Applied Behavior Analysis Intervention Research Articles

Family-Centric Applied Behavior Analysis Facilitates Improved Treatment Utilization and Outcomes.

Background/Objective: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by lifelong impacts on functional social and daily living skills, and restricted, repetitive behaviors (RRBs). Applied behavior analysis (ABA), the gold-standard treatment for ASD, has been extensively validated. ABA access is hindered by limited availability of qualified professionals and logistical and financial barriers. Scientifically validated, parent-led ABA can fill the accessibility gap by overcoming treatment barriers. This retrospective cohort study examines how our ABA treatment model, utilizing parent behavior technicians (pBTs) to deliver ABA, impacts adaptive behaviors and interfering behaviors (IBs) in a cohort of children on the autism spectrum with varying ASD severity levels, and with or without clinically significant IBs. Methods: Clinical outcomes of 36 patients ages 3-15 years were assessed using longitudinal changes in Vineland-3 after 3+ months of pBT-delivered ABA treatment. Results: Within the pBT model, our patients demonstrated clinically significant improvements in Vineland-3 Composite, domain, and subdomain scores, and utilization was higher in severe ASD. pBTs utilized more prescribed ABA when children initiated treatment with clinically significant IBs, and these children also showed greater gains in their Composite scores. Study limitations include sample size, inter-rater reliability, potential assessment metric bias and schedule variability, and confounding intrinsic or extrinsic factors. Conclusion: Overall, our pBT model facilitated high treatment utilization and showed robust effectiveness, achieving improved adaptive behaviors and reduced IBs when compared to conventional ABA delivery. The pBT model is a strong contender to fill the widening treatment accessibility gap and represents a powerful tool for addressing systemic problems in ABA treatment delivery.

The Effects of Applied Behavior Analysis on Verbal Behavior With Autistic Individuals Using the Verbal Behavior Milestones Assessment and Placement Program (VBMAPP) and the Assessment of Basic Language and Learning Skills (ABLLS).

Introduction Applied behavior analysis (ABA) is a fundamental practice-based intervention for treating autism spectrum disorder (ASD). Few studies have directly measured and evaluated the effects of ABA on verbal behaviors, mainly using the Verbal Behavior Milestones Assessment and Placement Program (VBMAPP) and the Assessment of Basic Language and Learning Skills (ABLLS) as outcome measures. This study aims to fill this gap by examining the relationship between ABA interventions and the enhancement of verbal skills, as measured by the VBMAPP and the ABLLS, in a convenience sample of individuals with ASD. Materials and methods At The Oxford Centers (TOCs) in Brighton and Troy, Michigan, USA, 33 individuals with autism received treatment from January 2018 to July 2021, spanning 43 months. A pretest-posttest design was employed to retrospectively examine any impacts between ABA interventions and alterations in verbal scores among individuals with ASD. Depending on developmental age, all subjects underwent two verbal assessments with a six-month interval in-between. Twelve children were administered the VBMAPP, while 21 were given the ABLLS. Results Paired t-tests for pretest and posttest VBMAPP subscales resulted in statistically significant effects (p<0.05) for (VBMAPP - Mand), (VBMAPP - Tact), (VBMAPP - Listener Responding), (VBMAPP - Visual Perceptual Skills and Matching-to-Sample), (VBMAPP -Independent Play), (VBMAPP - Social Play), (VBMAPP - Motor Imitation), (VBMAPP - Spontaneous Vocalization), (VBMAPP - Intraverbal), (VBMAPP - Group Behavior), and (VBMAPP - Linguistic Structure). As measured by Cohen's d, effect sizes were moderate to mostly high (-0.623to -1.688). There were non-significant results (p>0.05) for (VBMAPP - Listener Responding by Feature, Function, and Class) and (VBMAPP - Echoic). Paired t-tests for pretest and posttest ABLLS subscales resulted in statistically significant effects (p<.05) for all ABLLS scales: (ABLLS - Receptive Language), (ABLLS - Requests), (ABLLS - Labeling), (ABLLS - Intraverbals), (ABLLS - Spontaneous Vocalizations), (ABLLS - Syntax Grammar), (ABLLS - Social Interactions), and (ABLLS - Generalized Responding).As measured by Cohen's d, effect sizes were moderate to mostly high (-0.656 to -1.372). Conclusions The administration of ABA treatments had a noteworthy influence, with statistically significant impacts on improving verbal behaviors on 11 of the 13 VBMAPP scales and all of the ABLLS scales. As measured by Cohen's d, effect sizes were moderate to high for both scales. These findings underscore the importance and effectiveness of ABA interventions in enhancing verbal skills in children with ASD. However, it's crucial to note that further confirmatory studies are required to verify the reliability of these original findings, emphasizing the ongoing need for research in this field.

