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Autism Spectrum Disorder Research Proposal for Improved Social Interactions and Communication Skills

Autism Spectrum Disorder (ASD) is characterized by detrimental deficits in social communication and interaction, restrictive and repetitive patterns of behaviors, interest or activities. It is estimated that 70% of children with ASD suffer from uncontrollable behavioral outbursts that increase their peer isolation along with the stress of their caregivers. These uncontrollable and involuntary behaviors are stressful to the individual in many ways. This research study is being conducted to review the benefits of encouraging an increase in organized social activities between people with and without ASD in hopes that some of the uncontrollable behavioral outbursts that previously increased peer isolation will decrease or disappear over experience with organized social activities. Previous research on this study has been thoroughly reviewed and examined in order to gain a crucial understanding of this topic. The research potential from the interview style experiment will assist in future programs with the complete integration of children, adolescents, and young adults into the mainframe of society.

Related Papers

Journal of Autism and Developmental Disorders

Nina Linneman

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Andrew Yockey , Amanda Tipkemper

Adolescents with autism spectrum disorders (ASDs) often have difficulty with social interactions. This study aimed to increase social interactions in adolescents with ASD. Teachers developed friendship goals based on social skills outlined in the teaching-family model. Teachers provided reinforcement to students for displaying positive behaviors linked to goals throughout the school day. The current study also examined student, parent, and teacher perceptions of adolescent social interactions using interviews and surveys. During their interviews, adolescents reported that they were often lonely. Parents indicated that their children needed to learn skills to improve peer interactions. Observers used a behavioral system to quantify the types of social interactions displayed by adolescents. After a baseline period, teachers developed an intervention focusing on friendship goals to encourage students to engage in social interactions. The intervention had a limited impact on improving social interactions. The findings for the current study indicated limited improvement in social interactions resulting from the teacher-directed intervention. Parents, adolescents, and teachers highlighted the need for adolescents with ASDs to find ways to utilize social skills to reduce loneliness and improve peer support. Future research investigating the impact of teaching interaction/friendship skills around the students' interests (e.g., sports) may help them learn skills to interact more with peers. Additionally, assessing the impact of individualized planning to improve each adolescent's skills may be more influential in changing social behavior than a system-wide intervention, such as the one implemented in this study.

Focus on autism and other developmental disabilities

Rose Mason , Debra Kamps , Sarah Feldmiller

Jairo Rodríguez-Medina

International Journal of Early Childhood Special Education

ZUHAR RENDE BERMAN

Steven Kapp

Sander Begeer

Child and Adolescent Psychiatric Clinics of North America

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5 Research Topics for Applied Behavior Analysis Students

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Whether you are in an ABA program right now or would like to be soon, it may be time to start thinking about research topics for your thesis or dissertation. All higher-level ABA courses will require students to have substantial independent research experience, which includes setting up a research experiment or trial, taking data, analyzing data, and suggesting next steps. And this also includes writing a professional paper either to turn in or submit to a scientific journal.

Overall, there will be quite a bit of research and writing that occurs in an ABA program.

If you’re currently in a program, read about these five research topic examples that might pique your curiosity.

1. Industrial Safety

In one classic study from 1987 , researchers examined how creating a token economy might increase safety at dangerous industrial sites. The study rewarded pit-mine workers when they and their colleagues avoided incidents that resulted in personal injury or equipment damage. They also rewarded workers who took extra steps to ensure the safety of others and report incidents. By using applied behavior analysis to incentivize self-motivated conduct modification, the researchers created improvements that persisted for years.

Behavior-Based Safety (BBS) “is an approach to occupational risk management that uses the science of behavior to increase safe behavior and reduce workplace injuries.”

Successful applications of BBS programs adhere to the following key principles ( Geller, 2005) :

Focus interventions on specific, observable behaviors.
Look for external factors to understand and improve behavior.
Use signals to direct behaviors, and use consequences to motivate workers.
Focus on positive consequences (not a punishment) to motivate behavior.
Use a science-based approach to test and improve BBS interventions.
Don’t let scientific theory limit the possibilities for improving BBS interventions.
Design interventions while considering the feelings and attitudes of workers within the organization.

The field of BBS can always improve, and your contribution to it through research can help. Consider choosing industrial safety and ABA as one of your research topics.

2. Autism Spectrum

Advocates also note that there remains a small but significant portion of autism sufferers who don’t respond to conventional techniques. There’s an ongoing need to study alternative methods and explore why certain approaches don’t work with some individuals. ABA techniques and their relation to autism-spectrum disorders will continue to pose important research questions for some time.

Not only can you conduct your own research (legally and ethically), and study other works of scientific literature, but you can be in the middle of it all like the professionals at the Marcus Autism Center do.

The center at Marcus is one of the most highly-regarded in the field of autism in the United States. They have a behavioral analysis research lab where clinician-researchers with expertise in applied behavior analysis.

According to their site:

“Although this work continues, the Behavior Analysis Research Lab recently expanded its research focus to include randomized clinical trials of behavioral interventions for core symptoms of autism, as well as co-occurring conditions or behaviors, such as elopement (e.g., wandering or running away) and encopresis (e.g., toileting concerns). Our goal is to disseminate the types of interventions and outcomes that can be achieved using ABA-based interventions to broader audiences by studying them in larger group designs.”

Depending on where you live, there may be experiential research opportunities for you as a student to dive into, such as the positions they have open at Marcus.

3. Animal and Human Intelligence

For example, researchers note that in 2010, dogs bit 4.5 million Americans annually, with 20 percent of bites needing medical intervention. They further suggest that ABA can provide a valid framework for understanding why such bites occur and preventing them. Similarly, studies that examine why rats may be able to detect tuberculosis or how service dogs help people involve learning about these creatures’ behaviors.

AAB, or Applied Animal Behavior , is an example of an organization that conducts research, supports animal behaviorists, and promotes the well-being of all animals that work in an applied setting.

The Animal Behavior Society is another example, which is the leading professional organization in the United States that studies animal behavior. They say that animal behaviorists can be educated in a variety of disciplines, including psychology biology, zoology, or animal science.

There is definitely room for more research in the field of animal behavior and its impact on humans.

4. Criminology

One study showed a potential correlation between allowing high-risk students to choose their schools and their likelihood of criminal involvement. While school choice didn’t affect academic achievement, it generally lowered the risk that people would commit crimes later in life.

Criminologists, behavioral psychologists, and forensic psychologists are all hired to work with local law enforcement and even the FBI to determine the motives of criminals along with the societal impacts, generational changes and other trends that might help be more proactive in the future. Mostly, they investigate why people commit crimes.

If you have ever watched a forensics TV show like Crime Scene Investigation (CSI) then you have a good idea of what their job entails. Between criminal profiling, working directly with a team, and investigating and solving cases is what it’s all about.

Experts on applied behavior analysis state:

“Its value to law enforcement investigations and criminal rehabilitation efforts make it an essential tool for any forensic psychologist. Research shows that successful application of applied forensic behavior analysis can lead to lower recidivism rates in convicts and a higher success rate in apprehending criminal suspects.”

Applied behavior analysis students who research these fields could play big roles in advancing societal knowledge.

5. Education

ABA is all around in education––you just cannot escape it! Everything, even academics, revolves around behavior . Whether it is on the county level or the classroom, there are FBAs, BIPs, data collection, positive reinforcement, consequences, token economies, trial and error, behavioral interventions, and much more.

And teachers aren’t the only staff privy to ABA. School social workers, school counselors, behavioral specialists, and paraprofessionals all have access to ABA and can implement strategies based on individual student needs.

Education techniques rely heavily on applied behavior analysis. Instructors may be tasked with giving consequences to students or devising custom lessons, and these tasks often involve understanding how to incentivize appropriate behavior while motivating learners.

Like other kinds of ABA, applied education research also provides the opportunity for internships and postgraduate residency programs. Because many of this field’s modern foundations lie in education, classroom-based research is a natural fit for students who want to apply their discoveries.

Research Topics for Applied Behavior Analysis Students: Conclusion

Applied behavior analysis is complex, but studying it is extremely rewarding. This field provides students at all educational levels with ample opportunities to contribute to scientific knowledge and better people’s lives in the process. There are almost too many fields to choose from in terms of where you want to lean. Think about your interests, what you have access to in your surrounding area (unless you are willing to move), and consider what type of research will help you move forward in your educational career and beyond. There are ABA programs and careers out there waiting for each of you!

Brittany Cerny

Master of Education (M.Ed.) | Northeastern State University

Behavior and Learning Disorders | Georgia State University

Updated December 2021

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Dr. Mary Barbera

Research Topics in ABA for Practitioners with Dr. Amber Valentino

As professionals, practitioners, clinicians, and even parents we share a common goal of wanting to make the world a better place for our children, a big way to do this is through research. Dr. Amber Valentino, author of Applied Behavior Analysis Research Made Easy, is on the podcast to discuss the importance as well as logistics of research in the field.

ABA Research Design

Many peer reviewed, published journal requirements involve really drilling down to specific topics and definitive objects of change. This can be an obstacle in the ABA field for practitioners. But this isn’t the end of the line for research. In its truest form, Applied Behavior Analysis research is messy, it’s a combination of big ideas and discussion. Knowledge is one of the biggest barriers in the profession of ABA, more research and more access to research is the solution.

Transfer Trial ABA

I’ve been able to work on several studies and trials with my mentor, Dr. Rick Kubina, that I talk about in this episode. In 2005, I coauthored a peer reviewed journal article, Using Transfer Procedures to Teach Tacts to a Child with Autism. This study was born out of work done with my son Lucas to correct a tact error with greetings. I never published this study because of the mixed procedures but I did present, and all 4 of the subjects learned equally as well with this method and Lucas only learned this way. Just a few years later, I was able to meet a Doctor who did his dissertation on transfer procedures and actually quoted my work on that study. The need for studies and for information is there.

Dr. Valentino is the Chief Clinical Officer for Trumpet Behavioral Health, she is very passionate about advocating for research with practitioners. Her book Applied Behavior Analysis Research Made Easy: A Handbook for Practitioners Conducting Research Post-Certification, is a great read for professionals who want to contribute research to the field, break barriers, and get started. You can find out more about her on the TBH website as well as her personal blog, Behavior-Mom.

Dr. Amber Valentino On The Turn Autism Around Podcast

Dr. Valentino currently serves as the Chief Clinical Officer for Trumpet Behavior Health where she develops workplace culture initiatives, supports clinical services, leads all research and training activities, and builds clinical standards. Her primary clinical and research interests span a variety of topics including verbal behavior, ways to connect the research to practice gap, professional ethics, and effective supervision. Dr. Valentino serves as an Associate Editor for Behavior Analysis in Practice and previously served as an Associate Editor for The Analysis of Verbal Behavior. She is on the editorial board for the Journal of Applied Behavior Analysis (JABA) and serves as a frequent reviewer for several behavior analytic journals. She is the author of the book: Applied Behavior Analysis Research Made Easy: A Handbook for Practitioners Conducting Research Post-Certification. She works to support dissemination of behavior analysis to the general parent population through her personal website, behavior-mom.com.

YOU’LL LEARN:

Why is it important for practitioners to conduct research?
How can applied research help the field of ABA and autism?
What are obstacles for practitioners to complete or publish research?
How to navigate solutions when your study isn’t approved for publishing?
What are the many ways practitioners can initiate studies and research?
Do you have to identify a mechanism of change in a study?
How to access knowledge to conduct research?

