Therapy for Autism Spectrum Disorder and Other Developmental Conditions Essay

Therapy for Autism Spectrum Disorder and Other Developmental Conditions Essay

Abstract

The purpose of this study is to explore the efficacy of ABA in managing autism spectrum disorders among children. The study seeks to answer the research question, how effective is ABA therapy for autism spectrum disorders? The goal is to analyze the effects of ABA therapy, and determine where it is effective and where it has shortcomings. Therapy for Autism Spectrum Disorder and Other Developmental Conditions Essay

Literature Synthesis: Applied Behavioral Analysis (ABA) Therapy for Autism Spectrum Disorder and Other Developmental Conditions

Autism

Autism is a neurodevelopmental condition, characterized by repetitive and limiting behavioral patterns, interests and activities. In fact, it is a spectrum disorder ranging from mild to severe. It is recognized by distinctive characteristics that include high prevalence of behavioral abnormalities, wide spectrum of language alterations, and impaired intellectual functioning. Persons diagnosed with autism experience difficulty in social interaction and communication (Zhou et al., 2019). While autism has always been a concern with efforts made to manage the condition showing that it cannot be cured but can be managed to improve outcomes (Medavarapu et al., 2019), it has become of greater concern in the face of globalization. That is because globalization has increased cultural and linguistic diversity that highlight the shortcomings that persons with autism face (Liao, Dillenburger & Buchanan, 2018).

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ABA therapy

ABA therapy is described as a non-biological therapy for managing autism spectrum disorder to improve outcomes. An intensive behavioral intervention that teaches the appropriate behavior breaking down tasks into small discrete steps, ABA therapy trains the client in a systematic and precise way. It is characterized by stimuli being presented discretely with responses, immediate feedback, intense reinforcement, data collection, and systematic trials of instruction (Medavarapu et al., 2019). It focuses on generalizing behaviors to new environments and situations, teaching new skills, increasing and reinforcing desirable adaptive behaviors, and reducing any interfering maladaptive behavior. ABA therapy is based on the theory that while normal children learn well through listening and imitation, children with autism spectrum disorders perform poorly in such learning environments. Instead, children with autism spectrum disorders perform well in learning environments that apply routine and directness (Medavarapu et al., 2019).

Criticizing ABA therapy

The use of ABA therapy in managing autism is not a new concept with many research studies on this subject. In fact, ABA therapy is widely used as an effective intervention for children with autism spectrum disorders. Still, there are questions about the degree of effectiveness of ABA therapy. The results of a meta-analysis that included 29 studies revealed that ABA therapy is effective in improving intellectual abilities, communication skills, expressive language skills, receptive language skills, IQ, adaptive behavior, socialization, and daily living skills (Makrygianni et al., 2018). Therapy for Autism Spectrum Disorder and Other Developmental Conditions Essay

Portnova et al. (2020) explores the use of ABA therapy among children with low-functioning autism, showing that it is effective in managing the autism as it keeps their electroencephalography (EEG) microstates within the ranges reported for typically developing children. This shows that the therapy is effective in managing low-functioning autism.

ABA therapy is a well-established intervention for autism spectrum disorders with research studies reporting that it improves adaptive behavior, IQ, and expressive language skills. However, there are concerns that ABA does not improve autism symptoms severity, and problem behaviors (Reichow et al., 2018). Dixon et al. (2021) concurs with these findings, reporting that ABA therapy improves skills acquisition and IQ scores.

Tiura et al. (2017) criticizes ABA therapy, explaining that while it may be effective in managing autism, its effectiveness can be improved by personalizing it for the individual patients. This understanding concedes that there is heterogeneity of autism spectrum disorders, and that heterogeneity can act as predictor of treatment outcomes.

Wang et al. (2019) reveals that while ABA therapy has been effective in managing autism through encouraging behavior that are helpful and discouraging behaviors that are not helpful, globalization has highlighted the shortcomings of ABA therapy. Based on a secondary research approach that evaluated available literature, the study revealed that cultural and linguistic diversity inherent in globalization may be a shortcoming for ABA therapy effectiveness.

