA: Brooks/Cole Publishing.Google Scholar
  11. Greer, R. D. (2002). Designing teaching strategies. New York, NY: Academic Press.Google Scholar
  12. Greer, R. D., Keohane, D. D., & Healy, O. (2002). Quality and comprehensive applications of behavior analysis to schooling. The Behavior Analyst Today, 3(2), 120–132.CrossRefGoogle Scholar
  13. Greer, R. D., McCorkle, N., & Williams, G. (1989). A sustained analysis of the behaviors of schooling. Behavioral Residential Treatment, 4, 113–141.Google Scholar
  14. Greer, R. D., & McDonough, S. H. (1999). Is the learn unit the fundamental measure of pedagogy? The Behavior Analyst, 20, 5–16.CrossRefGoogle Scholar
  15. Greer, R. D., & Ross, D. E. (2008). Verbal behavior analysis. Boston, MA: Allyn and Bacon.Google Scholar
  16. Ingham, P., & Greer, R. D. (1992). Changes in student and teacher responses in observed and generalized settings as a function of supervisor observations. Journal of Applied Behavior Analysis, 25(1), 153–164.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Jacobson, J. W., & Mulick, J. A. (2000). System and cost research issues in treatments for people with autistic disorders. Journal of Autism and Developmental Disorders, 30(6), 585–593.CrossRefPubMedGoogle Scholar
  18. Jacobson, J. W., Mulick, J. A., & Green, G. (1998). Cost-benefit estimates for early intensive behavioral intervention for young children with autism: General model and single state case. Behavioral Interventions, 13, 201–226.CrossRefGoogle Scholar
  19. Kates-McElrath, K., & Axelrod, S. (2007). Behavioral intervention for autism: A distinction between two behavior analytic approaches. Behavior Analysis Review, 2. Retrieved from
  20. Keller, F. S. (1968). “Good-bye teacher . . .” Journal of Applied Behavior Analysis, 1(1), 79–89.Google Scholar
  21. Keohane, D. (1997). A functional relationship between teachers use of scientific rule governed strategies and student learning (Unpublished doctoral dissertation). Columbia University, New York, New York.Google Scholar
  22. Keohane, D., & Greer, R. D. (2005). Teachers’ use of a verbally governed algorithm and student learning. International Journal of Behavioral Consultation and Therapy, 1(3). Retrieved from
  23. Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3–9.CrossRefPubMedGoogle Scholar
  24. McGee, G. G., Morrier, M. J., & Daly, T. (1999). An incidental teaching approach to early intervention for toddlers with autism. The Journal of the Association for Persons With Severe Handicaps, 24(3), 133–146.CrossRefGoogle Scholar
  25. Motiwala, S. S., Gupta, S., Lilly, M. B., Ungar, W. J., & Coyte, P. C. (2006). The cost effectiveness of expanding intensive behavioural intervention to all autism children in Ontario. Healthcare Policy, 1(2), 135–151.PubMedPubMedCentralGoogle Scholar
  26. Office of Overseas Schools U.S. Department of State (2018, June 4) Retrieved from
  27. Olchowski, A. E., Foster, M., & Webster-Stratton, C. H. (2007). Implementing behavioral intervention components in a cost-effective manner: Analysis of the Incredible Years Program. Journal of Early and Intensive Behavior Intervention, 3(4)–4(1), 284–304. Retrieved from
  28. Piccininni, C., Bisnaire, L., & Penner, M. (2017). Cost-effectiveness of wait time reduction in intensive behavior intervention services in Ontario, Canada. JAMA Pediatrics, 171(1), 23–30.CrossRefPubMedGoogle Scholar
  29. Prizant, B. M., & Rubin, E. (1999). Contemporary issues in interventions for autism spectrum disorders: A commentary. The Journal of the Association for Persons With Severe Handicaps, 24(3), 199–208.CrossRefGoogle Scholar
  30. Selinske, J., Greer, R. D., & Lodhi, S. (1991). A functional analysis of the comprehensive application of behavior analysis to schooling. Journal of Applied Behavior Analysis, 24, 107–117.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Skinner, B. F. (1957). Verbal behavior. New York, NY: Prentice-Hall.CrossRefGoogle Scholar
  32. Stabile, M., & Allin, S. (2012). The economic costs of childhood disability. Future Child, 22(1), 65–96.CrossRefPubMedGoogle Scholar
  33. Stallings, J. (1980). Allocated academic time revisited, or beyond time on task. Educational Researcher, 9, 11–16.CrossRefGoogle Scholar
  34. Steege, M. W., Mace, F. C., Perry, L., & Longenecker, H. (2007). Applied behavior analysis: Beyond discrete trial teaching. Psychology in the Schools, 44(1), 91–99.CrossRefGoogle Scholar
  35. The Challenging Behaviour Foundation. (2014). Briefing paper: Early intervention for children with learning disabilities whose behaviours challenge. United Kingdom: Council for Disabled Children Retrieved from Scholar
  36. Twyman, J. S. (1998). The Fred S. Keller School. Journal of Applied Behavior Analysis, 31(4), 695–701.CrossRefPubMedCentralGoogle Scholar
  37. Weiss, M. J. (2001). Expanding ABA interventions in intensive programs for children with autism: The inclusion of natural environment training and fluency based instruction. The Behavior Analyst Today, 2(3). Retrieved from
  38. Weiss, M. J. (2005). Comprehensive ABA programs: Integrating and evaluating the implementation of varied instructional approaches. The Behavior Analyst Today, 6(4). Retrieved from

Copyright information

© Association for Behavior Analysis International 2019

Authors and Affiliations

  1. 1.The Children’s Institute of Hong KongKennedy TownHong Kong

Personalised recommendations