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Applied Behavior Analysis Research Made Easy – Amazon.com
Amber Valentino, Chief Clinical Officer – Trumpet Behavioral Health
Behavior Mom

Dr. Amber Valentino – Turn Autism Around Podcast Transcript

Transcript for Podcast Episode: 165 Research Topics in ABA for Practitioners with Dr. Amber Valentino Hosted by: Dr. Mary Barbera Guest: Dr. Amber Valentino

Mary: You're listening to the Turn Autism Around podcast, episode number one hundred and sixty five. Today we are talking about applied research and how to get research from practice to publication and how to make the world a better place for our kids and our clients. Dr. Amber Valentino is the guest. She serves as chief clinical officer for Trumpet Behavior Health. She's also the author of a brand new book called Applied Behavior Analysis. Research Made Easy. And she works to support dissemination of behavior analysis to the general parent population. And she also has a personal website called Behavior-Mom.com. So you should check that out. The episode is really great. I know when you hear research, you're thinking, Oh, this is going to be boring. It is not boring. I think it's filled with really good, practical information for everyone listening. So let's get to this important episode with Dr. Amber Valentino.

Welcome to the Turn Autism Around podcast for both parents and professionals in the autism world who want to turn things around, be less stressed and lead happier lives. And now your host, Autism Mom, Behavior Analyst, and bestselling author, Dr. Mary Barbera.

Mary: OK, thank you so much Amber for joining us today. I'm super excited to talk to you.

Dr. Valentino: Thank you so much. Overjoyed to be here. Thanks for having me.

Mary: Yeah. So why don't you tell our listeners and I don't know the answer to this? Describe your fall into the autism and ABA world.

Amber Valentino on the Turn Autism Around Pocast

Dr. Valentino: Yeah. So I imagine I have a story that's very similar to other people's story, and that is I was 18 years old. I was a new college freshman and I had a work study job in Ohio and I ran out of money. The work study program sort of capped. I needed a way to pay my bills. So I was searching around campus. This was in the 90s, not to date myself, but I was searching around campus trying to find a job. And I saw this just lovely flier for working with a kid in his home and doing this thing called ABA. And at that time, I was an English major, so I think that I had any interest in children or working with children in any way. But, you know, fast forward, I applied for the job, got the job, and that just started now over a 20 year career and commitment to people with autism and applied behavior analysis. And I just I fell in love with the work then, and I still love it to this day.

Mary: Yeah, that is a very common pathway. I think, you know, almost all of the professionals I've interviewed have started that way.

Dr. Valentino: So, yeah, and it was, you know, I was listening to one of your other podcasts and you were talking about how around that time there really was no managed care at all. There was no support in that caught me thinking of my own experience. And at the time, you know, in Ohio and I mean everywhere, these families just paid out of pocket. So this family was paying me out of pocket for my time and all of the therapists 40 hours a week for their young son. They were flying a consultant in from Wisconsin to work with them. And it was interesting to listen to your experience and just to remember where we are and where we are today with services. And there's still a lot of work to be done, but certainly cares a lot more accessible now than it was then.

Mary: Yeah, definitely. OK, so you wrote a book and I just found out about it. I reached out to you for this interview and you were nice enough to send me an electronic copy of the book, so I don't have it to hold up at this moment. But it's called Applied Behavior Analysis: Research Made Easy a Handbook for Practitioners Conducting Research Post Certification.

Dr. Valentino: It's a mouthful.

Mary: Yeah, I'm you know, ABA Research Made Easy, that's easy. So why did you write this book and how did you get into the whole research world?

ABA Research Made Easy:

Dr. Valentino: Oh, awesome. Well, I'll answer the second question first, because that kind of leads into how I wrote this book. You know, I've always been a practitioner, I've always wanted to be a practitioner, and I have always wanted to help families. And so I early in my career was fortunate to be in a position where I applied research was kind of a thing. It was it was a thing people did. And I got integrated early in my career and did some applied studies, published some, but made it made a pretty significant career change about a decade ago. And at that time, I thought, Well, I'm not really going to do research anymore. I'm taking a job as a clinician. I'm going to have a caseload and work with families and provide supervision and all that good stuff. And that was the case for a few months. And then a wonderful mentor of mine, Dr. Linda LeBlanc, who was at Trumpet Behavioral Health at that time, really showed me that you can be a practitioner and you can do applied research and you can be both. And so I opened the door to seeing research in a different way and just continued on that path and was able to do some really good work with my clients. That was systematic and had good experimental control and had a story to tell. And so over the years, I've been able to to publish that, which has been which has been wonderful.

Mary: Yeah. So I I know I've seen Dr. Linda LeBlanc present at conferences and I know her great work. I've read a lot of her research studies. I haven't had her on the show yet, so I will definitely be...

Dr. Valentino: Next guest. Yeah, yeah.

Mary: So your book came out and then recently came out just at the end of the year.

Dr. Valentino: It recently came out. Yeah, so. So the second part of that was how did I write a book? It's really funny. I was not planning to write a book. I don't know that a lot of people are right. It certainly was a distant goal for me. I thought someday I'd like to write a book and it's kind of funny. The new Harbinger publications contacted me and said, Would you like to write a book and I was very pregnant with my son, and I said, no, I don't want to write a book, that's crazy. But, you know, I sat back and thought about it and I said, Well, if not now when, you know, this might be the opportunity. And so I signed the contract the day before my son was due. And you know, it's funny. When we first started working together, we actually didn't have a topic. They kind of contacted me on what we saw, how they got my name. But we were talking about supervision, ethics, you some of the publications that I, I have done and I threw this one in here because we had published a study. My colleague doctor just wanted go, and I had published a study about barriers to for practitioners in conducting research. And I said, Oh, this might be kind of cool. And the publisher did their research and examined it a little bit and said, We think this is the topic. And, you know, and then it was born. And so I feel blessed that the opportunity came my way. And several years later, here we are. We have it in print and it's available for people to buy.

Mary: Yeah. So I know we're going to talk about your research studies and my research studies that I publish because I have also been in the autism world for over two decades, and I am very interested in research that really makes a difference. And I get super frustrated when people, you know, are trying to reference 1995 study on some specific a little thing and trying to justify, you know, procedures that just don't make sense anymore. But let's start with and I was able to read a good chunk of your book, maybe half or three quarters of your book, which was great and I would highly recommend it. So the first few chapters you talk about why we as practitioners should do research. And so why? Why should people listening? And we have a lot of parents listening and we are going to pull it back to be practical and kind of have you thinking about you and your team and and just how you can benefit from knowing about research and looking into it and encouraging your professionals who are working with your child to also do research? So so why should we as practitioners do research?

Dr. Valentino: Yeah, it's such a great question and so great. I think I have a whole chapter dedicated to that in the book. You know, behavior analysis is really unique in that the methods that researchers use to examine basic and applied topics are the same methods that practitioners use to figure out if their interventions are effective. And so there are a whole host of reasons, but the first one that comes to mind and the one that's really at the forefront is that it makes you a better practitioner. Right. So all of those things that we do from a research perspective, we have good treatment integrity we have inner observer agreement. We have a good experimental control. Those things aren't just good for a research study, they're good for your client, they're good for effective intervention and evaluating the impact of your services. And so I like to give this analogy, and I like to say, well, you know, let's say you implement an intervention with a child and you simply just do an AB design, right? So you have baseline and then you go in intervention and you say it, that's it. It works, and you want to start to disseminate that. And so you're about to invest a whole lot of time and effort into training people to implement this intervention. Will you want to make sure that that intervention is actually the thing that caused the change, right? So a reversal, whatever design that you have is going to help you make sure that that investment is going to be worth it both for a client. But then it also happens to be good for research study as well. So. So the benefits to practitioners, even if you're study or your case never gets published, you're still doing really good clinical work, which I think is the take home message and super important.

Mary: Yeah, I know early on from 2003 to 2010, I was the lead behavior analyst for the Pennsylvania Verbal Behavior Project, which is now known as the Patten ABA Supports Initiative. But in that in part of that, it was a whole it was a whole big project is still is going strong many, many years later. But part of that was we wanted to not only train behavior analysts and kind of home grow, if you will, behavior analysts, but we wanted to show that our interventions were effective because we were getting lots of money from a state government agency. And so we wanted to show that what we were doing was better than what was previously done for kids in public school autism classrooms. And so part of the initiative was was actually requiring behavior analyst. To set up a little research studies and to have real designs and have inter observer agreement and then to meet once or twice a year or to to actually present those those publications and. And I think when you when you do research and I have done research and we're going to talk about your research and my research, but when you do research and you, you publish it or you present it, you do tend to think differently then. Yeah. After that, you're like, Wow, you know? Yeah. One one example. And I think people in my audience will relate to this is is one of the case studies I remember was trying to see if teaching kids to answer questions like an intraverbal response. If that was better with a tact, a label to enterable transfer or if that was better as an echoic to interverbral transfer and just. Kicking out these these questions to ask, you know, we had lists of questions and we were trying to figure out like what to ask, and I remember one question was where are prisoners kept? And I was like, Oh my God, that is so confusing, because you would need to know, you know, a prison is synonymous with a jail. You would need to know the past tense of keeping is kept. You would need to know, you know, all of this abstract language. It makes you realize how complicated languages. And so when you are really picking out, you know these things in it, it makes you really think differently.

Dr. Valentino: Oh, it really does in such a good example. And you know, the other part of that is that when you're conducting research, you're also reading. Right. And so if you want to dig in and kind of figure out what questions haven't been answered in the literature yet, a huge part of that is reading and being knowledgeable on a topic and knowing what's out there already just naturally makes you a better practitioner. So there's this whole process of reading and formulating a question and digging in like you described that we just we all benefit our clients benefit and you benefit as a practitioner by by engaging in it. It's that even if nothing comes of it in terms of a publication or a presentation, there's still a process there that's extraordinarily valuable.

Mary: Yeah. So you talk in your book about two big research gaps. Can you tell us what they are? Yeah.

Dr. Valentino: So I think about the research to practice gap as being pretty bi directional, right? So if you just do a Google search for research to practice Gap, it's present in all disciplines. All disciplines have this in a human resources. You know, every discipline identifies this. And so it's it's the same for behavior analysis. And so there's sort of two ways this can go. The first is that obviously there is research that's being published that is sort of delayed or doesn't hit the practitioner population as quickly as it could. So there's best practices out there, but practitioners just don't know about them because they're not keeping in contact with the literature and not aware of of best practices. And I talk a little bit about ways to overcome those in my book. I mean, obviously a big part of that is is reading, but I think we need to break down the barriers associated with accessing literature, which is huge. But the part that my book is really focused on is the opposite, which is practitioners who are out there coming up with research questions every day, asking really wonderful questions and answering them and doing so in the context of their clinical practice. But that population could really be informing the literature and help to resolve that research practice gap in a way that is informed by what clients are experiencing and what issues that they have. So that's really what the book is about, that sort of second part of the gap and how practitioners can contribute back to the research literature.

Mary: Sure, sounds good. So when I was reading your book, there was a reference to a research study you had published on manding for information. And I know you have lots of publications like how many peer reviewed journal articles have you published? Do you know?

Dr. Valentino’s Publications:

Dr. Valentino: Oh gosh, I haven't looked in a while. It's probably somewhere in the 30 40 range. It's not. It's not huge. It's it's it's the, I would say, doublings of a busy, busy practitioner. But yeah, I've managed to stay pretty productive over the years.

Mary: Awesome. Yeah. Why don't you tell us about the manding for information study? What kind of design, was it? And then...

Dr. Valentino: Sure, absolutely. And I know this is something very near and dear to your heart, and you probably know that the mand for information repertoire is a critical one. It's super, super important for kids to learn it. To me, it's this one of these critical skills that helps the child learn naturally from their environment. Right. So if they're told to do something but they don't know how to do it and they can ask somebody, How do I do that? And then obviously follow the instructions you just you're in a different space, language wise than you are if you don't have that skill.

Mary: And I'm thinking before we explain the study, there's probably a lot of people that don't know what a mand for information please do.