Criticism of ABA therapy for effects on intensity and duration on outcomes shows strong effects on academic and language domains that report strong responses for both therapy intensity and duration. This suggests that some of the skills may require higher treatment intensity to be learned while other skills may require higher treatment duration to be learned. This shows that regardless of therapy intensity, some skills are best acquired through long-term treatment. Still, the study is unclear about the effect of high intensity treatment regardless of duration (Linstead et al., 2017).

Kupferstein (2018) also criticizes ABA therapy, noting that children with autism spectrum disorders exposed to ABA therapy are likely to report high prevalence of posttraumatic stress symptoms and lower satisfaction with the therapy later on as older children and adults. Therapy for Autism Spectrum Disorder and Other Developmental Conditions Essay

Area of further study

The strength of evidence in this literature synthesis is limited because it mostly comes from small studies that are not of optimum design. The synthesis has included non-randomized studies that increase the risk of bias. This shows that additional research is necessary to estimate the effect of ABA therapy in managing autism spectrum disorders. In addition, the current evidence reveals that ABA therapy may not be suited for the realities of globalization, and that changes are necessary in the application of the therapy with a focus on personalization for each client’s needs. Therefore, further research is required to apply primary research approaches in exploring the efficacy of ABA therapy in managing autism spectrum disorders among children.

Literature Matrix: Applied Behavioral Analysis (ABA) Therapy for Autism Spectrum Disorder and Other Developmental Conditions

Article Title, Author, etc. (Current APA Format) Study Purpose Sample (Characteristics of the Sample: Demographics, etc.) Methods Study Results Level of Evidence (Use Melnyk Framework) Study Limitations Would Use as Evidence to Support a Change? (Yes or No) Provide Rationale.
Example, A. (2015) Title etc. per Current APA To identify the need for technology to prevent falls A convenience sample of 44 nurses in an acute care hospital A non-experimental, descriptive survey Findings indicate that fall rates decreased by 2% with the introduction of technology into the care setting Level 6: descriptive design Conducted in only one setting, small sample size Does provide some good foundational information even though the level is a 6.
Portnova, G.V., Ivanova, O., & Proskurnina, E.V. (2020). Effects of EEG examination and ABA-therapy on resting-state EEG in children with low-functioning autism. AIMS Neuroscience, 7(2), 153-167. https://doi.org/10.3934/Neuroscience.2020011

 

