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 2. Development of Cognitive Skills

The Ministry of Education classification of the development of cognitive skills is best represented in this review by the NSP classifications of learning readiness, academic, and higher cognitive functions skills. The NSP has defined learning readiness as tasks which “serve as the foundation for successful mastery of complex skills …, dependent measures associated with these tasks include but are not restricted to imitation, following instructions, sitting skills, attending to environmental sounds [and] attention to tasks” (Wilczynski & Christian, 2008, p. 52). Academic tasks are defined by the NSP as “tasks that are precursors to or required in order to succeed with school activities. Dependent measures associated with these tasks include … preschool activities (e.g., sequencing, color, letter number identification, etc.), fluency, latency, reading, writing, mathematics, science, history or skills required to study or perform well on exams” (Wilczynski & Christian, 2008, p. 51). Higher cognitive functions have been defined as tasks which “require complex problem-solving outside the social domain… including … critical thinking, IQ, problem-solving, working memory, executive functions, organizational skills, and theory of mind tasks” (Wilczynski & Christian, 2008, p. 52). These NSP classifications and definitions seem to cover the Ministry of Education classification of development of cognitive skills quite well.

Evidence from the NSP review

There is emerging evidence that antecedent package interventions were useful for the development of academic skills. Behavioural packages demonstrated emerging evidence for the development of both academic and learning readiness skills. Emerging evidence was demonstrated by modelling on higher cognitive function skills. Finally, there is emerging evidence that pivotal response treatment interventions were useful for the development of learning readiness.

Additional evidence from New Zealand reviewers

Three items published between 1998 and 2007 had not been included by NSP as they excluded people with ASD who were older than 21 years and/or had additional psychiatric or medical diagnoses A further seven studies were published in 2007 after the closing date for the NSP study. Of these 10 items, three items received SMRS scores of 3.0 showing beneficial effects among 8 participants. The other seven items received SMRS scores of 2.0 and showed beneficial effects for nine participants in six of the items. The final item with three adult participants was rated as ineffective.

Three studies looked at academic skills for 11 to 16 year olds for whom beneficial effects were found for behavioural interventions. Six studies looked at 13 children ages 2 to 8 for whom beneficial effects in the area of learning readiness were demonstrated. Overall the additional evidence indicated further beneficial effects in the areas of learning readiness and academic skills from behavioural interventions.

Evidence from studies published from 1998 – 2007

Thirty items in the period from 1998 to 2007 received an SMRS coding above 2. Of these, two items looked at higher cognitive skills, 16 examined learning readiness, and 12 studies investigated academic skills. In these categories five items received an SMRS rating of 3 and one item was rated 4, all of which reported beneficial effects of behavioural interventions. The remaining 24 items reviewed by NSP and/or NZ reviewers received a SMRS rating of 2. Of these items, seventeen indicated effective interventions, the results of six items were unknown or difficult to interpret, and one item was rated ineffective with learning readiness for adult participants.

Summary of this section

Overall, the 30 items reviewed in the cognitive skills area certainly meet the criterion of emerging evidence and could be classified as heading towards demonstrating strong evidence for the interventions. There were a relatively small number of studies in the area of cognitive skills. This would indicate that in the past academic and cognitive skills were not targeted for intervention with ASD participants. Nevertheless, this appears to be a growing research focus as noted by the fact that 13 of the 30 items in this area were published in 2007.