Replicative Study of the Impacts of Applied Behavior Analysis on Target Behaviors in Individuals With Autism Using Repeated Measures.

Background The effectiveness of interventions based on applied behavior analysis (ABA) for individuals with autism has been well documented in numerous meta-analyses, systematic reviews, and cost-benefit analyses. However, an observed 'efficacy-effectiveness gap' exists, which can be attributed to various factors. This third replication study, therefore, has significant implications for the field. By assessing the impact of ABA treatment, specifically involving discrete trial training and mass trials, within a naturalistic environment, the study provides valuable insights that can inform and improve the delivery of ABA treatments in real-world settings. Methods The study was conducted using a repeated measures research design. Retrospective chart review data were collected from 62 individuals with autism, age(M=8.65, SD=4.53), all of whom were level two autistic and required moderate support in communication, socialization, and daily life. These individuals received ABA treatment over five months. The study measured cumulative target behaviors using a repeated measures design, which allowed for the identification of statistically significant differences across 12 time points. This robust methodology ensures the validity and reliability of the study's findings. Results Mixed repeated measures analysis of variance (ANOVA) indicated statistical significance (sphericity assumed), F(11,495) = 55.432, p < 0.001 (time). Multiple comparisons using bootstrapped paired t-tests showed p < 0.05 on time points 1-8 and non-significance (p > 0.05) on time points 9-12. There was a significant interaction effect (sphericity assumed) with time x (age category), F(44,495) = 2.338, p < 0.001. Interaction contrasts indicated statistically significant differences over time, mainly within the one-year to four-year-old, five to eight-year-old, and most in the nine to 12-year-oldage groups. There was some significance within the 13- to 16-year-old age group and no significance within the 17- to 26-year-old age group. Conclusions Over five months, individuals with autism who underwent ABA treatments demonstrated a statistically significant enhancement in general target behaviors. This finding is crucial as it underscores the effectiveness of ABA treatments in a naturalistic environment. Moreover, the study's discovery of a significant interaction between time and age in these behaviors provides valuable insights into the impact of age on treatment outcomes. Extensive large-N studies of general ABA broad effectiveness and repeated measures designs are lacking and can lead to further research to improve quality and outcomes. These findings contribute to the body of empirical evidence and emphasize the importance of replicative efficacy studies in ensuring the reliability of research findings.

Predicting Behavioral Target Mastery With Age, Intensity and Duration, Open Targets, and Maintenance Failure With Applied Behavior Analysis in Individuals With Autism.

