An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder

Abstract

Applied behavior analysis (ABA) is considered an effective treatment for individuals with autism spectrum disorder (ASD), and many researchers have further investigated factors associated with treatment outcomes. However, few studies have focused on whether treatment intensity and duration have differential influences on separate skills. The aim of the current study was to investigate how treatment intensity and duration impact learning across different treatment domains, including academic, adaptive, cognitive, executive function, language, motor, play, and social. Separate multiple linear regression analyses were used to evaluate these relationships. Participants included 1468 children with ASD, ages 18 months to 12 years old, M=7.57 years, s.d.=2.37, who were receiving individualized ABA services. The results indicated that treatment intensity and duration were both significant predictors of mastered learning objectives across all eight treatment domains. The academic and language domains showed the strongest response, with effect sizes of 1.68 and 1.85 for treatment intensity and 4.70 and 9.02 for treatment duration, respectively. These findings are consistent with previous research that total dosage of treatment positively influences outcomes. The current study also expands on extant literature by providing a better understanding of the differential impact that these treatment variables have across various treatment domains.

The development and implementation of a training program for pediatric dentistry residents working with patients diagnosed with ASD in a special needs dental clinic

“…While the majority of psychology practitioners work with clients in an office setting using variations of talk therapy to achieve positive therapeutic outcomes, behavior analysis professionals typically work with clients in their natural setting. Behavior analysts treat target behaviors by designing and implementing interventions to address behaviors in the context in which the behaviors occur, in order to achieve socially significant results that are generalizable and maintain over time 28–30 . Therefore, if a behavior problem were to arise, for example, in a dental clinic during a routine exam, the behavior analyst would assess and treat the challenging behavior in the dental operatory.…”

“…Since behavior change is achieved through operant conditioning which includes the modification of antecedents and consequence of behaviors in a natural context as well as teaching adaptive replacement behavioral repertories, behavior analytic treatments often require multiple hours of service delivery per week to be effective. The recommendation for individuals with ASD is a range from 30 to 40 hours per week, with many receiving 5 to 35 hours of programming per week 29–32 . Given these parameters, behavior analysis offers a tiered service delivery model (Figure 1), allowing the high demand for behavior analysis practitioners to be met for consumers while simultaneously ensuring the delivery of a high‐quality and affordable service.…”

Effectiveness of a SCERTS Model-Based Intervention for Children with Autism Spectrum Disorder (ASD) in Hong Kong: A Pilot Study

“…All these findings suggest that the 5-month intervention appeared to have similar impacts to those of the 10-month intervention on the participating children’s development. Previous literature has suggested that although treatment intensity has significant and reliable positive effects on participants’ improvement, the effect of treatment duration has been inconclusive (Linstead et al 2017). In the present study, both the 5-month training and the 10-month training offered 35 h of active engagement with the participants every week, and that high treatment intensity is likely to have contributed to the significant changes shown in both groups, regardless of the program’s duration.…”

“…To fill that gap, the Heep Hong Society has commenced a project that aims to adapt and implement the SCERTS model on a larger scale and has combined that project with a research study to assess the effectiveness of the project in helping children with ASD, their parents, and their teachers. While some prior studies found that longer treatment duration had positive effects on the effectiveness of the treatment for children with ASD (Linstead et al 2017; Virués-Ortega 2010), some concluded that treatment duration alone was not a strong enough predictor of the effectiveness of the intervention (Virues-Ortega e al. 2013).…”

Evaluating Kupferstein’s claims of the relationship of behavioral intervention to PTSS for individuals with autism

“…ABA-based interventions have been demonstrated to result in substantial positive changes in the quality of lives for individuals diagnosed with ASD (e.g. Howard et al, 2014;Linstead et al, 2017;Lovaas, 1987;McEachin et al, 1993), and have been endorsed by multiple organizations (e.g. Autism Speaks, The Association for Behavior Analysis International, The United States Surgeon General, National Institute of Mental Health, The American Psychological Association).…”