Technical review of published research on applied behaviour analysis interventions for people with Autism Spectrum Disorder

Publication Details

New Zealand Ministries of Education and of Health requested a technical review of the evidence base on the effectiveness of Applied Behaviour Analysis (ABA) for people with Autism Spectrum Disorders (ASD).

Released on Education Counts: April 2010

Author(s): Oliver Mudford, Neville Blampied, Katrina Phillips, Dave Harper, Mary Foster, John Church, Maree Hunt, Jane Prochnow, Dennis Rose, Angela Arnold-Saritepe, Heather Peters, Celia Lie, Katrina Jeffrey, Eric Messick, Catherine Sumpter, James McEwan and Susan Wilczynski (2009), Auckland UniServices Limited.

Date Published: 15 January 2009 - Revised 16 January 2009

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Results: Organisation

Reporting on results of our review by Ministry of Education target categories

Table 5 shows the required organisation of the review as specified by the Ministry of Education and the equivalent (or best fit) National Standards Project (NSP) classifications of the evidence divided by targeted areas for intervention. The extent to which NSP and Ministry categories match is discussed at the start of each section of the results and in the Discussion section.

Table 5. Ministry of Education and corresponding NSP categories of behaviours targeted for intervention.
SectionMinistry of Education categoriesEquivalent NSP categories (from Table 3)
1Social development and relating to othersInterpersonal
2Development of cognitive (thinking) skillsLearning readiness
Academic
Higher cognitive functions
3Development of functional and spontaneous communication which is used in natural environmentsCommunication
4Engagement and flexibility in developmentally appropriate tasks and play and later engagement in vocational activitiesIndependent play/leisure
Vocational
5Development of independent organisational skills and other behavioursPersonal responsibility
Self-regulation
6Prevention of challenging behaviours and substitution with more appropriate and conventional behavioursIncludes all problem behaviours that have been changed using antecedent manipulations, and those changed using methods that increase incompatible or alternative behaviours
7

Reducing challenging behaviours 

Replaces “Improvement in behaviours considered non-core ASD behaviours, such as sleep disturbance, self mutilation, aggression, attention and concentration problems.”

Includes all problem behaviours changed by behavioural methods other than those defined for the “prevention” category
8Comprehensive behavioural programmesEarly intensive behavioural intervention
9Generalisation of abilities across multiple natural environments outside the treatment settingIncluded in SMRS coding, and can be extracted therefrom
10Maintenance of effects after conclusion of interventionIncluded in SMRS coding, and can be extracted therefrom
 Development of fine and gross motor skills
(not addressed in this review – see below for explanation)
 


The writers of Result Sections 1 to 8 (Table 5) were supplied with the NSP Strength of Evidence Classification System (SECS) tables (described in Table 4) and Excel spreadsheets containing evidence tables with NSP and NZ-unique data for their particular category. These evidence tables contained data only on items published from 1998-2007 with Scientific Merit Rating Scale (SMRS) scores ≥2.0. Each produced a succinct report using the standardised headings and methods, as follows.

  1. Introduction: Explained how the Ministry of Education category was addressed by one or more NSP categories. 
  2. Evidence from NSP review: Described evidence from SECS ratings across different behavioural intervention categories (Table 2) relevant to the section. 
  3. Additional evidence from New Zealand reviewers: Included description of additional data provided from New Zealand-unique items, i.e., the extent to which additional data may have changed NSP’s findings. (See Appendix C for data and Appendix D1 for references) 
  4. Evidence from studies published from 1998-2007: Data contained in section writers’ spreadsheets were reviewed and indications given for strength of evidence concerning the use of behavioural methods to alleviate behavioural deficits (sections 1-5) or reduce behavioural excesses (sections 6 & 7) or both excesses and deficits (section 8) when only 1998-2007 articles were included. 
  5. Brief summary of section.

The writers of Results Sections 9 and 10 took a different approach since the data they reviewed derived from all of the items in the NSP and NZ-unique evidence tables, across all categories of intervention type and intervention targets. They were instructed to report on the extent to which generalisation (or maintenance) had been addressed by experimental design and method and to review generalisation and maintenance effects for the items recorded in the original NZ-unique database of 91 items with SMRS 2.0. This represents 18% (91/508) of the SMRS composite >2.0 of NSP and NZ databases combined. The reason for non-inclusion of review of generalization and maintenance effects from the NSP database is explained at the beginning of these sections.

Motor skills were assessed in only four items with SMRS >2.0 published in 1998-2007. In no case were motor skills specifically targeted for change, but were assessed routinely as part of comprehensive Vineland assessments. Since the vast majority of behaviours (the subject matter of ABA) involve fine and/or gross physical movement, most categories of behaviour targeted for improvement could be viewed as motor behaviours. We believe that interventions that aim to target these skills directly have not used ABA methods or, if they have, none of the research studies met our inclusion criteria. Possibly, since motor skills deficits are not defining features of ASD, there has been little research interest in addressing them. For these reasons, and with prior agreement from the Ministry of Education (7th October, 2008), we have not produced a review of ABA interventions targeting motor skills specifically.