Background Researchers have studied the effects of age, treatment intensity, andtreatment duration with applied behavior analysis (ABA) outcomes in autistic individuals. This study's primary objective was to evaluate the predictive capabilities of age, intensity, and duration of treatment, open behavioral targets, and behavior maintenance failure on behavioral target mastery. Methods A retrospective cohort of 100 autistic individuals treated with ABAwith functional analysis and discrete trial training, mass trials, and naturalistic training were treated and analyzed. Target behavioral mastery data was collected via a retrospective chart review contained within the "Catalyst" tracking software. ABA treatment was administered for three months between March 19, 2023, and June 11, 2023. Multiple linear regression was performed using the percentage of behavioral targets mastered as the dependent variable. The independent variables were age, average trials to behavioral mastery, average teaching days to behavioral mastery, and percentage of behavioral targets that failed in maintenance. Results The multiple linear regression model was statistically significant (R=0.443, R²=0.196, adjusted R2=0.150, F(5, 87)=4.239, p=0.002). The average teaching days to mastery (β=0.416, p=0.019) and percentage of targets failed in maintenance (β=0.201, p=0.047) significantly predicted the percentage of behavioral targets mastered. However, age (β=0.079, p=0.419), average trials to mastery (β=-0.271, p=0.114), and open targets (β=0.184, p=0.081) did not significantly predict the percentage of behavioral targets mastered. The analysis of variance (ANOVA) resulted in non-significant (p>0.05) age group differences between the above variables. Conclusions The predictor variables average teaching days to mastery (intensity and duration) and percentage of targets failed in maintenance had a statistically significant effect on the percentage of behavioral targets mastered. The predictor variables age, average trials to behavioral mastery (intensity and duration), and open behavioral targets had a non-significant influence on the percentage of behavioral targets mastered. A non-significant difference between age groups was found in all study variables.

Impact of Applied Behavior Analysis on Autistic Children Target Behaviors: A Replication Using Repeated Measures.

Applied behavior analysis (ABA) is a primary evidence-based practice in treating autism spectrum disorder (ASD). Ongoing research is needed to report the resultsof ABArelative to attaining target behaviors. This study aims to replicate the results of previous research to determine the effectiveness of ABA of target behaviors in autisticchildren with a new timepoint sample of data. Materials & methods: A repeated measures analysis tracked 98 autistic children, which included four adult participants, over three timepoints during a one-month snapshot period from 6/7/23to 7/7/23. This study used a retrospective chart review to gather data on target behaviors to determine the effectiveness of ABA treatments across age categories. A mixed (between x within) analysis of variance (ANOVA) and subsequent post hoc and interaction contrasts were used to determine statistical significance. Mixed (between x within) ANOVAindicated statistical significance (sphericity assumed), F(2,160) = 32.893, and p < 0.05, across time. Using bootstrapped paired t-tests, multiple comparisons indicated p < 0.001 on all three multiple comparisons, with Bonferroni corrected α = 0.017. There was also a non-significant interaction effect (sphericity assumed) with (time) x (age category), F(8,160) = 0.333, p = 0.952, likely due to sizeable within-group variation resulting in a lowered statistical power. Conclusions: This replication found that autistic children receiving the ABA intervention demonstrated statistically significant improvement in target behaviors over the one-month snapshot period.

Preventing Insurance Denials of Applied Behavior Analysis Treatment Based on Misuse of Medically Unlikely Edits (MUEs)

Preventing Insurance Denials of Applied Behavior Analysis Treatment Based on Misuse of Medically Unlikely Edits (MUEs)

Applied behavior analytic intervention services for children with autism spectrum disorders: an investigation of Chinese parents

Introduction Applied behavior analysis (ABA)-based interventions have been used worldwide for several decades to improve socially significant behaviors of individuals with autism. However, as the utilization of the ABA-based interventions in the Chinese mainland is relatively new, it remains unclear about some fundamental aspects of using these interventions in this region. Method This study investigated the use of ABA-based interventions in Beijing and surrounding areas by using a quantitative survey (N = 85) and a qualitative semi-structured interview (N = 10) to collect data from parents of children with autism. Results This study found that (a) the ABA-based intervention service was the most popular one chosen by parents, and the majority of these parents reported improvements in children’s behaviors and gave positive evaluations for the work of professionals; (b) this service was mainly delivered at autism organizations (i.e. autism clinics/schools) or children’s homes, but rarely used in mainstream school settings; (c) the high cost of ABA interventions was a financial burden for families; and (d) a high proportion of parents were involved in interventions as assistant therapists. Furthermore, some aspects of the use of this service varied with families’ socioeconomic levels. The qualitative interviews expounded upon motivations for parents’ choices and evaluations for this service. Conclusion These findings provided valuable insights for service providers, policymakers, and researchers to optimize ABA-based intervention services for Chinese children with autism.

