Association for Behavior Analysis International

The synthesis of evidence is central to the translation of scientific knowledge into practice. Most clinical sciences use meta-analysis methodology to aggregate the evidence from multiple individual studies. Meta-analyses are often used as the final scientific product preceding the transfer of evidence to health and education decision-makers and to the wider public. The use of meta-analysis in behavior analysis has been hampered by (a) the multiple metrics used across studies, (b) the limited use of randomized and non-randomized controlled studies, (c) the absence of purposely-developed effect size estimators for single-subject experimental designs, and (d) the lack of quantitative approaches to appropriately evaluate the idiosyncrasies of individual studies and individual participants within studies. Analytical developments over the last few years have helped to overcome some of these limitations. Some of these developments are illustrated in the current series of review studies. K. Hurl's meta-analysis compares the relative effectiveness of interventions for problem behavior that were and were not preceded by a functional assessment. R. Anderson's study features a quantitative synthesis of behavioral interventions for severe feeding disorders. J. McCormack will present a meta-analysis of the differential outcome effects in clinical and non-clinical population. Finally, A. Arnold-Saritepe will present a review of evidence-based practices for severe behavior in individuals with developmental disabilities and autism.

There is a growing interest in treatments to transition children from tube feeding (e.g., nasogastric or gastrostomy tubes) to oral feeding. A number of literature reviews identify applied behaviour analysis as having the strongest evidence for the treatment of pediatric feeding disorders. However, few studies have reviewed the nutritional outcomes for tube fed children. These outcomes include primarily the reduction or elimination of tube feeds and weight gain. In addition, the individual studies available do not allow a cogent comparison of behaviour-analytic intervention with other multidisciplinary treatment studies, such as tube weaning or hunger provocation programs. In the current investigation we conducted a meta-analysis of treatments for children dependent on tube feeding, combining datasets of different metrics (e.g., single-case and group designs). This presentation will cover our meta-analysis methods, results, and implications for future research and clinical practice.

Severe behavior presents a significant challenge for both the individual and caregiver in terms of quality of life. Challenging behavior is commonly reported in individuals with intellectual disabilities, 10-15 %, however for those with autism and / or profound intellectual disabilities the prevalence is much higher, 39-65%. At least 10% of individuals in the latter category have challenging behavior that would be considered to be severe. Adolescent and young adult males make up two-thirds of this group. While the progression of severe behavior disorders has not been well documented, it would appear that the overall prognosis for this group of individuals is not good, with potentially 80% continuing to engage in these behaviors 20 years later. Many of the studies published contain complex multi-component interventions that do not always report long term follow up or generalization data. This paper aims to review the behavioral literature for the intervention of the most severe challenging behavior (e.g., aggression, property destruction and self-injurious behavior) using Reichow, Volkmar and Cicchetti?s (2008) method for evaluating and determining evidence-based practice. It is hoped that this review will support researchers and clinicians in developing effective long lasting interventions that allow those with severe behaviors to live a less restricted life in the community.