Association for Behavior Analysis International

While there is a strong consensus that applied behavior analysis (ABA) is an effective treatment for autism spectrum disorder (ASD), evidence also indicates variation in individual response to treatment. Several factors have been suggested to have an effect on ABA treatment outcomes. Some factors are specific to the child at the start of treatment (e.g., age, IQ, symptom severity, and skill level), while other factors are treatment specific (e.g., treatment intensity and treatment duration). The present studies evaluate the effects of treatment specific factors on outcomes in large and geographically diverse samples of children with ASD receiving ABA services in community-based settings. These studies investigate the relationship between treatment intensity and skill acquisition, the effects of treatment hours on outcomes across all areas of a comprehensive treatment program, and the impact of features of supervision (i.e., supervision intensity, supervisor credentials, years of experience, and caseload) on skill acquisition. The findings of these studies have significant implications on treatment delivery practices and the optimization of treatment response.

Ample research has revealed that high intensity applied behavior analysis (ABA) treatment (i.e., 30-40 hours per week) significantly improves outcomes of children with autism spectrum disorder (ASD). However, relatively few studies have directly compared higher with lower intensity treatment or investigated these effects across all domains. Two studies were conducted with groups of children receiving behavioral intervention in community-based settings. The first study evaluated the relationship between treatment intensity and learning. A regression analysis was conducted with 810 children between 1.5 and 12 years of age. Results indicated a strong linear relationship between treatment intensity and skill acquisition, where a greater number of treatment hours consistently predicted greater progress over time. The second study examined the relationship between treatment intensity and outcomes within eight treatment domains. A multiple regression analysis was conducted with 599 children. While positive effects were observed across all treatment domains, the greatest effects based on treatment intensity were seen for language, play, and academic skills, and the weakest effects seen for adaptive skills, executive function, and cognition. Treatment duration showed a relatively week impact on outcomes. These findings support existing evidence of the benefits of high intensity ABA treatment programs for children with ASD.

Applied behavior analysis (ABA) is a well-established treatment for autism spectrum disorder (ASD). While ample research has shown the benefits of high treatment intensity, very little research has investigated the role of supervision intensity or other elements of supervision in treatment outcomes. The present study examined the relationship between ABA treatment response and supervision intensity, supervisor credentials, years of experience, and caseload in a large and geographically diverse sample of children receiving ABA services in community-based settings. The present analysis included 663 children with ASD. A multiple linear regression analysis was performed to evaluate the impact of supervision and treatment intensity on learning outcomes. When analyzed together, supervision and treatment intensity accounted for slightly more of the observed variance than therapy hours alone. Additional regression analyses were conducted to evaluate the effect of supervisor credentials, years of experience, and caseload. Supervisor credentials were found to have a significant impact on treatment outcome. Supervisor years of experience and caseload were unexpectedly not found to have a meaningful relationship to skill acquisition. These findings provide guidance for best practice recommendations.