To study the effects of ABA therapy & EEG on autism Preschoolers with ASD and a control group of normal children Prospective cohort study EEG microstates were linked to unpleasant emotions and senses Level II Sampling was affected by the difficulty in recruiting participants Yes. It is a well done study providing enrichment of EBP
Tiura, M., Kim, J., Detmers, D., & Baldi, H. (2017). Predictors of longitudinal ABA treatment outcomes for children with autism: A growth curve analysis. Research in Developmental Disabilities, 70, 185–197. https://doi.org/10.1016/j.ridd.2017.09.008 To find out the predictors of ABA treatment outcomes in children with autism N=35 with a mean age of 3 years who have autism spectrum disorder (ASD) Experimental prospective study Higher cognitive functions mean better growth for the child Level II Using dichotomous as opposed to predictor variables, using age-equivalent scores, and te use of a subjective developmental checklist. Yes. It enriches EBP knowledge.
Artoni, S., Bastiani, L., Buzzi, M. C., Buzzi, M., Curzio, O., Pelagatti, S., & Senette, C. (2017). Technology-enhanced ABA intervention in children with autism: A pilot study. Universal Access in the Information Society, 17(1), 191–210. https://doi.org/10.1007/s10209-017-0536-x  To determine if technology can reinforce the effectiveness of ABA therapy in children with autism N=7 children with autism and pilot study lasted 9 months Prospective pilot study There was improved communication in the test participants at the end of the study. Meaning ICT enhances the effectiveness of ABA therapy Level II The small sample size affects validity and reliability Yes. The study provides evidence for EBP
Dixon, M.R., Paliliunas, D., Barron, B.F., Schmick, A.M., & Stanley, C.R. (2019). Randomized controlled trial evaluation of ABA content on IQ gains in children with autism. Journal of Behavioral Education,1-23. https://doi.org/10.1007/s10864-019-09344-7  To study the effect of ABA therapy on skill acquisition and IQ scores N=8 children with autism Randomized controlled trial (RCT) Skill acquisition improved in both study and control groups. Better IQ scores occurred only in the intervention group given comprehensive ABA therapy. Level I A small sample size affects validity and generalizability Yes. This is a level I study that provides the best available evidence for EBP
Kupferstein, H. (2018). Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis. Advances in Autism, 4(1), 19-29. https://doi.org/10.1108/AIA-08-2017-0016 To determine the prevalence of PTSD in those with autism exposed to ABA therapy N=460 participants consisting of adults with autism and caregivers of autistic children Online survey Almost 50% (46%) of all respondents met DSM-5 criteria for PTSD. About 86% had been exposed to ABA therapy Level III An online survey has the disadvantage of the researcher not knowing if the real respondent is the one who answered the questions Yes. It provides important evidence for EBP and further research
Sochanski, M., Snyder, K., Korneder, J., & Louie, W-Y.G. (2021). Therapists’ perspectives after implementing a robot into autism therapy. The 30th IEEE International Conference on Robot & Human Interactive Communication (RO-MAN). https://doi.org/10.1109/RO-MAN50785.2021.9515375 To find out the perceptions of ABA therapists with regard to socially assistive robots (SARs) ABA therapists Cross-sectional study (interviews) Overall perception was positive from the ABA therapists who stated that children would benefit from ABA delivered by SARs Level III There was no clear random sampling. Convenience samples may not be representative. Yes. The study provides important EBP information
Wang, Y., Kang, S., Ramirez, J., & Tarbox, J. (2019). Multilingual Diversity in the Field of Applied Behavior Analysis and Autism: A Brief Review and Discussion of Future Directions. Behavior Analysis in Practice, 1-10. https://doi.org/10.1007/s40617-019-00382-1 To examine the way multilingualism can be used better in ABA therapy A  number of scholarly studies on multilingualism were reviewed Systematic review A number of strategies are still required to improve the use of multilingualism in ABA. They include discrete trial training (DTT) Level I The number of studies reviewed was limited and may affect inferences drawn Yes. The findings enrich EBP
Billing, E., Belpaeme, T., Cai, H., Cao, H.-L., Ciocan, A., Costescu, C., … Ziemke, T. (2020). The DREAM Dataset: Supporting a data-driven study of autism spectrum disorder and robot enhanced therapy. PLOS ONE, 15(8), e0236939. https://doi.org/10.1371/journal.pone.0236939 To support a data-driven evaluation of ASD and robot-facilitated ABA therapy N=61 children with ASD Cross-sectional Robot Enhanced Therapy (RET) study RET-delivered ABA therapy produces improved results Level III The study has many confounding variables that include possible design flaws of the robots Yes. It provides some evidence for clinical practice
Callahan, K., Foxx, R.M., Swierczynski, A., Aerts, X., Mehta, S., McComb, M.-E., … Sharma, R. (2019). Behavioral Artistry: Examining the Relationship Between the Interpersonal Skills and Effective Practice Repertoires of Applied Behavior Analysis Practitioners. Journal of Autism and Developmental Disorders, 49, 3557–3570. https://doi.org/10.1007/s10803-019-04082-1  To evaluate interpersonal skills related to behavioral artistry and ABA therapy N=212 students of ABA therapy Experimental study Those with higher BA performed better as ABA therapists Level II Numerous confounding variables were not controlled and may affect the result Yes. It adds t EBP knowledge and practice.
Liao, Y., Dillenburger, K., & Buchanan, I. (2017). Does culture matter in ABA-based autism interventions? Parent and professional experiences in the UK and China. European Journal of Behavior Analysis, 19(1), 11–29. https://doi.org/10.1080/15021149.2017.1399657 To determine the level of multiculturalism in ABA therapy delivery N=7 participants Cross-sectional cross-cultural study Profound cultural differences were identified based on geographical region like China and the UK Level II The sample size was small and may affect generalizability of the findings Yes. This study adds to the knowledge already there of EBP

 Literature Synthesis: Applied Behavioral Analysis (ABA) Therapy for Autism Spectrum Disorder and Other Developmental Conditions

