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 3. Development of Functional and Spontaneous Communication which is Used in Natural Environments

Research reviewed in this section addressed communication skills as defined by Wilczynski and Christian (2008, p.52):

verbal or nonverbal signaling to a social partner regarding content of sharing of experiences, emotions, information, or affecting the partner’s behavior and behaviors that involve understanding a partner’s intentional signals for the same purposes. This systematic means of communication involves the use of sounds or symbols. Dependent measures associated with these tasks include but are not restricted to requesting, labeling, receptive, conversation, greetings, nonverbal, expressive, syntax, speech, articulation, discourse, vocabulary, and pragmatics. Behaviours measured in research reviewed included as examples labelling, use of syntax, conversation, requests, and pragmatics.

Communication as defined above may be viewed as prerequisite to the development of functional and spontaneous communication in natural environments.

Evidence from the NSP review

Based on the systematic evaluation of the evidence the NSP review reported that there was strong evidence that behavioural treatments using naturalistic teaching strategies were beneficial to developing communication skills with children. Additional behavioural treatments identified in the review as having emerging evidence of their success included treatments specifically developed to facilitate communication skills as well as more general treatments. Communication targeted programmes classified as having emerging evidence of a beneficial effect included: Verbal Behaviour interventions, Scripting, Picture Exchange Communication System, Peer Training Packages and Functional Communication Training packages. Evidence of the success of these treatments typically involved studies with children between the ages of three and nine years. More general behavioural techniques found to have emerging evidence of success in developing language included Behavioural Packages, Joint Attention and Modelling.

Additional evidence from New Zealand reviewers

Between 1998 and 2007 there were five items identified by NZ reviewers targeting communication skills that were not included in the NSP review. Except for one article scored at SMRS of 3, these articles received SMRS scores of 2. These additional items support conclusions that can be drawn from the data included in the NSP review.

Evidence from studies published from 1998-2007

Of the 123 items reviewed by the NSP and/or New Zealand reviewers that assessed communication skills, three were given an SMRS composite score of 4. Of these, two provided evidence of a beneficial effect with the remaining article providing insufficient evidence to confirm a beneficial effect. Twenty four items reviewed obtained a score of 3 and, of these, 17 provided evidence of a beneficial effect while the evidence from the remaining seven items was insufficient to draw a conclusion. The majority of items examining communication obtained a SMRS score of 2. Of these 67 provided evidence of a positive effect, 25 do not provide sufficient evidence to draw a conclusion and two provided evidence that the intervention was ineffective. Considering all items obtaining a composite score of 2 or more on the SMRS, 70% showed evidence of a beneficial effect of a behavioural intervention for improving communication while 2% found a behavioural treatment ineffective.

Summary of this section

The review provides considerable evidence of a positive effect of a range of behavioural treatments on communication skills. The behavioural studies examined tended to address and measure specific aspects of communication that may be viewed as necessary prerequisites of spontaneous communication in naturalistic environments. However the behavioural interventions and the measurement of the effects of these of necessity lead to somewhat artificial environments. Thus the studies do not specifically address the use of language spontaneously in natural environments. The majority of the studies reviewed examined the effectiveness of communication programmes with preschool or primary school aged children. The effectiveness of behavioural programmes at facilitating communication in older children and young adults is unclear.