Applied behavior analysis interventions for autism spectrum disorders

Applied behavior analysis (ABA) has been considered the gold standard intervention for individuals diagnosed with autism spectrum disorder (ASD) for over 60 years. ABA, as a therapeutic intervention, dates to the 1960s and first appeared in studies conducted by Ole Ivar Lovaas. ABA gained the attention of many practitioners in 1987 when Lovaas reported children who received 40 hours or more of ABA treatment per week had significantly better outcomes than children who received 10 hours or less of ABA treatment per week after 2 or more years of intervention (Lovaas, 1987). Lovaas and his team of trained student therapists used interventions informed by behaviorism to target self‐stimulatory behaviors, play skills, and expressive language skills among other targeted goals and found that 47% of children in the experimental group achieved a normal score for intellectual and educational functions compared to 2% of children in the control group (Lovaas, 1987).

Reading comprehension intervention for students with autism spectrum disorder level 1 using the iPad graphic organizer app

Research has found that students with autism spectrum disorder (ASD) may face difficulties in reading comprehension. This study explored the functional relationship between the use of a graphic organizer (GO) app on the iPad and the number of correct independent responses to reading comprehension questions by one student with ASD Level 1. The study used an applied behavior analysis intervention that used an ABAB design. Aseven-question reading comprehension questionnaire was used to collect data Strong evidence was found of a functional relationship between the use of the graphic organizer (GO) on the iPad and an increase in correct independent responses by the student. Future research can develop to replicate the results and further explore how the use of a GO app on the iPad affects reading comprehension in students with ASD.

Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes

BackgroundWith increasing numbers of individuals diagnosed with autism spectrum disorder (ASD) and with affirmation of applied behavior analysis (ABA) as an evidence-based standard of care for ASD, there has been a proliferation of agencies offering ABA services over the last several decades. Disagreement exists among ABA providers and health plans that reimburse those providers on the optimal number of hours of ABA services that should be reimbursed. This study aims to understand whether children who receive more hours of ABA therapy achieve better outcomes and to evaluate the impact of the COVID-19-induced shift to telehealth clinical supervision on outcomes.MethodsA retrospective cohort analysis was performed using data from the Vineland 3 Comprehensive Interview Form to assess function throughout ABA treatment. Paired sample t tests, independent sample t tests, Cohen’s D, and Pearson correlations were used to determine relationships between Vineland scores and input variables including hours of service and modality of supervision (in-person vs. telehealth).ResultsWhile statistically and clinically significant improvements in function were observed, children appear to have improved outcomes independent of the number of hours of service received. There were also no significant associations between modality of supervision and Vineland standard scores.ConclusionsThese findings challenge prior research that demonstrated a linear dose–response relationship. By tailoring treatment dosage to the individual client’s needs, providers may be able to better maximize functional progress of the client, to preserve family time, and to utilize health plan dollars more efficiently.

Behavior analytic jargon does not seem to influence treatment acceptability ratings.

Some have argued that behavior analysts have insulated themselves by eschewing the vernacular and adopting idiosyncratic and sometimes counterintuitive technical terms to describe their science and practice. Because of this, behavior analysis plays a minor role in psychology and related fields and effective behavior-change interventions go unused. All told, findings about the effects of behavior-analytic jargon are mixed. Studies that provided technical terms independent of context have produced unfavorable results, whereas studies that have provided context have produced positive or neutral results, overall. This study evaluated the effects of behavioral jargon on the acceptability ratings of several applied behavior analysis interventions described in terms of varying target behaviors, populations, and settings. We presented brief vignettes adapted from published research articles that were described in either jargon or nonjargon versions. There were no appreciable differences in the rated acceptability of interventions described with or without jargon.

