Efficacy of Interventions Based on Applied Behavior Analysis for Autism Spectrum Disorder: A Meta-Analysis

Abstract

Objective To systematically evaluate evidence for the use of interventions based on appied behavior analysis (ABA) to manage various symptoms of children with autism spectrum disorder (ASD).Methods Sensitivity analyses were conducted by removing any outlying studies and subgroup analyses were performed to compare the effectiveness of ABA and early start denver model (ESDM), picture exchange communication systems (PECS) and discrete trial training (DTT).Results 14 randomized control trials of 555 participants were included in this meta-analysis. The overall standardized mean difference was d=-0.36 (95% CI -1.31, 0.58; Z=0.75, p=0.45) for autism general symptoms, d=0.11 (95% CI -0.31, 0.54; Z=0.52, p=0.60) for socialization, d=0.30 (95% CI -0.02, 0.61; Z=1.84, p=0.07) for communication and d=-3.52 (95% CI -6.31, -0.72; Z=2.47, p=0.01) for expressive language, d=-0.04 (95% CI -0.44, 0.36; Z=0.20, p=0.84) for receptive language. Those results suggested outcomes of socialization, communication and expressive language may be promising targets for ABA-based interventions involving children with ASD. However, significant effects for the outcomes of autism general symptoms, receptive language, adaptive behavior, daily living skills, IQ, verbal IQ, nenverbal IQ, restricted and repetitive behavior, motor and cognition were not observed.Conclusion The small number of studies included in the present study limited the ability to make inferences when comparing ABA, ESDM, PECS and DTT interventions for children with ASD.

Efficacy and acceptability of pharmacological, psychosocial, and brain stimulation interventions in children and adolescents with mental disorders: an umbrella review

“…We ultimately included 14 NMAs and 90 MAs, reporting on 15 disorders or groups of disorders. For ADHD, we included three NMAs 5,20,21 and 21 MAs 22‐42 ; for autism, one NMA 43 and 21 MAs 12,44‐63 (including one focusing on comorbid anxiety disorders and autism) 12 ; for depressive disorders, two NMA 7,10 and seven MAs 64‐70 ; for obsessive‐compulsive disorder, one NMA 71 and six MAs 72‐77 ; for anxiety disorders, two NMAs 11,78 and five MAs 12,79‐82 (plus two MAs specific on social anxiety disorder 83,84 ); for enuresis, one NMA 85 and six MAs 86‐91 , for disruptive behavior/dissocial/conduct disorders, five MAs 92‐96 (plus one focusing on youth with comorbid ADHD) 25 ; for eating disorders, one NMA 97 and four MAs 98‐101 ; for schizophrenia spectrum disorders, three NMAs 8,102,103 and two MAs 104,105 ; for bipolar disorder, four MAs 106‐109 ; for tic disorder, two MAs 110,111 ; for Tourette's disorder, two MAs 112,113 ; for encopresis, two MAs 114,115 ; for developmental coordination disorder, one MA 116 ; and for PTSD, one MA 117 .…”

Tele-Assisted Behavioral Intervention for Families with Children with Autism Spectrum Disorders: A Randomized Control Trial

“…The ABA method studies particular dynamic interactions between the organism and its environment, and this method has been adapted to improve challenging behaviors in children with ASDs [ 18 , 19 ]. ABA therapy for autism is usually administered with a high intensity and used to achieve specific, measurable goals [ 19 ]. In this field, ABA is based on behaviorist theories that state that simple and complex behavior can be taught through a system of rewards and consequences.…”

“…ABA focuses on a behavioral approach, making it possible to simultaneously improve behavioral, cognitive, social, and communicative skills [ 19 , 20 ]. This system uses “reinforcement” (i.e., rewards) to motivate children with autism to learn new skills, as well as multiple trials that start with a prompt (i.e., antecedent) to execute the desired behavior.…”

“…Overall, systematic reviews [ 18 , 19 , 21 , 22 ] have demonstrated that ABA interventions show promising evidence in terms of efficacy and are a viable intervention for individuals on the autism spectrum, both in telehealth and in-person [ 9 , 23 ], although the variability of the study designs, the heterogeneity of the participants’ clinical presentation, and the methodological limitations reduce the generalizability of study findings.…”

Overview of a Life Skills Coaching Program for Adults on the Autism Spectrum: Coaches’ Perspectives

“…This diversity suggests that coaches were skilled in their ability to tailor their ideas and approaches to each individual client based on their specific goals as well as their strengths and challenges. Behavioral intervention research has demonstrated the effectiveness of one-on-one approaches with children with autism and tailoring a program to meet the individual needs of each child (Yu et al., 2020). These components may be critical ingredients in work with adults as well.…”