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Applied Behaviour Analysis for Autism: Evidence, Issues, and Implementation Barriers

  • Autism Spectrum (A Richdale and L Lawson, Section Editor)
  • Published:
Current Developmental Disorders Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Interventions to address the needs of autistic individuals have been extensively researched. We briefly review the key findings and explore why, in spite of strong supporting evidence, the uptake of evidence-based procedures remains poor.

Recent Findings

Numerous meta-analyses, systematic reviews, and cost benefit analyses testify to the effectiveness of interventions based on applied behaviour analysis (ABA). Despite the progress made by both the autism advocacy and scientific communities, controversy and division remain among researchers, clinicians, and within the autism community. Funding for these evidence-based interventions is not always available.

Summary

Misunderstandings and misconceptions about ABA abound. Challenges regarding appropriate research methods to evaluate the effectiveness of individualised interventions contribute to disagreements about what counts as evidence. There is an urgent need to reconcile these differences, develop mutual understanding between these communities, work together on research focused on promoting implementation, and to influence policy.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. U.S. Department of Health and Human Services. Mental health: a report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999. Available from: https://www.hsdl.org/?abstract&did=730796. Accessed 24 September 2021

  2. Fombonne E, MacFarlane H, Salem AC. Epidemiological surveys of ASD: advances and remaining challenges. J Autism Dev Disord. 2021. https://doi.org/10.1007/s10803-021-05005-9.

  3. Baxter AJ, Brugha TS, Erskine HE, Scheurer RW, Vos T, Scott JG. The epidemiology and global burden of autism spectrum disorders. Psychol Med. 2015;45(3):601.

    Article  CAS  Google Scholar 

  4. Laragy C, Fisher KR. Choice, control and individual funding: the Australian National Disability Insurance Scheme. In: Stancliffe R, Wehmeyer M, Shogren K, Abery B. (eds) Choice, preference, and disability. Positive psychology and disability series. Springer, Cham. (2020). Available from: https://doi.org/10.1007/978-3-030-35683-5_7.

  5. Lovaas OI. Behavioral treatment and normal educational and intellectual functioning in young autistic children. J Consult Clin Psychol. 1987;55(1):3–9. Available from: https://doi.org/10.1037/0022-006X.55.1.3.

  6. Kanner L. Autistic disturbances of affective contact. Nervous Child. 1943;2(3):217–50.

  7. Skinner B. Behavior modification Science New Series. 1974;184(4154):813. https://doi.org/10.1126/science:185.4154.813.

  8. Friedman PR. Legal regulation of applied behavior analysis in mental institutions and prisons. Ariz Law Rev. 1975;17(1):39–104.

    PubMed  Google Scholar 

  9. American Psychological Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Arlington VA.

  10. Gillberg C, Allely C, Bourgeron T, Coleman M, Fernell E, Hadjikhani N, Sarovic D. The neurobiology of Autism. In: Volkmar FR, editor. Autism and Pervasive Developmental Disorders. 3rd ed. Cambridge: Cambridge University Press; 2019. p. 129–57.

    Chapter  Google Scholar 

  11. Whitehouse A, Varcin K, Waddington H, Sulek R, Bent C, Ashburner J, Eapen V, Goodall E, Hudry K, Roberts J, Silove N, Trembath D. Interventions for children on the autism spectrum: a synthesis of research evidence. Autism CRC, Brisbane, 2020.

  12. Hubbard R, Parsa RA, Luthy MR. The spread of statistical significance testing in psychology: the case of the Journal of Applied Psychology, 1917–1994. Theory Psychol. 1997;7(4):545–54. https://doi.org/10.1177/0959354397074006.

    Article  Google Scholar 

  13. Loftus G. On the tyranny of hypothesis testing in the social sciences. Psyccritiques. 1991;36:102–5.

    Google Scholar 

  14. Blampied N. A legacy neglected: restating the case for single-case research in cognitive-behaviour therapy. Behav Chang. 1999;16(2):89–104. https://doi.org/10.1375/bech.16.2.89.

    Article  Google Scholar 

  15. Baer DM, Wolf MM, Risley TR. Some current dimensions of applied behavior analysis. J Appl Behav Anal. 1968;1(1):91–7. https://doi.org/10.1901/jaba.1968.1-91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Chiu MM, Roberts CA. Improved analyses of single cases: dynamic multilevel analysis. Dev Neurorehabil. 2018;21(4):253–65. https://doi.org/10.3109/17518423.2015.11199046.

    Article  PubMed  Google Scholar 

  17. Individuals with Disabilities Education Act 1990. US Congress - Public Law. 1990.

  18. United Nation Convention for the Rights of the Child. UNCRC; 1990. Available from: https://treaties.un.org/doc/Publication/MTDSG/Volume%20I/Chapter%20IV/IV-11.en.pdf. Accessed 24 September 2021

  19. Reichow B. Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. J Autism Dev Disord. 2012;42:512–20.

    Article  Google Scholar 

  20. Fusar-Poli P, Radua J. Ten simple rules for conducting umbrella reviews. Evid Based Ment Health. 2018;21(3):95–100. https://doi.org/10.1136/ebmental-2018-300014.

    Article  PubMed  Google Scholar 

  21. National Standards Report, Phase 2. National Autism Centre, National Autism Center, Randolph MA. 2015. Available from: http://www.autismdiagnostics.com/assets/Resources/NSP2.pdf Accessed 9 Nov 2020.

  22. Hume K, Steinbrenner JR, Odom SL, Morin KL, Nowell SW, Tomaszewski B, Szendrey S, McIntyre NS, Yücesoy-Özkan S, Savage MN. Evidence-Based Practices for Children, Youth, and Young Adults with Autism: Third Generation Review. J Autism Dev Disord. 2021. https://doi.org/10.1007/s10803-020-04844-2.