Dr. Valentino: Yeah. Or do you want me to go ahead? Go ahead? Oh yeah, yeah. So a man is just another word for a request. And the most often you heard the hear the word mand associated with those early requests, so juice, candy, cookie. These are all those meaningful things that a person maybe wants in their life. But as that repertoire gets more sophisticated, people can start to request. Ah, man, four different things and one of those things being information, so when we talk about man's information, we're talking about what people might traditionally consider wage questions. So why did you do that? What is that? Where did you go? The thing that makes this a difficult topic of study is that the man is a verbal operant part of language that is controlled by something very unique and that is the motivating operation. And so in order to teach somebody to ask a question, you have to do so under the right conditions. You have to make sure that they're motivated in the demand for information literature. You have to make sure that they're motivated for that information, which is actually conceptually a very difficult thing to do and set up, right. So I have several studies on manding for information, and I will do a shout out to my previous supervisor, Dr. Alex Schillingsberg, who really is at the forefront of this body of literature. She's published a time and in fact, several of my publications are with her as first author in me somewhere else in the line. But the most recent mand for information study that I published was the first one that I'm aware of that taught kids to ask why? So up into that point, we had not had any studies that demonstrated how to teach that. And it makes sense because it's a little bit more complicated to teach somebody to ask why they they have to be motivated for information, but in a very unique way. And so we had a handful of clients in a clinic that needed this as a goal. They had learned other forms of manding for information. And so it was published in the Journal of Civil Behavior a couple of years ago. We did it, set multiple baseline design and looked at just some creativity in the conditions that would enable us to make sure that the kids were asking why under the right conditions, that is when they were motivated to have that answer versus when, when they were not. So yeah, some of those study very applied, though something we would have done even if it weren't a research study. We still need to teach them why, and we still need to do it under the right conditions.

Mary: Yeah, yeah, that's great. And we can put that in the show notes your show notes are going to be at MaryBarbera.com/165. So you can go there, you can send people there. You can watch this video and then look at all the show notes, which is great. And the one thing I will add is if you're listening and your child is not talking or just requesting with sign language or requesting vocally, just, you know, a handful of things, you're a far way away from teaching. Why? And so we usually get items insight as your first mands, which is kind of combined, as a tact. And then there's bands for actions like open up and those sorts of things. Then there's madns for help mands. Yes and no, which is super complicated. Man's for attention, which is what we consider joint control, which is complicated like you can't prompt. And in my case, Lucas, when he was little, you can't promote mom, look at the cow when he has no, you know, no interest in the cow, no interest in sharing that. So what you can get is a lot of weird language that gets shaped up if you're trying to teach, you know why. For instance, when the child doesn't even have mands for attention appropriately, so you can really get messy language. And as part of my Verbal Behavior Bundle course, I have a whole lesson on how to teach the first three what, where and which. Now they don't have to be the first three, but they tend to be easiest to teach. So I have videos to show people how to do that, but each child is different and their motivations are different. And so you really have to know ABA well to be able to pull off teaching mands for information. And some kids just develop it naturally and then you're great. But for the kids that don't, it's a fine line between teaching rote language and weird language and teaching appropriate language. And it so research studies like you're describing Amber are awesome.

Dr. Valentino: Yeah, it's really interesting when you look back at the mand for information literature, and it wasn't called that. So when you look back historically, I mean, people didn't know they were navigating this and figuring it out, but it very much taught those mands under faulty stimulus control, meaning they would basically change the topography of the mand to get a kid to ask for candy. So it would be like, What is it? And or they hold a piece of candy and he'd say, Tell them, say what is it? And then kid would say, What is it? And they'd give the candy? Right? So in order for that was effective, they would be able to show that it was effective. But they really just taught the kid that what they were holding up was, what is it? That's the new label now instead of candy. So in order to end, you've seen that evolve over the years, but in order to teach it effectively, you have to have something that obviously the child doesn't know what it is and then teach the child to ask. And then that, of course, can lead later to something reinforcing. But that's very much the early studies was just changing the topography of a basic mand to what is it? And it was effective. But as we've evolved, we've changed the way we set up those experiments. Yeah, yeah.

Applied Research:

Mary: Yes. No is also an area that can get messed up very quickly. And I know I I didn't publish a yes no case study, but I did one. I presented one. I have a whole lesson within the verbal behavior bundle on how to teach. Yes, no and I consider myself, you know, pretty expert at teaching. Yes and no. And there's really there's a wide open gap. At least there was last time I logged on on how to teach yes and no. So these are these are all good topics and very much related to the content in my courses, in both of my books. Let's talk before we move on to different kinds of research. I do want to talk about the two peer reviewed journal articles that I published. One is using transfer procedures to teach tacts to a child with autism, and that was. I coauthored that in 2005 with my mentor, Dr. Rick Kubina, now. I also interviewed him on the podcast and we talked about the article so we can link that in the show notes. So we don't have to go in-depth. But you know, I came up with that study idea actually, because Lucas went to a private ABA school for a year and a half. Otherwise, he was in public school his whole life. But he went there and he would have errors when when his therapists to come home and go to school said by Lucas, he would say by Hayley, which was this teacher's name at the time, because she was the only one practicing greetings with her name. And but I knew because I was a new BCBA and I lived and worked with Lucas his whole life that I knew that was a tacting error. Like, he knew all 16 kids in his typical preschool class because we used pictures and quote unquote drilled him with these names. And we also taught him greetings with video modeling. So I knew that he had if he knew the tact, he would have the greeting. So I knew there was a tact error. So I asked the school to send me pictures. They were on a three week break. At the end, he learned all the pictures, all the people's names, and went back and generalized it immediately to greetings. So I called up recombined and I said. Here's a great study, I mean, this is people's names. Greetings, I mean, how functional and applied is this? It's a great site. We should publish it. And he as a researcher, so Mary, you can't just publish stuff like this set up this study. And I had just taken my exam and he's like, We can't publish that, but we can set up a study to publish something to to show he's like, What did you do as the intervention? I'm like, We drilled. And then he really challenged me like, No, what exactly did you do? And it was a mixture of receptive to tact transfers and echoic to tact transfers. But the literature up until that point, there really wasn't any peer reviewed journal articles studies on it. But what there was was Dr. Mark Sundberg, who's also been on a podcast. We can link in the show notes in his Ables book at the time, right? in the big book. I forget what the title of that was, but the main book he talked about teaching everything as echoic to tact transfers, hold up a pen and say, This is a pen. What is it? pen? But Lucas would just zone out. He would echo you and he would zone out. So if it wasn't part receptive? It wasn't going to work for Lucas. He would just zone out, he would never learn it. But if if you combine a touch, Amber, touch Susie Touch and then who's this called Touch Amber, wh's this? Amber. Then he would get it, and I would also use partial echoics. So Rick Kubina to be in to help me set up a study with tax that he didn't know. And we did a multiple baseline. And Jack Michael, Dr. Jack Michael, rest in peace to our grandfather verbal behavior. He was the editor of the analysis, The Verbal Behavior, and I emailed him. He's just like, Where are you? Where did you come from? My mom? Mean lying. Like, you know, it was truly applied Research well, that

Dr. Valentino: That is a beautiful example. What you just described is what I hope every practitioner does, which is I found this really great thing and it worked. And maybe you can't exactly define why it worked and how or how it worked. Or maybe you can. But to go down this path of being able to describe that and demonstrate it, that's huge. And that's a huge contribution. And practitioners are doing this every day. They're doing what you've described every day, but they're just not thinking about it like you were thinking about it and Rick kind of coached you along to say, Let's investigate.

Mary: If I wouldn't have had Rick Kubina and Dr. Jack Michael was like, We are publishing this. And in fact, he sent it to our reviewer and it was late. It was like, I mean, I had no idea when things were due or anything. He's just like, This is really good. And he's like, the reviewer said, no, because, you know, it was a mixture of an echoic. And, you know, I did set a timer and I did have intra observer agreement. So it wasn't like completely, you know, winging it. But I didn't know how much a part of the receptive was important. But I knew. And they also the reviewers, like they didn't know if it was like a Mary/Lucas thing.

Dr. Valentino: Mm-Hmm.

Mary: So he basically Dr. Michael just said in the discussion, You say you don't know how much of this further research is needs to be done splitting out receptive to tact and echoic to tact and a mixture. So what I did was I developed an alternating treatment design and used for different students. And I never published that, but I did present that, and all four of them learned equally as well with the mix procedure. And Lucas only learned that way.

Dr. Valentino: Yeah, that's awesome. And I think that a lot of times practitioners might come into the situation like you did, where there's still a question about what the mechanism of change was or what exactly. And they think, well, I couldn't publish it then. Well, people published studies all the time where they don't know exactly what the mechanism of change was or they can't pinpoint something, exactly, but that's what research is all about. And as long as you can pinpoint that and discussion sections are great for that, you say we did it, but this is not exactly how we set up the study, but the next one should look like this. That's beautiful, and that's acceptable. And that's what research is all about. And in fact, that's really what applied research is all about in and in its truest form, applied research. Really, it's a little bit messy, and that's OK. Yeah.

Mary: Then later, I think it was 2007 or 2008. I was at the ABAI conference and there was analysis of verbal behavior had just come out and people were like, Mary, this this study is quoting your work like this. And I ended up meeting the guy. His name is Dr Chris Flou, and he did his whole doctoral dissertation on transfer procedures using the Barbora and could be in the 2005 study. He's like, I feel like I typed that a zillion times, but there's been multiple studies on transfer procedures. Even I the the is where our prisoners cap. I mean, that was all based on my original study and trying to figure out which transfer procedures work best. So we'll link that in the show notes, you know, sorry to go on it. I feel like I'm I want to get your expertize. But at the same time, how real this need is, and these examples in my world are just so prevalent.

Dr. Valentino: I think it's perfect, and I think it really is exemplifying what I try and talk about in the book that process that you went through. So I'm happy that you went off on a tangent to talk about it a little bit more in depth.

Mary: Well, I want to get into the obstacles one more or actually two more things I'm going to link in, the show notes. One is a qualitative study that I did when I was going for my doctoral dissertation, I did a qualitative research design study, and so I published the experiences of autism mothers who become behavioral analysts, a qualitative study which we can link in the show notes that was 2007. And then in 2011, I published my dissertation. I didn't publish it as an actual study, but we can link that in the show notes as well that time fluency based procedures. But I do want to get into the obstacles for publication, which you have several chapters as well as additional things. But what do you think are the main obstacles for people to publish research or even to do research?

Obstacles for Practitioners Publishing Research:

Dr. Valentino: Yeah, it's a good question. And exactly there's a whole chapter dedicated to this. So in the book, I differentiate between obstacles and barriers, and I consider obstacles to be sort of the things that you need as an individual to address, like how do you overcome these personally and individually? And then barriers I consider to be more institutional right, where you need help from other people to get over that barrier and to overcome it. And so, you know, the obstacles that are I write about in my book and this section, I should note, just as a side sidebar is based on a research study, my colleague, Dr. Jessica Quantico and I published in Behavior Analysis and Practice, which was a survey about this very topic. What are the obstacles and barriers that you face as a practitioner? And so I use that article and that survey data to talk about some of these things in the book. But you know, one of the reported obstacles that people struggle with is lack of knowledge. They're just scared that they don't know enough and that they are going to make a mistake or do something wrong. And so what I try and encourage in the book is for people just to to know that they do have the knowledge by the very basis of you having to be CPA. You have learned this now. You might not be thinking about experimental design in an applied way. You might not be thinking about it in a way that lends itself to a research study right now. But the skills are very easily acquired because you already have the foundation. So I just try and minimize people's fears in that regard like you're it's OK, you're going to be fine, it's going to be OK. And then one other obstacle that comes up a lot and this is much like anything we want to do in life this time. And so people obviously report, that's great. Amber, I love that I don't have the time and so much luck with anything you want to do in life. I usually try and encourage people to realize that they're never going to wake up one day and suddenly have a ton of free time. I think we're all just waiting for the next moment. Well, when I get a new job or I change, I move to a new city or my kid gets a little older, I'll have time. You'll never have that in. So you have to make it. You have to make the time you have to say, I'm going to commit in some way. And maybe that commitment is only 30 minutes or an hour or a week. But that's a commitment and get going. And as I was preparing for this interview, it's interesting. I was looking back at my own research publications and I graphed them like, grab me number of your read publications per year just as a self-monitoring to see how productive I am. And it's funny to look back because the year that was the most productive for me was the year that I was carrying nearly a full caseload. So I was seeing clients. I had no research as part of my job. And so I think about that and I read about that in the book that the times that you feel like you don't have the the time is probably the time when you should start so that you can convince yourself that you can indeed do it. And so the whole book is really geared toward that population. You know, those BCBAs wake up in the morning, they do an observation in a school. They go supervise an r.b.g. They go to a center and they have a meeting. They go back to another school. You know that their days are just packed. They're not sitting in an office all day. And how you can integrate it. And so, so so obstacles of big ideas, time and then some of the institutional barriers, lack of opportunities and then limited access to literature are probably two of the big ones. And I try and recommend ways for people to overcome those. I do recommend being involved in an organization that can support you. So I'm very proud at Trumpet Behavioral Health that we have a lot of supports around this. We have access to literature, free access to literature. We really cultivate a space where people can learn and read and commit to this in a way where you might have to make those. You might have to make those opportunities and get those opportunities yourself. But it's it's very doable.