Autistic experiences of applied behavior analysis.

Autism spectrum disorder is a developmental disability affecting individuals across their entire lifespan. Autistic individuals have differences from nonautistic people (sometimes called allistic or neurotypical people) in social skills, communication, and atypical interests and/or repetitive behaviors. Applied behavior analysis is one of the first and most common interventions recommended for autistic children. However, autistic individuals argue that applied behavior analysis damages their mental health and treats them as though they are a problem to be fixed. This study examined the experiences of seven autistic individuals who received applied behavior analysis interventions as children to understand what autistic adults think about their applied behavior analysis interventions, how they feel about the applied behavior analysis interventions they received, and what recommendations autistic adults have for the future of applied behavior analysis. The findings include: Autistic adults remember traumatic events from applied behavior analysis, do not believe that they should be made to behave like their peers, gained some benefits but suffered significant negative long-term consequences, believe that applied behavior analysis is an unethical intervention, and recommend that applied behavior analysis practitioners listen to autistic people and consider using interventions in place of applied behavior analysis.

Examining Predictors of Different ABA Treatments: A Systematic Review.

In the recent literature, there is a broad consensus on the effectiveness of Applied Behavior Analysis interventions for autism spectrum disorder (ASD). Despite their proven efficacy, research in clinical settings shows that these treatments are not equally effective for all children and the issue of which intervention should be chosen for an individual remains a common dilemma. The current work systematically reviewed studies on predictors and moderators of response to different types of evidence-based treatment for children with ASD. Specifically, our goal was to critically review the relationships between pre-treatment child characteristics and specific treatment outcomes, covering different aspects of functioning (i.e., social, communicative, adaptive, cognitive, motor, global functioning, play, and symptom severity). Our results questioned the binomial “better functioning-better outcome”, emphasizing the complex interplay between pre-treatment child characteristics and treatment outcomes. However, some pre-treatment variables seem to act as prerequisites for a specific treatment, and the issue of “what works for whom and why” remains challenging. Future research should focus on the definition of evidence-based decision-making models that capture those individual factors through which a specific intervention will exert its effects.

Machine learning-based ABA treatment recommendation and personalization for autism spectrum disorder: an exploratory study

Autism spectrum is a brain development condition that impairs an individual’s capacity to communicate socially and manifests through strict routines and obsessive–compulsive behavior. Applied behavior analysis (ABA) is the gold-standard treatment for autism spectrum disorder (ASD). However, as the number of ASD cases increases, there is a substantial shortage of licensed ABA practitioners, limiting the timely formulation, revision, and implementation of treatment plans and goals. Additionally, the subjectivity of the clinician and a lack of data-driven decision-making affect treatment quality. We address these obstacles by applying two machine learning algorithms to recommend and personalize ABA treatment goals for 29 study participants with ASD. The patient similarity and collaborative filtering methods predicted ABA treatment with an average accuracy of 81–84%, with a normalized discounted cumulative gain of 79–81% (NDCG) compared to clinician-prepared ABA treatment recommendations. Additionally, we assess the two models’ treatment efficacy (TE) by measuring the percentage of recommended treatment goals mastered by the study participants. The proposed treatment recommendation and personalization strategy are generalizable to other intervention methods in addition to ABA and for other brain disorders. This study was registered as a clinical trial on November 5, 2020 with trial registration number CTRI/2020/11/028933.

[Effect of parent-child cooperative music therapy on children with autism spectrum disorder and their mothers: a prospective randomized controlled study].

