Applied behavior analytic intervention for autism in early childhood: meta-analysis, meta-regression and dose-response meta-analysis of multiple outcomes
Abstract
A number of clinical trials and single-subject studies have been published measuring the effectiveness of long-term, comprehensive applied behavior analytic (ABA) intervention for young children with autism. However, the overall appreciation of this literature through standardized measures has been hampered by the varying methods, designs, treatment features and quality standards of published studies. In an attempt to fill this gap in the literature, state-of-the-art meta-analytical methods were implemented, including quality assessment, sensitivity analysis, meta-regression, dose-response meta-analysis and meta-analysis of studies of different metrics. Results suggested that long-term, comprehensive ABA intervention leads to (positive) medium to large effects in terms of intellectual functioning, language development, acquisition of daily living skills and social functioning in children with autism. Although favorable effects were apparent across all outcomes, language-related outcomes (IQ, receptive and expressive language, communication) were superior to non-verbal IQ, social functioning and daily living skills, with effect sizes approaching 1.5 for receptive and expressive language and communication skills. Dose-dependant effect sizes were apparent by levels of total treatment hours for language and adaptation composite scores. Methodological issues relating ABA clinical trials for autism are discussed.
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Evidence shows that comprehensive early interventions are effective on developmental outcomes when delivered with intensity, at least twenty hours per week for several years.
“We also have amassed a great deal of evidence of the effectiveness of comprehensive early interventions on the developmental outcomes of children with ASD when interventions are delivered with intensity, at least twenty hours per week for several years.18”
From Longitudinal follow-up of children with autism receiving targeted interventions on joint attention and play (2012) · cites this paper as [18]
Greater change is identified in cognitive developmental domains compared to spoken language, with language outcomes requiring longer durations of intervention.
“In general, greater change is identified in cognitive developmental domains compared to spoken language, with language outcomes requiring longer durations of intervention.18”
From Longitudinal follow-up of children with autism receiving targeted interventions on joint attention and play (2012) · cites this paper as [18]
Reinforcement-based interventions significantly increase both cognitive and social outcomes and successfully reduce aberrant behaviors in ASD.
“Accumulating evidence from over 40 years of research indicates that these reinforcement-based interventions significantly increase both cognitive and social outcomes, and successfully reduce aberrant behaviors [3].”
From Social “wanting” dysfunction in autism: neurobiological underpinnings and treatment implications (2012) · cites this paper as [3]
Later programs focusing on functional analysis of problem behaviors were more successful in addressing core deficits.
“Later programs focusing on the functional (that is, contextual) analysis of problem behaviors were more successful in addressing core deficits [3,5,6,32,42,190-196].”
From Social “wanting” dysfunction in autism: neurobiological underpinnings and treatment implications (2012) · cites this paper as [3]
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- Authors
- Virués-Ortega, J.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2010-06
- Volume
- 30
- Issue
- 4
- Pages
- 387-399
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2154650119
- Cited by
- 615
- References
- 67
- Citations by year
- 2026: 29 · 2025: 39 · 2024: 41 · 2023: 27 · 2022: 44 · 2021: 46 · 2020: 52 · 2019: 52 · 2018: 41 · 2017: 56 · 2016: 38 · 2015: 38 · 2014: 33 · 2013: 33 · 2012: 23
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- applied behavior analysis, autism spectrum disorder, early childhood intervention, long-term intervention, language development, intellectual functioning, social functioning, daily living skills, dose-response relationship, intervention effectiveness, methodological quality of clinical trials
- MeSH terms
- Autistic Disorder, Behavior Therapy, Child, Preschool, Humans, Language, Language Development, Language Development Disorders, Social Behavior, Speech Therapy, Treatment Outcome
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