Mary: Yeah, yeah, that's great. So I think one of the barriers for me is. You know, when you're doing research. People really want to have control and study one little thing like transfer procedures to teach tact, you know, like break it down to one slice, a small slice. And for me, I have a four step approach that I've created over the years based on my my background as a registered nurse, as a mom, as a BCBA, as an advocate, as a researcher with a Ph.D.. And so I want to get the word out to help kids with the whole thing, you know? So it's not even just the time. It's like, I can't slice out one little minuscule thing and I get frustrated when applied research is just not, you know, well, it's too big. It's, you know, even within the transfer study that got published thanks to Rick Kubina and Jack Michael, you know, advocating for it. There's big issues like with my toddler course, for instance, we use, you know, a shoebox, for instance, and then we say Banana, Banana, Banana as we hand the child a picture of a banana that he puts in the box. So if he says nana or banana, it's part mand because he wants the item to put in the box. It's part tact because you can see it is part echoic and its listener responding and attention and everything like that. That is multiple control, there's a lot of variables. You know, we're training online, we have no control over what people are actually doing. But I know my methods work. So it's like, how do we get from massive testimonials and transformation? And people are saying, even within trumpet, you know, I'm sure you have success stories and things that are work, you know? But it's like having the, you know, setting up the study. And, you know, even even, you know, like my example of Lucas tacting the people's names and stuff like that like that actually would have been a more applicable study to names and, you know, to greetings generalizing the greetings. But it's like it's too late. It's already you already made the progress. And there's just so many millions of people that need my stuff that I just not that I've given up on research, but has said it is. It's not just the time, it's like we're in a hurry to help people. And I know in your situation you're the same. So like, do you talk about that in your book?

Dr. Valentino Yeah, that that's a really great analysis. I appreciate that you thought about it and you're right. You know, single subject design in particular has this level of specificity to it that, you know, people are trying to replicate your procedures and determine the exact mechanism for change which has its space and has its importance. And so I think anytime we can do that, particularly when we're doing that with early learners, we should do it. We should demonstrate that and that makes a contribution. But you know, as you were talking, I also started to consider and I talk about this in my book, that he rallies tend to talk to themselves a lot. We tend to publish in our own journals. We tend to speak our own language and there is a space for that and I've done a lot of that in my career. But there's also a lot of different avenues for different types of research, right? And so maybe what you're called to or other practitioners are called to is more outcome kind of studies, right? Or treatment package kind of evaluations. And there's a space for that. It may not be a particular behavior analytical journal. Or maybe it's in a completely different profession altogether, but there's a lot of really great behavior analysts who have sort of expanded their scope and done things that were different, that were bigger outcomes, larger outcomes, evaluating bigger treatment packages. And Pat is a really good example of this right who who wrote the book, the book's forward. A lot of his stuff is more mainstream, and it's out to psychologists and folks that aren't necessarily looking at single subject design as the only way that you can demonstrate something. Or that is a space where you can demonstrate a particular thing, but there are all sorts of avenues. So I would encourage practitioners to certainly do the small, single subject design, demonstrate when you can and when there's that level of specificity involved. But to think outside of the box in terms of audiences and maybe what you're trying to do is evaluate a bigger treatment package and some bigger picture outcomes with lots of kids that there's certainly an audience for that and certainly an outlet for that.

Mary: Yeah, yeah. So one of the obstacles to is is getting things accepted for publication. I know I had pretty good luck with, you know, the two studies that I published without a lot of revisions and that sort of thing, but recently actually Rick Kubina and I also wrote up a case study recently and within a month, I actually we wrote it up about a year ago or over a year ago, and it doesn't have as good of a design. Well, it was retrospective, so it kind of like it happened. What happened was Michelle C., who's in podcast Seventy Eight. We can link that on the show notes, and she's actually her latest update podcast is going to be 164. So one week ago, her updated podcast is going to happen, as well as the publication of a case study with Michelle C's daughter, Elena. And so we can link all that in the show notes. But what happened was Elena was diagnosed with autism in February of 2020 and with mom, who is a high school teacher by training, who just had a second baby, was at home and was trying to get the diagnosis and into ABA quickly. Her daughter was, you know, had two words as she would scream, she would scratch herself open wounds. That's how bad she would tantrum at times. And the world shut down and the world shut down to the point where she got no services, no Zoom services, nothing. And she found my online course. And within thirty three days and part of my online courses, baseline language assessment, you know, writing down. So she actually had an excel sheet with two words in one hour. And then at the end of the course, we say the same thing get a language assessment. And at that point, she had in one hour one hundred eighty words and phrases, prepositions, contractions, miraculous turnaround, which Michelle talks about in podcast 78. And she also then, you know, because she was posting in the group like, Oh my god, I have all this. I'm like, I need to talk to you. So before I hit, I asked her if I could record it and just kind of pretend it was a podcast. I had no idea what she was going to say. And in that podcast, she was talking about how she had a standardized language test from right before the diagnosis at a zero to three month level. You know, one of the lowest the lowest test was zero three months, probably functioning at more of a nine month low level for language. And then right after she took the course, she again got the test. And at that point, Alan was only 26 months old and her standardized speech test, one of them was a high of 30 months. So. That to me, as somebody like I have had this before, where the VB map really correlates with a standardized assessment that matches like a 30 month low level or something. Meanwhile, you know, I don't think we do enough of that where we're pulling in other standardized tests to show progress. And one of the good things about that case study, which we can link in the show notes, is all the variables were gone. Like she didn't have any services. She didn't leave the house. Her mom was the only person. She was just going by the videos. She wasn't even asking for help. Nobody looked at the videos. Nobody gave her any feedback, which can only certainly help. So, you know, at some point, then Rick Kubina and I just decided we're going to publish this as a white paper because we do think it's important to get out there. So is it would you have any advice for practitioners in that situation where, you know, should you just present it, you know, on your own?

Dr. Valentino/b> Yeah, absolutely. You know, I'll send you the reference afterwards. But Gina Green wrote an article around like the two thousand eight time frame where she she published a traditional case study in in traditional kind of psychology research. There is such a thing as a case study that is not single subject design per se, but is a very detailed and documented history of somebody who's hit somebody's diagnosis, their symptoms, and then a very detailed description of the intervention that took place. And so what you just described to me was a traditional case study that absolutely could be published. And the really great thing about Gina Green's paper is she talks about how these case studies are very important for people to publish. Because, as you probably know, one of the criticisms of ABA is there haven't been any large scale, randomized clinical controlled trials of ABA, and managed care companies are starting to highlight this and talk about it. And her point, and this was beyond, you know, this is before that the discussions that we're having today. But was the more of these case studies that we can publish, the more we can demonstrate the effectiveness of our intervention. And that has been historically how interventions have been demonstrated to be effective is with these single case studies. So I absolutely think there's an avenue for that. And again, it takes thinking outside of the ABA world and the traditional publications outlets and exploring where people might have published something very similar. And so there's that. And then I also really encourage practitioners to not always see publication as the end goal, at least in its traditional form, and that there's all sorts of ways to disseminate information, you know, white paper that you just described is beautiful newsletters and presenting at conferences and sharing information that way. And so with dissemination and sharing is really at the heart of your motivation. That doesn't always have to be in the form of a peer reviewed publication. You can look at these other ways to contribute to the field, the profession and the literature. It may not always fit that perfect experimental control box, and those are absolutely valuable, and they mean something to somebody and to the right audience are going to absolutely have an impact them and let you share that example.

Mary: Yeah. And when you said about, you know, you published a survey results, you know, I'd love to link that in the show notes as well because, you know, I have a free potty guide, for instance, which is 20 pages. And there really isn't the literature that there needs to be on potty training, especially kids with autism. And so I was looking at that the other day. We can link that in the show notes, and I had done a survey in 2013, which is highlighted in the potty guide. And it shows that, you know, typically developing kids are potty trained by three a usually and definitely by four and only 50 percent of kids with autism are were potty trained. I mean, this is like 300 people in 2013, but I'm thinking, you know, now with my audience, I mean, I could do surveys all day long. And that's the other thing is you can also partner with agencies or schools or, you know, I might even in the future, open up a whole research arm of my turn autism around courses and community. I'm very open to people taking anything and researching it because I know the interventions work and maybe some of them don't. Maybe some of them need to be tweaked. I'm sure that with coaching on top of the online, we could make massive improvements. But you know, I think one of the great things about you, Amber, is like presenting publication doesn't have to be the goal. We just want to get the best procedures out to the world as quickly as possible. And I think you are an example to show that we can collaborate, we can work together to, you know, really make the world a better place.

Dr. Valentino: Thank you so much, you and I. I think what you just described is the other piece of advice I would give practitioners is to not only think about different outlets, but think about different ways. So survey studies are beautiful, especially. We don't know a lot about a topic. So I published a little bit in the supervision space and a lot of my my studies have been a surprise because we don't know a whole lot about supervision and behavior analysis. And so that's a great way to get some meat under a topic that will probably facilitate single subject research later down the line and get things going. But survey studies are beautiful. There's also different outlets, too, like literature reviews and recommended practice papers. Then there's different ways to contribute that don't always involve these manipulations of a variable with one particular client which has its base, and I've done a fair share of. But if you open up the possibilities to these both those different types of writing and different types of contributions, and then you open up to outside of the behavioral analytic world. You don't have to force yourself into something you aren't interested in or doesn't work for the work you're doing. You can take what you're doing. You just have to find the right audience and the right outlet in the right way to do it. And that's really what I want practitioners to do. And at the heart of the book, I really try and help them through.

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Using Single Subject Experimental Designs

single subject experimental designs applied behavior analysis

What are the Characteristics of Single Subject Experimental Designs?

Single-subject designs are the staple of applied behavior analysis research. Those preparing for the BCBA exam or the BCaBA exam must know single subject terms and definitions. When choosing a single-subject experimental design, ABA researchers are looking for certain characteristics that fit their study. First, individuals serve as their own control in single subject research. In other words, the results of each condition are compared to the participant’s own data. If 3 people participate in the study, each will act as their own control. Second, researchers are trying to predict, verify, and replicate the outcomes of their intervention. Prediction, replication, and verification are essential to single-subject design research and help prove experimental control. Prediction: the hypothesis related to what the outcome will be when measured Verification : showing that baseline data would remain consistent if the independent variable was not manipulated Replication: repeating the independent variable manipulation to show similar results across multiple phases Some experimental designs like withdrawal designs are better suited for demonstrating experimental control than others, but each design has its place. We will now look at the different types of single subject experimental designs and the core features of each.

Reversal Design/Withdrawal Design/A-B-A

Arguably the simplest single subject design, the reversal/withdrawal design is excellent at identifying experimental control. First, baseline data is recorded. Then, an intervention is introduced and the effects are recorded. Finally, the intervention is withdrawn and the experiment returns to baseline. The researcher or researchers then visually analyze the changes from baseline to intervention and determine whether or not experimental control was established. Prediction, verification, and replication are also clearly demonstrated in the withdrawal design. Below is a simple example of this A-B-A design.

