Association for Behavior Analysis International

Changes in funding, delivery models, and other variables over the past 20 years have affected applied behavior analysis (ABA) services for people with autism. This symposium reviews some of these changes and their likely contribution to treatment outcomes for individuals with autism

Many individuals with autism have significant communication deficits. Attempts to address those deficits often entail individual or small group speech and language services being provided separately from, and/or in addition to, ABA services. We describe an integrated model where the expertise of a speech and language pathologist is utilized in a comprehensive ABA treatment program for young children with autism. Outcomes from this integrated model are compared with those resulting from an eclectic approach (i.e.,,a mixture of services such as low levels of ABA, speech and language pathology, sensory integration therapy, etc.). The benefits of the integrated model are outlined.

Which intervention to provide to young children with autism is among the most important decisions made by parents, teachers, clinicians, funders, and policymakers. Multiple studies have compared intensive ABA intervention to the most widely available alternative for young children with autism, eclectic (mixed-method) treatment. Results showed that ABA treatment consistently out- performed the eclectic model on standardized measures of cognitive functioning and adaptive skills (e.g., Howard, Sparkman, Cohen, Green, & Stanislaw, 2005; Howard, Stanislaw, Green, Sparkman, & Cohen, 2014). For instance, Howard et al (2014) found that after 3 years of treatment, more than 60% of the children who received intensive ABA scored in the normal range of cognitive functioning compared to only 25% of the children who received eclectic interventions, even when the latter was intensive and specifically designed for children with autism. Implications of findings that early intensive ABA intervention can prevent intellectual disabilities are discussed in terms of child well-being, independent adult functioning, and associated costs.

Intensive, comprehensive ABA intervention for young children with autism has been shown to be highly effective (e.g., Howard, Sparkman, Cohen, Green, and Stanislaw, 2005; Howard, Stanislaw, Green, Sparkman, and Cohen, 2014; Eldevik, Hastings, Hughes, Jahr, Eikeseth, & Cross, 2010). Historically these services have been provided in homes, university clinics, or private schools. This presentation describes a center-based model for delivery of comprehensive, intensive ABA intervention. Defining features, benefits, and challenges of such programs are described, and suggestions for adding components to clients treatment packages are offered.

In many locations in the United States, public policies now state that ABA services for people with autism are to be covered by health insurance. Successes and difficulties with adoption and enforcement of those policies are summarized. Suggested strategies for persuading healthcare systems in other jurisdictions to fund ABA services as medically necessary behavioral health treatments are offered.