  23. Eldevik S, Hastings RP, Hughes JC, Jahr E, Eikeseth S, Cross S. Using participant data to extend the evidence base for intensive behavioral intervention for children with autism. Am J Intellect Dev Disabil. 2010;115(5):381–405.

    Article  Google Scholar 

  24. Smith T, Iadarola S. Evidence base update for autism spectrum disorder. J Clin Child Adolesc Psychol. 2015;44(6):897–922.

    Article  Google Scholar 

  25. Virués-Ortega J. Applied behavior analytic intervention for autism in early childhood: meta-analysis, meta-regression and dose-response meta-analysis of multiple outcomes. Clin Psychol Rev. 2010;30(4):387–99. https://doi.org/10.1016/j.cpr.2010.01.008.

    Article  PubMed  Google Scholar 

  26. • CASP, the Council of Autism Service Providers Applied Behavior Analysis Treatment of Autism Spectrum Disorder: Practice Guidelines for Healthcare Funders and Managers 2nd Edition accessed May, 2020;6. Available from: https://casproviders.org/wp-content/uploads/2020/03/ABA-ASD-Practice-Guidelines.pdf.(These practice guidelines provide comprehensive, succinct, and accessible information regarding all dimensions affecting the effective and efficient delivery of behavioural interventions for individuals with ASD.)

  27. Behavior Analyst Certification Board. Available from: https://www.bacb.com/services/o.php?page=101134.

  28. Shook GL, Favell JE. The Behavior Analyst Certification Board and the Profession of Behavior Analysis. Behav Analysis Practice. 2008;1:44–8. https://doi.org/10.1007/BF03391720.

    Article  Google Scholar 

  29. Cooper JO, Heron TE, Heward WL. Applied behavior analysis. 3rd ed. Pearson Education, Inc; 2020.

  30. Sandoval-Norton AH, Shkedy G. How much compliance is too much compliance: is long-term ABA therapy abuse? Cogent Psychol. 2019;6:1. https://doi.org/10.1080/23311908.2019.1641258.

    Article  Google Scholar 

  31. •• Gorycki KA, Ruppel PR, Zane T. Is long-term ABA therapy abusive: a response to Sandoval-Norton and Shkedy. Cogent Psychology. 2020;7:1. https://doi.org/10.1080/23311908.2020.1823615. (In their academically rigorous response to Sandoval-Norton and Shkedy (2019), the authors of this paper address many of the common misconceptions and mis-information about ABA)

    Article  Google Scholar 

  32. Dillenburger K, Keenan, M, Gallagher S. A seat at the table: families affected by Autism. Amazon Kindle. 2015.

  33. Americans with Disabilities Act 1990. Available from: https://www.ada.gov/ada_intro.htm. Accessed 24 September 2021

  34. The Autistic Self Advocacy Network. Available from: https://autisticadvocacy.org/Accessed 7 Nov 2020.

  35. Autism Speaks. Available from: https://www.autismspeaks.org/. Accessed 7 Nov 2020.

  36. Office of Autism Research Coordination, National Institute of Mental Health, on behalf of the Interagency Autism Coordinating Committee (IACC). 2016 IACC Autism Spectrum Disorder Research Portfolio Analysis Report. January 2019. Available from: The U.S. Department of Health and Human Services Interagency Autism Coordinating Committee. Available from: https://iacc.hhs.gov/portfolio-analysis/2016/index.shtml. Accessed 24 September 2021

  37. Botha M, Dibb B, Frost DM. “Autism is me”: an investigation of how autistic individuals make sense of autism and stigma. Disabil Soc. 2020. https://doi.org/10.1080/09687599.2020.182278.

    Article  Google Scholar 

  38. Fletcher-Watson S, Adams J, Brook K, Charman T, Crane L, Cusack J, Leekam S, Milton D, Parr JR, Pellicano E. Making the future together: shaping autism research through meaningful participation. Autism. 2019;23(4):943–53.

    Article  Google Scholar 

  39. Milton DE, Bracher M. Autistics speak but are they heard? Journal of the BSA Medsoc Group. 2013;7:61–9.

    Google Scholar 

  40. Bottema-Beutel K, Kapp SK, Lester JN, Sasson NJ, Hand BN. Avoiding Ableist Language: suggestions for autism researchers. Autism in Adulthood. 2020;00:00. https://doi.org/10.1089/aut.2020.0014.

    Article  Google Scholar 

  41. Bourke R, Holden B, Curzon J. Using evidence to challenge practice: A discussion paper. Wellington: Ministry of Education; 2005.

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Authors and Affiliations

  1. School of Psychology, The University of Waikato, Private Bag 3105, Hamilton, 3240, New Zealand

    Angelika Anderson

  2. Melbourne Graduate School of Education, The University of Melbourne, Melbourne, Australia

    Monica Carr

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  1. Angelika Anderson
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Correspondence to Angelika Anderson.

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Note on Terminology:

There is currently no one term referring to individuals on the autism spectrum that is acceptable to all. We will use two terms interchangeably: (1) autism spectrum disorder (ASD), which is the diagnostic term used in the healthcare sector and in much of the scientific literature, and (2) autist, or autistic person, which is identity first language, preferred by those who believe that being autistic is part of a person’s identity.

This article is part of the Topical Collection on Autism Spectrum

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Anderson, A., Carr, M. Applied Behaviour Analysis for Autism: Evidence, Issues, and Implementation Barriers. Curr Dev Disord Rep 8, 191–200 (2021). https://doi.org/10.1007/s40474-021-00237-x

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