Advantages: Demonstrate experimental control Disadvantages: Ethical concerns, some behaviors cannot be reversed, not great for high-risk or dangerous behaviors

Multiple Baseline Design/Multiple Probe Design

Multiple baseline designs are used when researchers need to measure across participants, behaviors, or settings. For instance, if you wanted to examine the effects of an independent variable in a classroom, in a home setting, and in a clinical setting, you might use a multiple baseline across settings design. Multiple baseline designs typically involve 3-5 subjects, settings, or behaviors. An intervention is introduced into each segment one at a time while baseline continues in the other conditions. Below is a rough example of what a multiple baseline design typically looks like:

multiple baseline design single subject design

Multiple probe designs are identical to multiple baseline designs except baseline is not continuous. Instead, data is taken only sporadically during the baseline condition. You may use this if time and resources are limited, or you do not anticipate baseline changing. Advantages: No withdrawal needed, examine multiple dependent variables at a time Disadvantages : Sometimes difficult to demonstrate experimental control

Alternating Treatment Design

The alternating treatment design involves rapid/semirandom alternating conditions taking place all in the same phase. There are equal opportunities for conditions to be present during measurement. Conditions are alternated rapidly and randomly to test multiple conditions at once.

Advantages: No withdrawal, multiple independent variables can be tried rapidly Disadvantages : The multiple treatment effect can impact measurement

Changing Criterion Design

The changing criterion design is great for reducing or increasing behaviors. The behavior should already be in the subject’s repertoire when using changing criterion designs. Reducing smoking or increasing exercise are two common examples of the changing criterion design. With the changing criterion design, treatment is delivered in a series of ascending or descending phases. The criterion that the subject is expected to meet is changed for each phase. You can reverse a phase of a changing criterion design in an attempt to demonstrate experimental control.

Summary of Single Subject Experimental Designs

Single subject designs are popular in both social sciences and in applied behavior analysis. As always, your research question and purpose should dictate your design choice. You will need to know experimental design and the details behind single subject design for the BCBA exam and the BCaBA exam. For BCBA exam study materials check out our BCBA exam prep. For a full breakdown of the BCBA fifth edition task list, check out our YouTube :

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Digital Commons @ USF > College of Behavioral and Community Sciences > Child and Family Studies > Applied Behavior Analysis > Theses and Dissertations

Applied Behavior Analysis Theses and Dissertations

Theses/dissertations from 2009 2009.

It is Time to Play! Peer Implemented Pivotal Response Training with a Child with Autism during Recess , Leigh Anne Sams

Theses/Dissertations from 2008 2008

The Evaluation of a Commercially-Available Abduction Prevention Program , Kimberly V. Beck

Expert Video Modeling with Video Feedback to Enhance Gymnastics Skills , Eva Boyer

Behavior Contracting with Dependent Runaway Youth , Jessica Colon

Can Using One Trainer Solely to Deliver Prompts and Feedback During Role Plays Increase Correct Performance of Parenting Skills in a Behavioral Parent Training Program? , Michael M. Cripe

Evaluation of a Functional Treatment for Binge Eating Associated with Bulimia Nervosa , Tamela Cheri DeWeese-Giddings

Teaching Functional Skills to Individuals with Developmental Disabilities Using Video Prompting , Julie A. Horn

Evaluation of a Standardized Protocol for Parent Training in Positive Behavior Support Using a Multiple Baseline Design , Robin Lane

Publicly Posted Feedback with Goal Setting to Improve Tennis Performance , Gretchen Mathews

Improving Staff Performance by Enhancing Staff Training Procedures and Organizational Behavior Management Procedures , Dennis Martin McClelland Jr.

Supporting Teachers and Children During In-Class Transitions: The Power of Prevention , Sarah M. Mele

Effects of Supervisor’s Presence on Staff Response to Tactile Prompts and Self-Monitoring in a Group Home Setting , Judy M. Mowery

Social Skills Training with Typically Developing Adolescents: Measurement of Skill Acquisition , Jessica Anne Thompson

Theses/Dissertations from 2007 2007

Evaluating the effects of a reinforcement system for students participating in the Fast Forword language program , Catherine C. Wilcox

Theses/Dissertations from 2006 2006

The Acquisition of Functional Sign Language by Non-Hearing Impaired Infants , Kerri Haley-Garrett

Response Cards in the Elementary School Classroom: Effects on Student and Teacher Behavior , Shannon McKallip-Moss

The Effects of a Parent Training Course on Coercive Interactions Between Parents and Children , Lezlee Powell

The Effects of Role-Playing on the Development of Adaptive Skills in a Parent Training Program , Chantell A. Rodriguez-Del Valle

Archival evaluation of a proactive school wide discipline plan , Beth Rutz-Beynart

Effects of a multi-component interdependent group contingency game on the classroom behavior of typically developing elementary school children , Stacey D. Simonds

Establishing a Functional Analysis Protocol for Examining Behavioral Deficits using Social Withdrawal as an Exemplar , Melissa Penaranda Walters

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The Role of Choice Versus Preference: An Analysis of Why Choice Interventions Work , John D. Adelinis

The Effect of Direct Instruction Math Curriculum on Higher-Order Problem Solving , Pamela Christofori

The Effects of Response Cards on the Performance and Generalization of Parenting Skills , Bennie L. Colbert

A Comparison of Two Prompting Procedures on Tacting Behavior , Kelley N. Gardner

The Effects Of The Presence Of A Dog On The Social Interactions Of Children With Developmental Disabilities , Stephanie Walters

The Effects of Fluency Training on Performance, Maintenance, and Generalization of Parenting Skills , Gertie Williams

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Use of the Power Card Strategy as an Intervention with an Elementary School Student with Asperger Syndrome: Increasing On-Task Behavior in the General Education Setting , Jane M. Devenport

The Importance of Program-Delivered Differential Reinforcement in the Development of Classical Music Auditory Discrimination , Gudmundur Torfi Heimisson

The Impact of a Goal Setting Procedure on the Work Performance of Young Adults with Behavioral/Emotional/Learning Challenges , Robin Wagner Hogsholm

The Effects of Graphic Display and Training in Visual Inspection on Teachers' Detection of Behavior Change , Allana Duncan Luquette

Imitation and its Reciprocity in the Treatment of Autism , Roxana I. Nedelcu

Utility of Positive Peer Reporting to Improve Interactions Among Children in Foster Care , Jenny L. Van Horn

Behavioral Analysis of Interactions Between Teachers and Children with Selective Mutism , Jason D. Wallace

Theses/Dissertations from 2003 2003

Creating Positive Experiences: Increasing Parent Participation In A Low Income Elementary School , Krista Stinson Cayer

Evaluation Of A Presentation And Measurement Method For Assessing Activity Preference , Tara L. Lieblein

Using The ABLLS with English Language Learners: Implications for Students and Teachers , Lorie G. Schultz

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Chapter 10: Single-Subject Research

Single-Subject Research Designs

Learning Objectives

Describe the basic elements of a single-subject research design.
Design simple single-subject studies using reversal and multiple-baseline designs.
Explain how single-subject research designs address the issue of internal validity.
Interpret the results of simple single-subject studies based on the visual inspection of graphed data.

General Features of Single-Subject Designs

Before looking at any specific single-subject research designs, it will be helpful to consider some features that are common to most of them. Many of these features are illustrated in Figure 10.2, which shows the results of a generic single-subject study. First, the dependent variable (represented on the y -axis of the graph) is measured repeatedly over time (represented by the x -axis) at regular intervals. Second, the study is divided into distinct phases, and the participant is tested under one condition per phase. The conditions are often designated by capital letters: A, B, C, and so on. Thus Figure 10.2 represents a design in which the participant was tested first in one condition (A), then tested in another condition (B), and finally retested in the original condition (A). (This is called a reversal design and will be discussed in more detail shortly.)

A subject was tested under condition A, then condition B, then under condition A again.

Another important aspect of single-subject research is that the change from one condition to the next does not usually occur after a fixed amount of time or number of observations. Instead, it depends on the participant’s behaviour. Specifically, the researcher waits until the participant’s behaviour in one condition becomes fairly consistent from observation to observation before changing conditions. This is sometimes referred to as the steady state strategy (Sidman, 1960) [1] . The idea is that when the dependent variable has reached a steady state, then any change across conditions will be relatively easy to detect. Recall that we encountered this same principle when discussing experimental research more generally. The effect of an independent variable is easier to detect when the “noise” in the data is minimized.

Reversal Designs

The most basic single-subject research design is the reversal design , also called the ABA design . During the first phase, A, a baseline is established for the dependent variable. This is the level of responding before any treatment is introduced, and therefore the baseline phase is a kind of control condition. When steady state responding is reached, phase B begins as the researcher introduces the treatment. There may be a period of adjustment to the treatment during which the behaviour of interest becomes more variable and begins to increase or decrease. Again, the researcher waits until that dependent variable reaches a steady state so that it is clear whether and how much it has changed. Finally, the researcher removes the treatment and again waits until the dependent variable reaches a steady state. This basic reversal design can also be extended with the reintroduction of the treatment (ABAB), another return to baseline (ABABA), and so on.

The study by Hall and his colleagues was an ABAB reversal design. Figure 10.3 approximates the data for Robbie. The percentage of time he spent studying (the dependent variable) was low during the first baseline phase, increased during the first treatment phase until it leveled off, decreased during the second baseline phase, and again increased during the second treatment phase.

A graph showing the results of a study with an ABAB reversal design. Long description available.

Why is the reversal—the removal of the treatment—considered to be necessary in this type of design? Why use an ABA design, for example, rather than a simpler AB design? Notice that an AB design is essentially an interrupted time-series design applied to an individual participant. Recall that one problem with that design is that if the dependent variable changes after the treatment is introduced, it is not always clear that the treatment was responsible for the change. It is possible that something else changed at around the same time and that this extraneous variable is responsible for the change in the dependent variable. But if the dependent variable changes with the introduction of the treatment and then changes back with the removal of the treatment (assuming that the treatment does not create a permanent effect), it is much clearer that the treatment (and removal of the treatment) is the cause. In other words, the reversal greatly increases the internal validity of the study.

There are close relatives of the basic reversal design that allow for the evaluation of more than one treatment. In a multiple-treatment reversal design , a baseline phase is followed by separate phases in which different treatments are introduced. For example, a researcher might establish a baseline of studying behaviour for a disruptive student (A), then introduce a treatment involving positive attention from the teacher (B), and then switch to a treatment involving mild punishment for not studying (C). The participant could then be returned to a baseline phase before reintroducing each treatment—perhaps in the reverse order as a way of controlling for carryover effects. This particular multiple-treatment reversal design could also be referred to as an ABCACB design.

In an alternating treatments design , two or more treatments are alternated relatively quickly on a regular schedule. For example, positive attention for studying could be used one day and mild punishment for not studying the next, and so on. Or one treatment could be implemented in the morning and another in the afternoon. The alternating treatments design can be a quick and effective way of comparing treatments, but only when the treatments are fast acting.

Multiple-Baseline Designs

There are two potential problems with the reversal design—both of which have to do with the removal of the treatment. One is that if a treatment is working, it may be unethical to remove it. For example, if a treatment seemed to reduce the incidence of self-injury in a developmentally disabled child, it would be unethical to remove that treatment just to show that the incidence of self-injury increases. The second problem is that the dependent variable may not return to baseline when the treatment is removed. For example, when positive attention for studying is removed, a student might continue to study at an increased rate. This could mean that the positive attention had a lasting effect on the student’s studying, which of course would be good. But it could also mean that the positive attention was not really the cause of the increased studying in the first place. Perhaps something else happened at about the same time as the treatment—for example, the student’s parents might have started rewarding him for good grades.

One solution to these problems is to use a multiple-baseline design , which is represented in Figure 10.4. In one version of the design, a baseline is established for each of several participants, and the treatment is then introduced for each one. In essence, each participant is tested in an AB design. The key to this design is that the treatment is introduced at a different time for each participant. The idea is that if the dependent variable changes when the treatment is introduced for one participant, it might be a coincidence. But if the dependent variable changes when the treatment is introduced for multiple participants—especially when the treatment is introduced at different times for the different participants—then it is extremely unlikely to be a coincidence.

