Technical review of published research on applied behaviour analysis interventions for people with Autism Spectrum Disorder
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 5. Development of Independent Organisational Skills and Other Behaviours
We defined this category by combining two separate categories from the NSP: personal responsibility and self regulation. Personal responsibility was defined by Wilcynzski and Christian (2008, p. 52) as “tasks that involve activities which are embedded in everyday routines. Dependent measures associated with these tasks include but are not restricted to feeding, sleeping, dressing, toileting, motor skills, cleaning, family and/or community activities, health and fitness, phone skills, time and money management, and self advocacy”. Self regulation was defined as “tasks that involve the management of one’s own behaviors in order to meet a goal. Dependent measures associated with these tasks include but are not limited to: persistence, effort, task fluency, transfer of attention, being ‘on schedule,’ self-management, self-monitoring, self-advocacy, remaining in seat (or its opposite of ‘out of seat’), time management, or adapting to changes in the environment” (Wilczynski, personal communication). The merged categories appear to fit well into the Ministry of Education’s classification of “development of independent organisational skills and other behaviours.”
Evidence from the NSP review
The NSP review found emerging support for antecedent package, behavioural package, modelling, and pivotal research treatment interventions for improving performance on tasks involving personal responsibility. Strong support was found for behavioural package interventions for improving self-regulation skills, while emerging support was also found for antecedent package, schedules, and self-management interventions for improving self-regulation skills.
Additional evidence from New Zealand reviewers
Only two items published between 1998 and 2007 were excluded by NSP as they included people with ASD who were older than 21. Both items received SMRS scores of 2 and showed beneficial effects of ABA interventions on personal responsibility for the nine participants. An additional study reviewed by NZ reviewers only had an SMRS score of 3, but effects were rated as unknown. When combined with the evidence from the NSP review, the two additional items concerning adults support NSP’s finding on emerging evidence for the beneficial effects of ABA interventions on tasks involving personal responsibility.
Evidence from studies published from 1998-2007
Thirty-five items reviewed by NSP and/or NZ reviewers were published during the 1998 - 2007 period. An examination of the SMRS scores for this sub-sample found eight items with a SMRS score of 3, and 26 articles with a SMRS score of 2. Six of the eight items that scored 3 found beneficial effects of ABA interventions on personal responsibility and self-regulation, while the effects of two items were classified as “unknown”. Of the remaining 26 items that obtained a SMRS score of 2, 19 found beneficial effects of ABA interventions, five found unknown effects, and the effects of only two were rated as “ineffective”. Overall, the data from the 35 items reviewed here appear to fit into the “emerging support” category on the Strength of Evidence Classification System (SECS) scale.
Summary of this section
In summary, there appears to be strong support for behavioural interventions for the development of independent organisational skills and other behaviours (as defined as “personal responsibility” and “self regulation”) for people with ASD. However, it may be worth noting that although around 71% (25/35) of the reviewed items found beneficial effects of different behavioural interventions on personal responsibility and self-regulation, some interventions were more studied than others. Further research on some of the lesser studied interventions (e.g., self-management, modelling, schedules) may yield stronger overall support for the beneficial effects of behavioural interventions on personal responsibility and self-regulation.
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