Intensive Behavioural Interventions Based on Applied Behaviour Analysis for Young Children With Autism: An International Collaborative Individual Participant Data Meta-Analysis

Autism: The International Journal of Research & Practice

Rodgers, M., Simmonds, M., et al. (2021).

Autism: The International Journal of Research & Practice, 25(4), 1137-1153.

This systematic review and meta-analysis investigates the effects of comprehensive applied behavioral analysis-based teaching intervention approaches on a variety of outcomes in children on the autism spectrum. This summary highlights conclusions related to communication and language outcomes.

National Institute for Health and Care Research (United Kingdom)

From database inception to June 2019

Prospective randomized controlled trials or non-randomized controlled trials.

16

Five studies investigating the effect of applied behavioral analysis (ABA)-based interventions on receptive and expressive language outcomes in children on the autism spectrum reported varying results depending on the language measure used. Three studies using the Reynell developmental language scales (RDLS) showed a general benefit of early intensive ABA-based intervention with comprehension scores favoring the intervention at one year (MD=12.96; 95% CI=2.01 to 23.91) and at 2 years post-intervention (MD=11.78; 95% CI=2.12 to 21.45) and similar expressive language subscale outcomes. Meanwhile, two studies that used the Mullen scales of early learning (MSEL) found no evidence of benefit and showed no difference in receptive and expressive language subscales between the early intensive ABA-based intervention group and the control at either 1 year or 2 years post-intervention. The authors note a lack of longer-term follow-up data and a failure to investigate functional outcomes or the effects of family or social environmental influences on intervention outcomes.

Seven studies investigating the effect of applied behavioral analysis (ABA)-based interventions on verbal cognitive ability outcomes in children on the autism spectrum reported benefits from early intensive ABA-based interventions at 1-year post-intervention follow-up (MD=9.16; 95% CI=4.38 to 13.93) and at 2 years post-intervention follow-up (MD=14.13; 95% CI=9.16 to 19.10). Three studies investigating the effect of applied behavioral analysis (ABA)-based interventions on non-verbal cognitive ability outcomes reported benefits from early intensive ABA-based interventions at 1-year post-intervention follow-up (MD=9.45; 95% CI=0.33 to 18.59) and at 2 years post-intervention follow-up (MD=10.13; 95% CI=1.58 to 18.68). One study reporting outcomes at 7 years post-intervention follow-up found no significant difference between intervention groups (MD=4.39; 95% CI=–8.17 to 16.95). The authors conclude that "early intensive ABA-based intervention may lead to larger improvements in child cognitive ability ... after two years for some children, as compared to [treatment as usual] TAU/eclectic interventions" (p. 1150). Included studies demonstrated risk of bias and reported varying results.