Three graphs depicting the results of a multiple-baseline study. Long description available.

As an example, consider a study by Scott Ross and Robert Horner (Ross & Horner, 2009) [2] . They were interested in how a school-wide bullying prevention program affected the bullying behaviour of particular problem students. At each of three different schools, the researchers studied two students who had regularly engaged in bullying. During the baseline phase, they observed the students for 10-minute periods each day during lunch recess and counted the number of aggressive behaviours they exhibited toward their peers. (The researchers used handheld computers to help record the data.) After 2 weeks, they implemented the program at one school. After 2 more weeks, they implemented it at the second school. And after 2 more weeks, they implemented it at the third school. They found that the number of aggressive behaviours exhibited by each student dropped shortly after the program was implemented at his or her school. Notice that if the researchers had only studied one school or if they had introduced the treatment at the same time at all three schools, then it would be unclear whether the reduction in aggressive behaviours was due to the bullying program or something else that happened at about the same time it was introduced (e.g., a holiday, a television program, a change in the weather). But with their multiple-baseline design, this kind of coincidence would have to happen three separate times—a very unlikely occurrence—to explain their results.

In another version of the multiple-baseline design, multiple baselines are established for the same participant but for different dependent variables, and the treatment is introduced at a different time for each dependent variable. Imagine, for example, a study on the effect of setting clear goals on the productivity of an office worker who has two primary tasks: making sales calls and writing reports. Baselines for both tasks could be established. For example, the researcher could measure the number of sales calls made and reports written by the worker each week for several weeks. Then the goal-setting treatment could be introduced for one of these tasks, and at a later time the same treatment could be introduced for the other task. The logic is the same as before. If productivity increases on one task after the treatment is introduced, it is unclear whether the treatment caused the increase. But if productivity increases on both tasks after the treatment is introduced—especially when the treatment is introduced at two different times—then it seems much clearer that the treatment was responsible.

In yet a third version of the multiple-baseline design, multiple baselines are established for the same participant but in different settings. For example, a baseline might be established for the amount of time a child spends reading during his free time at school and during his free time at home. Then a treatment such as positive attention might be introduced first at school and later at home. Again, if the dependent variable changes after the treatment is introduced in each setting, then this gives the researcher confidence that the treatment is, in fact, responsible for the change.

Data Analysis in Single-Subject Research

In addition to its focus on individual participants, single-subject research differs from group research in the way the data are typically analyzed. As we have seen throughout the book, group research involves combining data across participants. Group data are described using statistics such as means, standard deviations, Pearson’s r , and so on to detect general patterns. Finally, inferential statistics are used to help decide whether the result for the sample is likely to generalize to the population. Single-subject research, by contrast, relies heavily on a very different approach called visual inspection . This means plotting individual participants’ data as shown throughout this chapter, looking carefully at those data, and making judgments about whether and to what extent the independent variable had an effect on the dependent variable. Inferential statistics are typically not used.

In visually inspecting their data, single-subject researchers take several factors into account. One of them is changes in the level of the dependent variable from condition to condition. If the dependent variable is much higher or much lower in one condition than another, this suggests that the treatment had an effect. A second factor is trend , which refers to gradual increases or decreases in the dependent variable across observations. If the dependent variable begins increasing or decreasing with a change in conditions, then again this suggests that the treatment had an effect. It can be especially telling when a trend changes directions—for example, when an unwanted behaviour is increasing during baseline but then begins to decrease with the introduction of the treatment. A third factor is latency , which is the time it takes for the dependent variable to begin changing after a change in conditions. In general, if a change in the dependent variable begins shortly after a change in conditions, this suggests that the treatment was responsible.

In the top panel of Figure 10.5, there are fairly obvious changes in the level and trend of the dependent variable from condition to condition. Furthermore, the latencies of these changes are short; the change happens immediately. This pattern of results strongly suggests that the treatment was responsible for the changes in the dependent variable. In the bottom panel of Figure 10.5, however, the changes in level are fairly small. And although there appears to be an increasing trend in the treatment condition, it looks as though it might be a continuation of a trend that had already begun during baseline. This pattern of results strongly suggests that the treatment was not responsible for any changes in the dependent variable—at least not to the extent that single-subject researchers typically hope to see.

Results of a single-subject study showing level, trend and latency. Long description available.

The results of single-subject research can also be analyzed using statistical procedures—and this is becoming more common. There are many different approaches, and single-subject researchers continue to debate which are the most useful. One approach parallels what is typically done in group research. The mean and standard deviation of each participant’s responses under each condition are computed and compared, and inferential statistical tests such as the t test or analysis of variance are applied (Fisch, 2001) [3] . (Note that averaging across participants is less common.) Another approach is to compute the percentage of nonoverlapping data (PND) for each participant (Scruggs & Mastropieri, 2001) [4] . This is the percentage of responses in the treatment condition that are more extreme than the most extreme response in a relevant control condition. In the study of Hall and his colleagues, for example, all measures of Robbie’s study time in the first treatment condition were greater than the highest measure in the first baseline, for a PND of 100%. The greater the percentage of nonoverlapping data, the stronger the treatment effect. Still, formal statistical approaches to data analysis in single-subject research are generally considered a supplement to visual inspection, not a replacement for it.

Key Takeaways

Single-subject research designs typically involve measuring the dependent variable repeatedly over time and changing conditions (e.g., from baseline to treatment) when the dependent variable has reached a steady state. This approach allows the researcher to see whether changes in the independent variable are causing changes in the dependent variable.
In a reversal design, the participant is tested in a baseline condition, then tested in a treatment condition, and then returned to baseline. If the dependent variable changes with the introduction of the treatment and then changes back with the return to baseline, this provides strong evidence of a treatment effect.
In a multiple-baseline design, baselines are established for different participants, different dependent variables, or different settings—and the treatment is introduced at a different time on each baseline. If the introduction of the treatment is followed by a change in the dependent variable on each baseline, this provides strong evidence of a treatment effect.
Single-subject researchers typically analyze their data by graphing them and making judgments about whether the independent variable is affecting the dependent variable based on level, trend, and latency.
Does positive attention from a parent increase a child’s toothbrushing behaviour?
Does self-testing while studying improve a student’s performance on weekly spelling tests?
Does regular exercise help relieve depression?
Practice: Create a graph that displays the hypothetical results for the study you designed in Exercise 1. Write a paragraph in which you describe what the results show. Be sure to comment on level, trend, and latency.

Long Descriptions

Figure 10.3 long description: Line graph showing the results of a study with an ABAB reversal design. The dependent variable was low during first baseline phase; increased during the first treatment; decreased during the second baseline, but was still higher than during the first baseline; and was highest during the second treatment phase. [Return to Figure 10.3]

Figure 10.4 long description: Three line graphs showing the results of a generic multiple-baseline study, in which different baselines are established and treatment is introduced to participants at different times.

For Baseline 1, treatment is introduced one-quarter of the way into the study. The dependent variable ranges between 12 and 16 units during the baseline, but drops down to 10 units with treatment and mostly decreases until the end of the study, ranging between 4 and 10 units.

For Baseline 2, treatment is introduced halfway through the study. The dependent variable ranges between 10 and 15 units during the baseline, then has a sharp decrease to 7 units when treatment is introduced. However, the dependent variable increases to 12 units soon after the drop and ranges between 8 and 10 units until the end of the study.

For Baseline 3, treatment is introduced three-quarters of the way into the study. The dependent variable ranges between 12 and 16 units for the most part during the baseline, with one drop down to 10 units. When treatment is introduced, the dependent variable drops down to 10 units and then ranges between 8 and 9 units until the end of the study. [Return to Figure 10.4]

Figure 10.5 long description: Two graphs showing the results of a generic single-subject study with an ABA design. In the first graph, under condition A, level is high and the trend is increasing. Under condition B, level is much lower than under condition A and the trend is decreasing. Under condition A again, level is about as high as the first time and the trend is increasing. For each change, latency is short, suggesting that the treatment is the reason for the change.

In the second graph, under condition A, level is relatively low and the trend is increasing. Under condition B, level is a little higher than during condition A and the trend is increasing slightly. Under condition A again, level is a little lower than during condition B and the trend is decreasing slightly. It is difficult to determine the latency of these changes, since each change is rather minute, which suggests that the treatment is ineffective. [Return to Figure 10.5]

Sidman, M. (1960). Tactics of scientific research: Evaluating experimental data in psychology . Boston, MA: Authors Cooperative. ↵
Ross, S. W., & Horner, R. H. (2009). Bully prevention in positive behaviour support. Journal of Applied Behaviour Analysis, 42 , 747–759. ↵
Fisch, G. S. (2001). Evaluating data from behavioural analysis: Visual inspection or statistical models. Behavioural Processes, 54 , 137–154. ↵
Scruggs, T. E., & Mastropieri, M. A. (2001). How to summarize single-participant research: Ideas and applications. Exceptionality, 9 , 227–244. ↵

The researcher waits until the participant’s behaviour in one condition becomes fairly consistent from observation to observation before changing conditions. This way, any change across conditions will be easy to detect.

A study method in which the researcher gathers data on a baseline state, introduces the treatment and continues observation until a steady state is reached, and finally removes the treatment and observes the participant until they return to a steady state.

The level of responding before any treatment is introduced and therefore acts as a kind of control condition.

A baseline phase is followed by separate phases in which different treatments are introduced.

Two or more treatments are alternated relatively quickly on a regular schedule.

A baseline is established for several participants and the treatment is then introduced to each participant at a different time.

The plotting of individual participants’ data, examining the data, and making judgements about whether and to what extent the independent variable had an effect on the dependent variable.

Whether the data is higher or lower based on a visual inspection of the data; a change in the level implies the treatment introduced had an effect.

The gradual increases or decreases in the dependent variable across observations.

The time it takes for the dependent variable to begin changing after a change in conditions.

The percentage of responses in the treatment condition that are more extreme than the most extreme response in a relevant control condition.

Research Methods in Psychology - 2nd Canadian Edition Copyright © 2015 by Paul C. Price, Rajiv Jhangiani, & I-Chant A. Chiang is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Applied Behavior Analysis

Getting started
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Find a specific article

Basics of a Literature Review

Examples of literature reviews, citation searching.

Writing and APA Format
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Conducting Research Literature Reviews Pius Library Q180.55.M4 F56 2010
Preparing Literature Review Qualitative and Quantitative Approaches Pius Library Q180.55.E9 P36 2008 There are several example literature reviews in the appendix of this book.
Evaluating Research Articles From Start to Finish Pius Library Q180.55.E9 G57 2011
Evaluating Research Methodology for People Who Need to Read Research Pius Library Q180.55 .E9 D355 2011
Encyclopedia of Measurement and Statistics eBook
Encyclopedia of Research Design
Statistics for People Who Think They Hate Statistics Pius Library HA29 .S2365 2009
Systematic Reviews in the Social Sciences Pius Library H62.P457 2006
Systematic Approaches to a Successful Literature Review Pius Library LB1047.3.B66 2012

A literature review may be conducted in order to inform practice and/or policy, serve as a basic element in a thesis or dissertation or as part of a proposal to obtain funding. The process can be divided into a series of steps:

Choose a topic. Look at recent literature for ideas and do a bit of preliminary searching of the existing literature.
Clarify your review question and the scope of your review
Brainstorm search terms to use and think about your search strategy
Begin searching for articles. I strongly recommend you keep a search log to document which databases you searched and what search terms you used.
Capture and manage search results. You may want to export results to Endnote or other citation management tool (see Managing Citations tab in this guide)
Screen results for inclusion based on critera you define
Evaluate the the articles. A worksheet which includes the bibliographic information about the article and summarizes elements of the article such as research design, interventions, findings, main variables etc. may give you a helpful overview
Synthesize results (this is the whole point!).

