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ABA: Applied behavior analysis




Evidence-Based research on ABA:

  • The Kids Who Beat Autism1
    This feature-length article in the New York Times Magazine (July 31, 2014) considered whether some children can can recover from autism. The article reviews the history of applied behavioral analysis (ABA), an intensive, highly structured one-on-one treatment for children on the autism spectrum that was developed at UCLA in the 1980s by Ivar Lovaas. Based on the results of this technique, which deconstructs every human social behavior into sequences of tiny steps and seeks to teach children the steps using behavioral therapy tools, Lovaas claimed that nearly half of the children who received this therapy in its full form recovered. The claim created considerable controversy, and examination of the treatment and Lovaas’ data identified a number of problems. More recent case studies, and two systematic reviews of those studies, have shown that although a certain percentage of individuals with the diagnosis do recover (have successful, functional lives), the rate of recovery may not be higher among individuals who underwent ABA or other intensive behavioral-based therapies than among those who received much less intensive types of therapy. The article follows 5 young people and their families from birth through their diagnoses and treatment; 4 of the 5 have recovered. The fifth, a young man, never learned to speak and now resides in a group home, in spite of intensive one-on-one therapy, yet another is a popular and accomplished honor student in his senior year of high school, in spite of no intensive therapy. Nothing in the studies seems to suggest what might predict whether any one child will benefit more from intensive therapy or even outgrow the diagnosis on his or her own.

  • Evaluating the efficacy of the PEAK Relational Training System using a randomized controlled trial of children with autism.2
    The PEAK Relational Training System is a series of assessments and curriculum guides consisting of four modules, based on B.F. Skinner’s theory that language learning is best described by the relationship between stimulating events (A), the response of the speaker (B), and subsequent actions on the part of the listener (C). The PEAK Direct Training Module is designed to assess and teach language skills according to this “ABC” design, such that individuals are reinforced for providing the appropriate response to a verbal statement (stimulus).

    Twenty-seven children diagnosed with pervasive developmental disorders (PDD) were randomized to either language instruction based on the PEAK Direct Training Module or treatment as usual (TAU, based on the child’s existing individualized educational plan [IEP]). All participants were evaluated using the PEAK direct training assessment prior to randomization. This assessment specifically evaluates an individual’s ability to learn language skills through direct contingencies (i.e., through reinforcement of specific verbal responses).

    After one month, both groups were re-assessed using the PEAK direct assessment after one month. Children in the experimental group made significantly more gains in language skills than those who were assigned to the TAU group.

  • A Randomized Clinical Trial Comparison Between Pivotal Response Treatment (PRT) and Adult-Driven Applied Behavior Analysis (ABA) Intervention on Disruptive Behaviors in Public School Children with Autism.3
    A recent study conducted in Iran randomized public school children with ASD to either Pivotal Response Treatment (PRT) or an adult-directed Applied Behavior Analysis (ABA) approach to language intervention. PRT is based on ABA but incorporates child choice, direct and natural rewards, reinforcing attempts, task variation, and interspersal of previously-learned and newly targeted language structures. The group that received PRT showed greater improvements in language acquisition, the primary outcome of interest, than did the group that received adult-directed ABA. The authors further hypothesized that because the PRT group showed greater improvements in language acquisition during the intervention, they would engage in less disruptive behaviors than the ABA group.

    During the first session, the time spent engaging in disruptive behaviors averaged 9.6 minutes for the children in the ABA group, compared to an average of 11.5 minutes for children in the PRT group. However, after three months of intervention, the children in the adult-directed ABA group engaged in disruptive behaviors for an average of 8.4 min per session, while the PRT group showed a mean of only 1.6 minutes of disruptive behavior per session.

  • ABA predictors of outcome4
  • Large-scale, publicly funded ABA outcomes5
  • Early and intensive ABA leads to better outcomes6
  • ABA in School Setting7
  • Overview of ABA research8
  • ABA Changing Core Symptoms Study9
  • Comparing ABA to Eclectic Treatments10

General Guides:

1 Padawer, Ruth. The Kids Who Beat Autism. New York Times Magazine. July 31, 2014.

2 McKeel AN, Dixon MR, Daar JH, Rowsey KE, Szekely S. Evaluating the efficacy of the PEAK Relational Training System using a randomized controlled trial of children with autism. Journal of Behavioral Education. 2015;24(2):230-41.

3 Mohammadzaheri F, Koegel LK, Rezaei M, Bakhshi E. A Randomized Clinical Trial Comparison Between Pivotal Response Treatment (PRT) and Adult-Driven Applied Behavior Analysis (ABA) Intervention on Disruptive Behaviors in Public School Children with Autism. Journal of Autism and Developmental Disorders. 2015.

4 Reprinted from Research in Autism Spectrum Disorders 5(1), 592-603. (2011), with permission from Elsevier

5 Reprinted from Research in Autism Spectrum Disorders, 6(2), 673-682. (2012), with permission from Elsevier

6 Reprinted from Research in Autism Spectrum Disorders 6(2), 829-835. (2012), with permission from Elsevier

7 Reprinted from Research in Autism Spectrum Disorders 6, 829–835. (2012), with permission from Elsevier

8 Reprinted from Clinical Psychology Review, 30 (4), 387-399. (2010), with permission from Elsevier

9 Reprinted from Research in Autism Spectrum Disorders 1, 304–317. (2007), with permission from Elsevier

10 Reprinted from Research in Developmental Disabilities 26, 359–383. (2005) with permission from Elsevier

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