Efficacy of ABA intervention research: Can you trust it?

Isaac Lynn

Abstract

Autism interventions are loudly proclaimed to be effective, yet evidence-based research is often non-existent. In the absence of quality research, interventions such as the most widely utilized in autism, ABA, is touted to be absolutely effective and possibly the only answer for gains to be made in changing autism.
Unfortunately, this may diminish the ability of the individual with autism to change in a positive manner. Additionally, immense monetary bills compound the problem. Caregivers may even bankrupt themselves trying to save their child or family member paying high premiums for ABA services that may or may not actually effectively change or manage behaviors of individuals with autism. This paper will discuss whether or not ABA research actually proves the effectiveness of ABA interventions.

ABA interventions are defined as “those in which the principles of learning theory are applied in a systematic and measurable manner to increase, reduce, maintain and/or generalize target behaviors” (Education, 2007). ABA includes methodology such as reinforcement of target behaviors, shaping and chaining new behaviors, fading inappropriate behaviors, response and stimulus prompting, discrimination training, programming new behaviors, ideas and attitudes as well as completing functional assessments. (Broadstock, 2008)

The research question was whether or not interventions and strategies based on ABA are actually effective in gaining the following outcomes for individuals with autism:

* social development * cognitive thinking skills * functional and spontaneous development of communication * engagement in developmentally appropriate tasks * developing fine and gross motor skills * diminishing challenging behaviors * generalization of appropriate skill sets across multiple environments

Method:

Literature was reviewed by searching, selecting and appraising materials related to ABA as an intervention that actually works to change behaviors in individuals with autism. Sources utilized were those in bibliographic databases such as Medline, PsychINFO, EMBASE, CINAHL, ERIC and the Cochrane Library. Additionally health assessment sites significant to ASD were used to also assess the effectiveness of ABA intervention research.
Each study was scrutinized through reading and entering data into Evidence tables looking specifically at methodology, results, author’s conclusions, reviewer’s comments and a summary study quality descriptor. In doing this, each study was presented alphabetically within two intervention categories: ABA interventions and PECS (Picture Exchange Communication System) interventions to decide if ABA was adequate as compared to PECS (West).

Each study was synthesized to determine if, in fact, there was enough data in three domains to prove that the intervention adequately serves individuals with autism. Those domains were: * Quality (was bias minimized) * Quantity (magnitude of the effect, number of the studies, sample size power) * Consistency (extent to which similar findings are reported) (West)

There were 461 articles reviewed with only 12 meeting all criteria for appraisal and synthesis. Most literature described varying terms for ABA interventions. However, they quickly showed there was no universally accepted description or definition of ABA based interventions. Some of the reviews and studies actually even called the interventions EIBI or Early Intensive Behavioral Interventions rather than ABA. There was also no age based criteria that was recorded other than a general term or definition of “preschool” children (West).

Of the twelve meeting all research criteria review procedures, 33% were found to be of only good quality. The remaining were found to be “fair” research quality and too broad to actually prove that ABA changes behaviors in individuals with autism (Broadstock, 2008).

Another issue was that the particular research was published only across and eighteen month period. This means that results were not founded on years of investigation and research but rather a few months which may or may not validate positive results. Some studies overlapped others that caused parallel technical summaries that caregivers may see as positive results validating ABA.

Caregivers often do not see limitations of the evidence base and then believe everything that they read or are told. If they read that ABA is the only answer to change autistic behaviors in many research articles, then they will believe that to be true. The research may seem to define the intervention as the “best” but also may not be founded without bias or multiple evidence-based samples and trials.

Because of this, caregivers may pay for ABA not knowing it is not the only intervention and they could be limiting their individual with autism’s access to other viable options for improvement. Can you trust the research? To a degree,

it is an option. However, each person must find as much information available to help them make the very best decision in choosing ABA or other interventions.

Works Cited
Broadstock, M. a. (2008). The Effectiveness of Applied Behavioral Analysis interventions for people with autism spectrum disorder. Systematic Review .
Education, M. o. (2007). Request for tender (RFT). . Review of published research on applied behavior analysis (ABA) interventions for people with autism spectrum disorder (ASD).
West, S. K. (n.d.). Systems to rate the strength of scientific evidence. Technology Assessment .