            Autism is a neurodevelopmental condition that is characterized by repetitive and limiting behavioral patterns, interests, and activities, as well as difficulty in social interaction and communication. Autism is a spectrum disorder that can range from mild to severe. Autism can be recognized by its distinctive characteristics, which include a high prevalence of behavioral abnormalities, a wide spectrum of language alterations, and impaired intellectual functioning. Autism affects approximately one child out of every 68, and it is significantly more prevalent in males (Baio et al., 2018). Autism is a developmental disorder that affects a person’s ability to communicate and understand others, which makes it challenging for autistic people to express themselves. Autism is a chronic ailment that not only affects the person who has it, but also the sufferer’s family members, who must learn to adapt to living with the condition. According to Miranda et al., autism is an illness with behavioral impairments; as a result, parents and caregivers of children with autism generally experience distress and dissatisfaction due to the disorder’s lack of effective therapies. This is because autism is an illness with behavioral impairments (2019). This highlights how critical it is to find a treatment for autism that is grounded in research. Therapy for Autism Spectrum Disorder and Other Developmental Conditions Essay

Because the studies in question were either systematic reviews or meta-analyses, the study carried out by Makrygianni et al. (2018), Reichow et al. (2016), and Medavarapu et al. (2019) present the most compelling body of data. The research provided the most elucidating explanations and the finest data that was currently available concerning ABA therapy and autism. In contrast, the research conducted by Linstead et al. (2017) is of a retrospective nature, it was conducted over a prolonged period of time, and it involves the gathering of data at predetermined intervals. As a direct consequence of this, the memory error was diminished, which contributed to an increase in the validity and reliability of the findings of the study. Linstead et al. (2017) made use of a large sample size, which not only contributes to an increase in the findings’ validity and reliability but also makes it possible for those findings to be generalized. Zhou et al. (2019), who conducted a cross-sectional investigation that was carried out over the course of several phases and validated the efficacy of the treatment modality, contributed to an increase in the trustworthiness of the results. They demonstrated that the treatment modality was effective. The research conducted by Zhou et al. (2019) does, however, contain a number of limitations that could have had an impact on the findings. Two of these limitations include the study’s relatively short length and its relatively small sample size. Because of these limitations, the reliability and validity of the findings may be diminished.

The studies by Sochanski et al.(2021) and by Billing et al. (2020) involved  Robot Enhanced Therapy (RET) and the support of ABA therapists. The studies showed RET is supported by therapists as well as RET-delivered ABA therapy produces improved results.

It is essential to note the fact that the studies investigated in this synthesis indicated the efficiency of ABA therapy and the methods employed in the modality in the treatment and amelioration of a variety of deficiencies and impairments that are typical of persons with autism.

Areas of Further Study

The synthesized literature demonstrates the efficacy of ABA therapy in improving behavioral problems, communication, and language skills, as well as improved social skills in children with autism. Only one study by Makrygianni et al. (2018) demonstrated that ABA therapy improves intellectual abilities in children with autism. Therefore, further studies are needed to investigate the efficacy of ABA therapy in improving intellectual abilities in children with autism.  Moreover, further research is required to comprehend how and the specific conditions that need to be modified for individuals with autism who do not respond to ABA therapy. In conclusion, there is a need to conduct comparative efficacy studies to establish if ABA therapy has higher efficacy than other active treatment modalities recommended in the treatment of impairments and deficits for children with autism.

Synthesis of Literature Assignment Instructions

Overview

Utilize the articles addressed in the literature matrix to write a synthesis of the research. You will only have 10 – 15 articles, but you should be able to draw some conclusions and form opinions about how the research could be used to make a practice change. It is important that students are able to not only analyze individual research studies, but to then see how the evidence on a topic “fits together”. This is beyond a simple literature review; it is looking at research as a whole and drawing conclusions. Therapy for Autism Spectrum Disorder and Other Developmental Conditions Essay

Review the articles you’ve gathered and address the following:

 

  1. What are the overall strengths and weaknesses of the research studies?
  2. Where there any obvious gaps in the research (something that wasn’t addressed that really needed addressing)?
  3. Which studies had similar conclusions? How did these studies differ in terms of strength of design, level of evidence (using Melnyk classification system), number of subjects, usefulness for practice, and other pertinent aspects of research?
  4. Were there studies that had very different or contradictory results? Why do you think this is the case?
  5. What is your overall conclusion about what the research is concluding and using the evidence for a practice change?
  6. Anything else you found pertinent or noteworthy about the research studies you reviewed.

