Table Of Content
Approximately 63.7 % of studies conducted did not implement either a mini or full reversal. Again, a reversal, mini or full, is not a required design component of the CCD; however, implementation of either type of reversal considerably increases design strength by demonstrating the independent variable can increase or decrease responding accordingly. The majority of the studies did not use the CCD as a shaping procedure and therefore the dimension of the behavior being modified, in most cases, was in the individual’s repertoire and should be compliant to directional shift. Therefore, specific target behaviors were recorded and classified following data collection for summation purposes. Participant age was classified as child (1 to 18 years) or adult (19 and above). Visual Communication Analysis (VCA), which can be considered an extension or augmentation of ABA, is a personalized treatment for individuals with ASD.
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One such method of naturalistic teaching is through the focused intervention practice of PRT, developed by Koegel and Koegel (2006), which is focused on improving the self-initiative and motivation of a child to communicate effectively in common real-life settings (Mohammadzaheri et al., 2015). Another focused intervention practice and naturalistic teaching method is FCT, a differential reinforcement-based procedure developed by Carr and Durand (1985) that reduces problem behaviors by replacing them with more appropriate communicative responses. Results indicate that the CCD has been utilized with varied populations, in varied settings, and targeted a wide variety of behaviors; however, the majority of CCD studies were structured in ways which threatened experimental control. Approximately 25 % (i.e., 26 studies yielded 69 graphs) of data reviewed met all requirements necessary for adequate control (see Table 1). This suggests some fundamental lack of understanding of the science underlying the CCD. Specifically, most studies lacked variation in phase magnitude (and did not compensate with a reversal), lacked variation in phase length, or implemented two or fewer changes in criterion; while some restricted responding so that criterions were forcibly met and or could not exceed the criterion.
Further Observations between Coding Groups
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It was also found that no one age group demonstrated improvement when correlated with the number of hours of rendered ABA services (Department of Defense, 2020). This evidence suggests there may be insufficient recent research justifying the need for high-intensity interventions, indicating that more research studies need to be conducted in the field of ABA in terms of assessing ABA impact with different or lower intensity interventions. The gold standard of research is typically denoted as a RCT, followed by CCT or prospective studies. As evident through this scoping review, 64% of all the study records included three or fewer participants, and the median number of participants was three, indicating methods more consistent with SCED.
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At LEARN, we refer to our approach as contemporary ABA to distinguish our therapy from the older, more structured form of treatment. The IRCA Reporter is filled with useful information for individuals, families and professionals. ABA is considered an evidence-based best practice treatment by the US Surgeon General and by the American Psychological Association.
Records recording improvement in adaptive behavior and emotional outcomes had follow-up measures 67% and 64% of the time, respectively. Studies reporting improvement in autism symptoms had follow-up measures 100% of the time (see Appendix 5, Table S7). Within the current cohort, out of the study records that signified some improvement, the frequency of mastery/criterion measures varied. Measures of mastery/criterion ranged from 0% and 14%, respectively, for autism symptoms and problem behavior improved outcomes, to 25% and 29%, respectively, for adaptive behavior and social/communication, and 43%–49% for cognitive, language, and emotional improved outcomes (Table S7). With regard to generalization, no study records showing improvements in autism symptoms assessed any measure of generalization.
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There are some exceptions to this, where in some circumstances a child may exhibit normal development for approximately 2 years followed by a marked regression in multiple areas of function. A total of 1,337 records were removed during title, abstract, and full-text screening because they met the exclusion criteria, were duplicate records, were reviews, or contained only non-ASD diagnoses. Multipart studies were separated into discrete records, yielding a total of 849 study records.
For example, in teaching social skills, a learner might be shown a video of a person saying thank you when given a toy or other object, and then asked to repeat the behavior as the teacher hands them an object. As previously reported, 25 interventions used a stable criterion of performance and therefore had a total of one criterion. As mentioned, it has been suggested that a changing criterion have at least two criterion shifts or two subphases of “B” within a study (Kazdin 2011, p. 172). Just over half of the studies varied phase length between criterions at least once (55.8 %) and a considerable proportion varied length two or more times (35.6 %).
The multiple baseline design is a poor model for the DCD in that it is significantly weakened by interdependence of baselines or results, whereas interdependence is an established expectation of the DCD. It is a fundamentally weak design that adds little to the literature in its present form. According to the BACB’s 2014 guideline, comprehensive ABT should include one-on-one treatment with a certified or licensed physician, qualified healthcare provider, or ABT technician of between 30 to 40 hours per week. This analysis, however, did not determine the optimal number of treatment hours per week. Because family members know that early intervention helps children on the autism spectrum learn new skills and decrease problem behaviors, they often want to consider behavioral therapies for their child.
The remaining 106 articles yielded a total of 267 CCD graphs (236) or intervention data (31). Articles were located in 57 different journals; see Table 2 for a summary list of journals. From these journals, 11 articles were published between 1971 and 1979 (10.4 %), 24 articles between 1980 and 1989 (22.6 %), 18 articles between 1990 and 1999 (17.0 %), 35 articles between 2000 and 2010 (33.0 %), and 18 articles between 2011 and 2013 (17.0 %). The exact causes of autism are unknown, although genetic factors are strongly implicated.
Family therapy is generally supported as a valuable treatment because it offers emotional support and guidance to parents who will contend with a myriad of services to assist their child. Individual therapy using social story technique and behavioral cue coaching are very useful for the older child/adolescent with Asperger’s syndrome and can make a difference in that child’s acceptance by others. Educational therapy includes intensive one-on-one therapy involving a wide array of techniques focusing on improvement in social, communication, and language skills, and may include ABT. Some children do not speak at all, others speak in limited phrases or conversations, and some have relatively normal language development. Repetitive play skills, resistance to change in routine and inability to share experiences with others, and limited social and motor skills are generally evident.
Unusual responses to sensory information, such as loud noises and lights, are also common. Affected children can exhibit unusual behaviors occasionally or seem shy around others sometimes without having ASD. What sets children with ASD apart is the consistency of their unusual behaviors. Symptoms of the disorder have to be present in all settings, not just at home or at school, and over considerable periods of time.
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