To study the effect of parent-child cooperative music therapy on the core symptoms of children with autism spectrum disorder (ASD) and their mothers. In this prospective study, 112 children with ASD and their mothers were divided into a music therapy group and an applied behavior analysis (ABA) group using a random number table (n=56 each). The children in the ABA group were treated with ABA, and those in the music therapy group were given parent-child cooperative music therapy in addition to the ABA treatment. The duration of intervention was 8 weeks for both groups. Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), Parenting Stress Index-Short form (PSI-SF), Family APGAR Index, and Herth Hope Index (HHI) were used to evaluate the core symptoms of children with ASD and the parenting stress, family APGAR index, and hope level of mothers before and after intervention. A total of 100 child-mother dyads completed the whole study, with 50 child-mother dyads in each group. After intervention, the children in the music therapy group had significantly lower total score of ABC scale and scores of sensation, social interaction, and somatic movement, as well as a significantly lower total score of CARS than those in the ABA group (P<0.05). After intervention, compared with the mothers in the ABA group, the mothers in the music therapy group had significantly higher total score of PSI-SF and score of parent-child dysfunctional interaction, significantly higher total score of HHI and scores of each dimension, and significantly higher total score of APGAR and scores of cooperation and intimacy (P<0.05). Parent-child cooperative music therapy combined with ABA can alleviate the core symptoms of children with ASD, reduce the parenting stress of their mothers, and improve family APGAR index and hope level.

Effectiveness of Smart Applied Behavior Analysis Intervention in Teaching Non-Verbal Autism to Speak and Read

Not being able to speak is one of the Autism Spectrum Disorder symptoms, which, if not treated properly, will remain unable to speak. Teaching them to speak and read is beneficial for cognitive development as well as its social and educational purpose. The aim of this study is to teach/train speaking and reading abilities in children with ASD (Autism Spectrum Disorder) who had been declared as non-verbal and should not expect to speak by clinics in the United States and Indonesia, using Smart ABA (Applied Behavior Analysis Rudy Sutadi’s Method). This study used an experimental method with a single-subject research design that focused on behavioral changes as a result of the treatment using Smart Applied Behavior Analysis on the subject. The participants were two nonverbal Autism Spectrum Disorder individuals, N (female, 12 years 6 months) and E (male, 9 years 8 months). This study showed that therapy with the Smart ABA resulted in the verbal abilities of both subjects. Both subjects eventually became verbal, and their verbal and nonverbal abilities continued to improve. The study was only on two children with non-verbal Autism Spectrum Disorder, using Indonesian with the Smart Applied Behavior Analysis method for autism that has been developed from the Applied Behavior Analysis Lovaas Method. It requires multi-center experimental research with large samples of various ages with multiple languages to further increase the validity and reliability. This novel Smart Applied Behavior Analysis method was developed by researchers based on the Lovaas Method's Discrete Trial Training/Applied Behavior Analysis.

Effect of probiotics combined with applied behavior analysis in the treatment of children with autism spectrum disorder: a prospective randomized controlled trial.

To study the effect of probiotics combined with applied behavior analysis (ABA) in the treatment of children with autism spectrum disorder (ASD). A total of 41 children with ASD who attended the Affiliated Hospital of Jiangsu University from May 2019 to December 2020 were enrolled and randomly divided into an observation group with 21 children and a control group with 20 children. The children in the observation group were given oral probiotics combined with ABA intervention, while those in the control group were given ABA intervention alone. The treatment outcomes were compared between the two groups. Autism Treatment Evaluation Checklist (ATEC) was used to evaluate the severity of behavioral symptoms in both groups before intervention and at 3 months after intervention. The fecal samples were collected to analyze the difference in intestinal flora between the two groups based on 16s rRNA high-throughput sequencing. Before intervention, there was no significant difference in the ATEC score between the observation and control groups (P>0.05). At 3 months after intervention, both groups had a significant reduction in the ATEC score, and the observation group had a significantly lower ATEC score than the control group (P<0.05). Before intervention, there was no significant difference in the composition of intestinal flora between the observation and control groups. At 3 months after intervention, there was a significant difference in the composition of intestinal flora between the observation and control groups. Compared with the control group, the observation group had significantly higher relative abundances of Bifidobacterium, Lactobacillus, Coprobacillus, Ruminococcus, Prevotella, and Blautia (P<0.05) and significantly lower relative abundances of Shigella and Clostridium (P<0.05). Probiotics may improve the effect of conventional ABA intervention in children with ASD by regulating intestinal flora.