 

Keep in mind that this is a synthesis, so you don’t want to discuss research using a “shotgun” approach where you talk about research A, then research B, then research C, etc. This doesn’t demonstrate an understanding of the research as a whole. An example of an approach for synthesis might be research A & B reached similar conclusions while research C reached a different conclusion with a smaller sample size. You would then add your own conclusions/opinion, based on the whole of what the studies are telling you.

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Instructions

 

  • This is a formal paper and should be written in narrative format, utilizing APA format per LU graduate level paper guidelines.
  • Please include a title page, abstract, and reference page.
  • Use headings to separate sections of your paper.
  • Clearly cite information from the research studies themselves and other sources used in evaluating them. Note that you may have several citations in one paragraph as you discuss different research studies.
  • A minimum of 5 pages is required, not including title, abstract, and reference pages.

Note: Your assignment will be checked for originality via the Turnitin plagiarism tool

References

Dixon, M.R., Paliliunas, D., Barron, B.F., Schmick, A.M., & Stanley, C.R. (2019). Randomized controlled trial evaluation of ABA content on IQ gains in children with autism. Journal of Behavioral Education, 30, 455-477. https://doi.org/10.1007/s10864-019-09344-7 

Kupferstein, H. (2018). Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis. Advances in Autism, 4(1), 19-29. https://doi.org/10.1108/AIA-08-2017-0016

Liao, Y., Dillenburger, K., & Buchanan, I. (2017). Does culture matter in ABA-based autism interventions? Parent and professional experiences in the UK and China. European Journal of Behavior Analysis, 19(1), 11–29. https://doi.org/10.1080/15021149.2017.1399657

Linstead, E., Dixon, D. R., Hong, E., Burns, C. O., French, R., Novack, M. N., & Granpeesheh, D. (2017). An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder. Translational psychiatry, 7(9), e1234. https://doi.org/10.1038/tp.2017.207.

Makrygianni, M. K., Gena, A., Katoudi, S., & Galanis, P. (2018). The effectiveness of applied behavior analytic interventions for children with Autism Spectrum Disorder: A meta-analytic study. Research in Autism Spectrum Disorders, 51, 18-31. https://doi.org/10.1016/j.rasd.2018.03.006

Medavarapu, S., Marella, L. L., Sangem, A., & Kairam, R. (2019). Where is the Evidence? A Narrative Literature Review of the Treatment Modalities for Autism Spectrum Disorders. Cureus, 11(1), e3901. https://doi.org/10.7759/cureus.3901.

Portnova, G.V., Ivanova, O., & Proskurnina, E.V. (2020). Effects of EEG examination and ABA-therapy on resting-state EEG in children with low-functioning autism. AIMS Neuroscience, 7(2), 153-167. https://doi.org/10.3934/Neuroscience.2020011

Reichow, B., Hume, K., Barton, E. E., & Boyd, B. A. (2018). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). The Cochrane database of systematic reviews, 2018(5), CD009260. https://doi.org/10.1002/14651858.CD009260.pub3

Tiura, M., Kim, J., Detmers, D., & Baldi, H. (2017). Predictors of longitudinal ABA treatment outcomes for children with autism: A growth curve analysis. Research in Developmental Disabilities, 70, 185–197. https://doi.org/10.1016/j.ridd.2017.09.008 

Wang, Y., Kang, S., Ramirez, J., & Tarbox, J. (2019). Multilingual Diversity in the Field of Applied Behavior Analysis and Autism: A Brief Review and Discussion of Future Directions. Behavior Analysis in Practice, 12(4), 795-804. https://doi.org/10.1007/s40617-019-00382-1

Zhou, Y., Yin, H., Wang, M., & Wang, J. (2019). The effect of family-focused psychoeducational therapy for autism spectrum disorder children’s parents on parenting self-efficacy and emotion. Archives of psychiatric nursing, 33(1), 17-22. https://doi.org/10.1016/j.apnu.2018.08.002 Therapy for Autism Spectrum Disorder and Other Developmental Conditions Essay

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