Literature reviews are part of a PhD dissertation. Use the Dissertations and Theses Full Text database to see the literature review chapters in the two PhD theses listed below. Just enter the dissertation title in quotes and you will retrieve the full text of the dissertation.

Using concurrent operants to evaluate perserverative conversation in children and adolescents diagnosed with Asperger's disorder by Matthew J. O'Brien
The effectiveness of specialized applied behavior analysis (ABA) on daily living skills for individuals with autism and related disorders ages 8 to 19 by Adriana Weyandt

Social Services Abstracts This link opens in a new window 1980-present. Indexes and abstracts over 1,000 journals and magazines in the social services in addition to social work dissertations. Includes citation tracking for articles included in the database.
Web of Science This link opens in a new window 1990-present. Brings together Arts & Humanities Citation Index , Social Sciences Citation Index , Science Citation Index Expanded and the newer Emerging Sources Citation Index . Search thousands of research journals by topic or do a Cited Reference search.
Scopus This link opens in a new window Some 1788-present. Search one of the largest abstract and citation databases for materials on science, engineering, technology, and medicine along with some social sciences and humanities.

To see the Find It @ SLU link when searching Google Scholar off-campus:

Sign in to Google Scholar Settings-Library Links
Search for “Saint Louis University”
Select “Find It @ SLU”
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Applied Behavior Analysis

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Two Ways to Find Single Subject Research Design (SSRD) Articles

Finding ssrd articles via the browsing method, finding ssrd articles via the searching method.

Search by Article Citation in OneSearch
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Types of Single Subject Research Design

Types of SSRDs to look for as you skim abstracts:

reversal design
withdrawal design
ABAB design
A-B-A-B design
A-B-C design
A-B-A design
multiple baseline
alternating treatments design
multi-element design
changing criterion design
single case design
single subject design
single case series

Behavior analysts recognize the advantages of single-subject design for establishing intervention efficacy. Much of the research performed by behavior analysts will use SSRD methods.

When you need to find SSRD articles, there are two methods you can use:

Click on a title from the list of ABA Journal Titles .
Scroll down on the resulting page to the View Online section.
Choose a link which includes the date range you're interested in.
Click on a link to an issue (date) you want to explore.
From the resulting Table of Contents, explore titles of interest, reading the abstract carefully for signs that the research was carried out using a SSRD. (To help, look for the box on this page with a list of SSRD types.)

Description: PsycInfo is a key database in the field of psychology. Includes information of use to psychologists, students, and professionals in related fields such as psychiatry, management, business, and education, social science, neuroscience, law, medicine, and social work. Time Period: 1887 to present Sources: Indexes more than 2,500 journals. Subject Headings: Education, Mobile, Psychology, Social Sciences (Psychology) Scholarly or Popular: Scholarly Primary Materials: Journal Articles Information Included: Abstracts, Citations, Linked Full Text FindIt@BALL STATE: Yes Print Equivalent: None Publisher: American Psychological Association Updates: Monthly Number of Simultaneous Users: Unlimited

First , go to APA PsycInfo.

Second , copy and paste this set of terms describing different types of SSRDs into an APA PsycInfo search box, and choose "Abstract" in the drop-down menu.

Third , copy and paste this list of ABA journals into another search box in APA PsycInfo, and choose "SO Publication Name" in the drop-down menu.

Drop-down menu showing: "SO Publication Name"

Fourth , type in some keywords in another APA PsycInfo search box (or two) describing what you're researching. Use OR and add synonyms or related words for the best results.

Hit SEARCH, and see what kind of results you get!

Here's an example of a search for SSRDs in ABA journals on the topic of fitness:

APA PsycInfo search with 3 boxes. 1st box: "reversal design" OR "withdrawal design" etc. 2nd box: "Analysis of Verbal Behavior" OR "Behavior Analyst" OR etc. 3rd box: exercise or physical activity or fitness

Note that the long list of terms in the top two boxes gets cut off in the screenshot - - but they're all there!

The reason this works:

To find SSRD articles, we can't just search on the phrase "single subject research" because many studies which use SSRD do not include that phrase anywhere in the text of the article; instead such articles typically specify in the abstract (and "Methods" section) what type of SSRD method was used (ex. withdrawal design, multiple baseline, or ABA design). That's why we string together all the possible descriptions of SSRD types with the word OR in between -- it enables us to search for any sort of SSRD, regardless of how it's described. Choosing "Abstract" in the drop-down menu ensures that we're focusing on these terms being used in the abstract field (not just popping up in discussion in the full-text).
To search specifically for studies carried out in the field of Applied Behavior Analysis, we enter in the titles of the ABA journals, strung together, with OR in between. The quotation marks ensure each title is searched as a phrase. Choosing "SO Publication Name" in the drop-down menu ensures that results will be from articles published in those journals (not just references to those journals).
To limit the search to a topic we're interested in, we type in some keywords in another search box. The more synonyms you can think of, the better; that ensures you'll have a decent pool of records to look through, including authors who may have described your topic differently.

Search ideas:

To limit your search to just the top ABA journals, you can use this shorter list in place of the long one above:

"Behavior Analysis in Practice" OR "Journal of Applied Behavior Analysis" OR "Journal of Behavioral Education" OR "Journal of Developmental and Physical Disabilities" OR "Journal of the Experimental Analysis of Behavior"

To get more specific, topic-wise, add another search box with another term (or set of terms), like in this example:

Four search boxes in PsycInfo. Same as above, but with a 4th box: autism OR "developmental disorders"

To search more broadly and include other psychology studies outside of ABA journals, simply remove the list of journal titles from the search, as shown here:

Search in PsycInfo without list of journal terms.

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Guidelines for conducting research studies with the autism community

1 Division of Neuroscience and Experimental Psychology, School of biological Sciences, Faculty of Biology, Medicine and Health Sciences, The University of Manchester

Rachel Taylor

2 The University of Bolton

Peter Baimbridge

3 Salfordautism

Daniel Poole

There has been growing awareness of the concern expressed by autism communities that the majority of research conducted does not reflect the priorities or needs of autistic people and their families. Further, many autistic people report that they feel unable to influence research and desire greater involvement in the research process. Our research generated practical guidelines for researchers to consider when conducting autism research, in order to increase involvement, collaboration and trust between researchers and the autism community. These guidelines are based on the output of focus groups and interview discussions with twenty-two autistic adults and eight parents of autistic children, conducted during a series of workshops carried out as a collaboration between the research network Autism@Manchester and Salfordautism, an autism support group led and run by autistic professionals.

The guidelines are organised into four sections: (1) pre-study considerations, (2) recruitment of participants, (3) study visit considerations and (4) post-study considerations. These sections are structured to reflect the research pathway, to allow researchers to understand more easily how to incorporate the recommendations into their research. The recommendations promote effective communication and equal partnerships between the autism and research communities, so that the needs of participants pre-research, during and post- research are taken into account, and so that participants are supported to become involved in research at the level they choose. It is hoped that by implementing transparent and participatory approaches to their work, researchers might be able to reduce some of the dissatisfaction that members of the autism community feel towards research, leading to higher standards in autism research.

Introduction

In recent years, there has been growing concern about a disconnect between researchers and the autism community (autistic people, their parents and family members) ( Chown et al ., 2017 ; Milton, 2014 ; Milton and Bracher, 2013 ; Pellicano and Stears, 2011 ; Woods and Waltz, 2019 ). It has been shown that there is a large gap between research priorities identified by academics and funding bodies, and those identified by autistic people and their families ( Pellicano, Dinsmore and Charman, 2014a ). While the majority of funded research focuses on basic research into biology, brain function and cognition, the autistic community would prefer more research on aspects related to day-to-day living, such as improving services and developing programmes to enhance individuals’ life skills. Indeed, in 2016 only 27% of the total research expenditure in the UK was spent on the top ten autism community priorities identified by the James Lind Alliance Priority Setting Partnership ( Warner, Cooper and Cusack, 2019 ).

In addition, the autism community has reported dissatisfaction with the level of engagement they have had with research. Poor communication about research opportunities and findings prevents them from getting involved in and influencing research, and leads to dissatisfaction with interpretations drawn about research ( Pellicano, Dinsmore and Charman, 2014b ). In contrast, researchers viewed themselves as engaged with the autism community in terms of dissemination and consultation.

This disconnect may be due to a number of factors, such as lack of involvement of the autism community in priority-setting, use of demeaning language about autistic people when describing research, resistance on behalf of researchers to involving the autism community, and unrealistic expectations about research from the autism community ( Nicolaidis et al ., 2011 ; Pellicano, Dinsmore and Charman, 2014b ). In addition, charities that often work closely with research bodies and governments to set research priorities have not involved autistic people in decision-making, and often have their own agendas that are not the same as those of the community they claim to serve ( Petric, Beadle-Brown and Bradshaw, 2017 ). This has reduced the opportunity for autistic people to influence research, and has further increased mistrust through negative “awareness” campaigns that promote charities but fail to change public perception of autism ( Rosenblatt, 2018 ; Waltz, 2012 ).

A further contributing factor may be a lack of familiarity of researchers with “autism as it is lived” and “real autistic people” outside of the laboratory. This is likely to exaggerate the difficulties that non-autistic researchers have with understanding autistic people, termed “The double empathy problem,” where autistic and non-autistic people fail to understand each other due to the differences in how they experience the world ( Milton, 2012 ; Milton, Heasman and Sheppard 2018 ). Applying this to research, non-autistic people may have difficulties in understanding concerns and experiences of autistic people, leading to a lack of appreciation of what autistic people might find difficult when taking part in research or how autistic people might interpret what researchers are doing. Consequently, studies may be designed in a way that causes autistic people to misinterpret what the researcher is trying to ask them to do, and/or to complete the research study in a state of anxiety, which will impact the data collection and potentially lead to unrepresentative findings.

The aim of this work is to provide practical guidelines for researchers to consider when embarking on autism research, in order to increase involvement, collaboration and trust between researchers and the autism community. The ultimate goal is to improve the experience and participation opportunities that autistic people have throughout the research process (i.e. from idea generation, through design, implementation, analysis, publication and dissemination).

Research participation

Different types of participation have been conceptualised as a ladder of power ( Arnstein, 1969 ), ranging from non-participation (e.g. being told what to do), through tokenism (e.g. informing after the fact instead of consultation in advance) to citizen power (e.g. partnership), where planning and decision-making are shared. Citizen power is akin to “participatory research,” where researchers and members of the community being researched engage, on an equal footing, in a sustained and bi-directional manner, in collaboration and partnership. Participatory research arose in the latter twentieth century within the disabled peoples movement, and the slogan “nothing about us, without us” was particularly taken up by those with learning disabilities (Walmsley, 2004; Walmsley and Johnson, 2003 ; Walmsley, Strnadová and Johnson, 2018 ).

A more nuanced model of Arnstein’s ladder has since been suggested that emphasises co-production without always needing to aim for citizen power, using a variety of involvement methods that cater for a diverse community of “users” at different points in their life ( Tritter and McCallum, 2006 ). For example, some may seek to become involved in a two-way dialogue as partners, while others may wish to provide input through questionnaires or even not wish to become involved. It is this more flexible approach that our work more closely aligns with, enabling autistic people to become involved at the level of participation they choose so that we can strive to produce reliable, meaningful research that can positively impact autistic people’s lives.