IMPROVING LISTENER RESPONDING SKILL USING BEE-BOT® IN AUTISM SPECTRUM DISORDER: CASE STUDY

Children with autism spectrum disorder may have a variety of communication deficits. Their communication difficulties include language delay, limited vocabulary, inability to speak words, echolalia or repetitive use of phonemes, words, or phrases, absence of eye-contact during communication, and poor non-verbal communication skills. Moreover, some of them are nonverbal so they have to learn how to communicate by using alternative and augmentative communication techniques. Some children on the spectrum in order to improve their receptive and expressive communication skills need to work on a highly structured therapeutic environment and others need to work on a natural environment. Educational robotics can be a successful tool for children on the spectrum in order to improve communicational skills. The main goal of this study is to implement Bee-Bot® robotic toy as a supportive tool for a child with autism in order to improve his listener responding skill across actions. The results showed that during speech and Applied Behavior Analysis intervention, the child improved his receptive skill in a more funny and educational way. Researchers identified that by using Bee-Bot®, the participant communicated intensively and participated to the activity more enthusiastically than using the traditional method of teaching at the table. Nevertheless, researchers should implement generalization and maintenance procedures to ensure that the participant will be able to apply the learned behavior and skill outside of the learning environment and continue to practice the acquired skill over time.&#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0781/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Ongoing, Explicit, and Direct Functional Assessment is a Necessary Component of ACT as Behavior Analysis: A Response to Tarbox et al. (2020).

Tarbox et al. (2020) offered preliminary functional analyses and practical guidelines for incorporating acceptance and commitment therapy (ACT) within the scope of practice of applied behavior analysis (ABA). Although we agree that this is a needed goal, the approach taken by the authors gives rise to important conceptual, ethical, and practical concerns that warrant further discussion. In particular, we propose that explicit functional assessment of behavior (FA) is necessary in any intervention said to be ABA, and we wonder about the apparent omission of explicit FA throughout the article. We question what we read as the authors' tacit assertion that the functions of verbal stimuli can be inferred based on behavioral topography, that the function of verbal behavior can likewise be inferred based on form, and that behavior-behavior relations are both causal and predictive of behavior, irrespective of context. Furthermore, we consider whether a number of procedures for functional assessment presented in the article under consideration are consistent with established ABA best practices. Finally, we discuss the extent to which ACT interventions absent explicit FA in ABA interventions introduces the possibility that the interventions may do harm, arguing that further discussion around competence and scope of ethical practice for behavior analysts who wish to incorporate ACT into their work is needed.

Board certified behavior analysts and school fidelity of Applied Behavior Analysis services: qualitative findings

The Federal government mandates the use of evidence-based practice for interventions with students. Applied Behavior Analysis (ABA) is one of these evidence-based practices, but despite this, many school systems do not implement ABA as described in the literature, which leads to loss of fidelity and integrity with implementation, and often results in ineffective interventions in the classroom. The research question “What are the experiences of Board Certified Behavior Analysis (BCBAs) who use evidence-based practices in conjunction with staff in schools for interventions with American K-12 students using ABA?” was developed to ascertain, from a BCBA’s perspective, why ABA interventions are not implemented with fidelity in classroom settings. Participants were BCBAs in the United States who consult and collaborate with school staff to implement ABA services for children with autism spectrum disorders (ASD). Findings indicate that BCBAs are not given adequate time or resources to provide sufficient training in ABA, that principles of ABA are sometimes misused in training in such a manner that exacerbates myths of ABA, and that a general lack of support from school administrators exists, all of which lead to a loss of implementation fidelity. This lack of implementation fidelity in turn leads to decreased outcomes for students with ASD in schools when ABA is not implemented with fidelity.