Increasing the opportunities for involvement and participatory research is important for increasing trust between researchers and the autism community, ensuring that the research priorities of autistic people are addressed and for creating research that is accessible, implemented and has real meaning for autistic people ( Walmsley, Strnadová and Johnson, 2018 ). It also has direct benefits for the quality of research by improving design and feasibility, contextualising research in terms of real-world meaning, and ensuring epistemological and ethical integrity ( Chown et al., 2017 ; Grinker et al ., 2012 ; Milton and Bracher, 2013 ; Walmsley, Strnadová and Johnson, 2018 ; Woods and Waltz, 2019 ). Although still relatively rare, there are some examples of emerging partnerships, particularly in the UK and US that involve the autism community in priority-setting exercises. Recent examples include the projects “Making the future together: Shaping autism research through meaningful participation” ( Fletcher-Watson et al ., 2018 ); “Autism: Top 10 Research Priorities,” developed by the charity Autistica and the James Lind Alliance; the Participatory Autism Research Collective (PARC; Participatory Autism Research Collective, 2017); and the “Innovative Technologies for Autism: Critical Reflections on Digital Bubbles” seminar series ( Parsons et al ., 2019 ). The Shaping Autism Research project has produced a starter pack for participatory autism research, providing some principles for how researchers, autistic people and their allies can work together in research ( Pellicano et al ., 2017 ). In the US, the Academic Autism Spectrum Partnership in Research and Education (AASPIRE) is a more established partnership that brings the academic and autism communities together as equal partners to work on projects that are of relevance to autistic adults ( Nicolaidis et al ., 2011 ). Further examples of participatory and autism-led research can also be found in Canada ( Tesfaye et al ., 2019 ; Young et al ., 2019 ) and Sweden ( Bertilsdotter Rosqvist, 2019 ).

Research procedure and aims

Our research builds on this emerging body of work by providing succinct and practical recommendations that researchers should take into account when conducting research with the autism community, in order to foster an ethos guided more by participatory research principles. The recommendations are targeted at autism researchers, but particularly those working in behavioural, cognitive and neuroscience fields where autistic adults or children generally visit a research site (e.g. a university or hospital). Currently, research into the biology, brain and cognition of autism is the most widely-funded autism research (for example, 56% of funded studies in the UK: Pellicano, Disnmore and Carman, 2014a ), so improving the autism community’s experience of this research may go some way to alleviating the disconnect with researchers.

The guidelines are based on focus group and interview discussions with autistic adults and parents of autistic children, conducted during a series of workshops that aimed to improve mutual understanding around the research process and to explore how the academic and autism communities could better work together on research. The project was carried out as a collaboration between Autism@Manchester and Salfordautism. Salfordautism is an autism support group led and run by autistic professionals serving the autism community in the Greater Manchester area in the UK. Autism@Manchester ( Autism@Manchester, 2017 ) is a community of academics, clinicians, practitioners, autistic individuals and their families that encourages and facilitates collaboration and knowledge exchange around autism research. This collaboration enabled autistic input at all stages of the project, including funding proposal, design, recruitment, data collection, discussion of results and paper-writing.

The guidelines are organised into four sections: (1) pre-study considerations, (2) recruitment of participants (3), study visit considerations and (4) post-study considerations. These sections are structured to reflect the research pathway, to allow researchers to easily understand how to incorporate the recommendations into their research. These guidelines are aimed at autism researchers, particularly those with limited experience of working with the autism community or with participatory approaches (e.g. early career researchers, or established researchers who are entering the autism field). Within each section are recommendations that are ordered to start with the least onerous, minimum standards that might be expected of researchers, and building up towards more comprehensive models of inclusive working. The guidelines are also aimed at the autism community, to highlight ways of getting involved in research and to share expectations of best practice with researchers.

Methodology

Thirty people took part in the study, including 22 autistic adults (20 male, 2 female) and eight parents of autistic children (6 mothers, 2 fathers). Participants were recruited from the Greater Manchester area through Autism@Manchester or Salfordautism mailing lists, and as well as via a UK-based conference for autistic people. All participants gave informed consent, and the study was approved by the University of Manchester Research Ethics Committee.

Five focus groups and two interviews were facilitated by authors of the paper (EG, AG, TB, PB, DP), each lasting approximately one hour and following an identical schedule. Two people opted for interviews, as they were more comfortable with this format rather than focus groups.

Participants recruited from the Greater Manchester area all attended at the same time for one focus group session. They were randomly divided into three groups of roughly equal size (without predefined criteria) and escorted to separate quiet rooms for the focus groups. Participants recruited at the conference could choose to attend a focus group session, which were included on the conference schedule at particular timeslots. If there were too many participants for a particular session (>5), extra participants were invited to return at a later time. Two focus groups and two interviews were conducted in a quiet room.

The focus group schedule (see Box 1 ) was generated through discussion within the research team. The participants were given access to the schedule in advance of the focus group, and were informed that they were welcome to complete interviews or written responses to focus group questions if preferred. All focus group participants were able to contribute verbally, and none used visual or augmentative communication methods. A note-taker was present at each focus group, but did not contribute to the discussion.

Focus group schedule

What previous involvement have you had with research? What did you like/not like about it/would you participate again/What did you find easy/difficult? What do you think could have been done better and how?
Do you have any concerns about getting involved in research?
How would you like to get involved in the future?
What advantages are there to participating in research (thinking about the different ways you can participate as discussed in the introductory presentations)?
What do you think might put off or prevent autistic people or their families from taking part in research?
How might we make it easier for autistic people or their families to take part in research?
How would you normally expect to hear about things like opportunities to take part in research? [Internet / website, Email, Facebook, Twitter, from a friend/someone you know, Radio, TV, magazine]
What would be your preferred ways for hearing about opportunities to take part in research?
How do you think we should share the results of these workshops?

All focus groups and interviews were recorded and transcribed in full, with participants given a number to preserve their anonymity. The research team read through the transcribed documents and generated summaries and key recommendations for the four sections of the guideline. A more detailed analysis of participants’ experiences and perceptions of research will be included in a future manuscript. Here, we have drawn out practical information regarding conducting research studies.

Results: Recommendations

This guidance provides practical recommendations in four areas:

Pre-study considerations

Recruitment of participants, study visit considerations, post-study considerations.

Note that the recommendations are ordered to start with the least onerous, minimum standards that might be expected of researchers, and build up towards more comprehensive models of inclusive working.

Interviews and focus group discussions with the autism community showed that there is a strong desire for autistic people’s involvement in research to go far beyond the passive role of research participants, with the aspiration that the autism community is involved at all levels of research, from conception through to writing papers. There are also active researchers already within the autism community who could play integral parts in both planning and conducting studies, avoiding issues of tokenism.

A key component highlighted during focus groups is the need to ensure that research is not just done for the sake of research. Although participants expressed the need for basic research, its contribution towards real benefits should be kept in mind by discussing the research with the autism community. Following on from this, researchers need to make sure they clearly communicate the perceived benefit to the autism community when promoting research. Our participants also expressed fear about “secret research” – that researchers were holding information back about how the findings would be used. They wanted to have more information about who the researchers were and to understand the philosophy of the researchers before making the decision about becoming involved in the research. By involving the autism community at all stages of the research, and improving knowledge around how gaining ethical approval for studies removes the possibility of “secret research,” these fears can be minimised.

Sample quotes

“I think that it’s really important for people who have an interest in researching autism to be very clear with those that they are inviting to contribute why they have an interest. What is their personal background? What has brought them to autism research?”

“I think the idea of autistic people actually having influence on the research that was done would be an excellent one… If it’s not done that way, it can very easily fall into the trap of researchers who are not autistic, have their own reasons for being interested and they approach us and use us as sources of information to address what they believe to be important, which may not be what we think is important. People with autism are not true equal participants in the process of knowledge creation.”

Key recommendations

Reciprocity should be a key consideration within research. No research should be done that is ‘just for research’s sake,’ and all studies should have clear lines of outcomes and outputs that enhance or advance the scientific, social and physical representation of autism.
For transparency and to familiarise participants with the research team, provide introductory information such as photos, why the researchers are interested in autism research, what the perceived impact of the research will be on the autism community, and a brief biography about the key people running the research. This could be in the form of a link to a website or information in the participant information sheet.
Closely involve members of the autism community as partners in specific research projects from the beginning to end, with co-produced outputs.
Factor payment for time and expertise into research grants for consultants from the autism community that treat autistic experts by experience contributors as equal to formal academic researchers. If this is not possible, consider other ways of rewarding participants for their time (e.g. library access, honorary contracts).
Create an experts by experience panel with members of the autism community in order to have a collaborative approach to research questions and studies. This group would advise throughout the research project (from idea generation to dissemination) and meet with the researchers on a regular basis.
Lobby university ethics panels to make consultation with the autism community a pre-requisite for ethical approval of autism studies.

Participants expressed a desire to take part in research, and wanted it to be easier to find out how to get involved. They reported missing opportunities for integrating the promotion of research with services or sites used by the autism community (social media sites, autism web sites, links with GPs, the NHS and support groups), and stated that a single directory of research opportunities would be ideal.

Researchers should clearly outline to all actual and potential participants what taking part in the study will involve and why the research is taking place. They should also explicitly detail exactly what is going to happen to the participant in additional information about the study. This approach will minimise the chance of stress and anxiety induced by unexpected activities during the research.

Responses during the workshop indicated that members of the autism community value taking part in research. Participants commented that taking part in research provided them with the opportunity to discuss autism with others and visit new places, and enabled them to gain more knowledge and understanding about themselves or their children. They also appreciated financial compensation, which may be provided in return for participating. In particular, participants stressed the value of participating in research after receiving their diagnosis as a useful way to learn more about themselves and to counter post-diagnosis isolation and confusion. Indeed, researchers are well-placed to direct participants to or directly share relevant existing literature that participants may express an interest in. Researchers should take these motivations into account when developing research protocols and recruitment documents (e.g. participant information sheets, debriefing notes) so that sufficient information about the research and findings is provided during and following the visit.

“What was annoying was that they sent out a load of instructions saying what to expect on the day, which was great, but then on the day they sprang a half an hour autism assessment on me, which really bothered me. And so I made up a really psychopathic story.”

“It almost becomes a virtuous circle…because the place that diagnosed me gave me some information about the autism forum, so then I learnt about all these things (research studies) that were happening that didn’t have a website or anything like that, and my friend’s place that diagnosed them, didn’t send them something like that. So it’s difficult, because that’s how you end up with the same people involved, over and over.”

Include details of what the study will involve and why it is taking place in a participant information sheet. In addition, provide clear information, including explicit and accurate information about exactly what the participant is going to be asked to do. Consider creating an accessible version of the participant information sheet with the critical information in large print, separating blocks of text into separate paragraphs.
Use multimedia sources, such as videos and photos, which the participant can be sent alongside the participant information sheet to display exactly what the participant is going to be asked to do, and to introduce the participant to the research team (e.g. a “What to expect” document).
Where possible, ensure participants are able to receive a fair rate of financial compensation in return for taking part in studies. Make sure the participant is made aware in advance of how much they can expect to receive and how (and when) they can expect to receive it.
Ask whether the participant requires time to visit the local area, and try to accommodate this.
Consider what information can you give to participants about the research, the findings and their own personal results. Consider a regularly updated website containing background information about the project, links to further information, publications and updates on study findings.
Have an experts by experience group read through information that will be received by participants to ensure that the material is clear as possible.
Actively seek more connections with the autism community via the Internet, key stakeholder agencies, the NHS/health system and other associated organisations, such as schools, playgroups and community centres

Travel and access to buildings where research is taking place was highlighted as a major cause of anxiety for participants, both in advance and on the day of the study. Providing clear information, including pictures or videos of the route and the rooms to be used within the research, was considered good practice for autistic participants. Parents slightly differed from autistic adults on this point, suggesting that this information should only be provided when there is certainty that there will not be any changes on the day, as otherwise the changes may cause confusion and distress for their child and adversely affect the research, or even prevent participation. Autistic adults indicated that as much advance information as possible is needed to reduce anxiety associated with travel to research studies, but appreciated that some changes would be expected and are beyond the researchers’ control.

A key recommendation from focus group discussions was that a good way to avoid anxiety and reduce stress is to provide a taxi service or organise alternative transport. Having a person to meet and greet participants at the door of the building, transport station or a familiar place was also considered useful. Refreshments and a quiet area should be provided (1) on arrival to allow participants time to unwind following travelling to a venue, as autistic people often find travelling particularly stressful and (2) during the visit, as autistic participants highlight the taxing and tiring nature of some research.

Childcare and other caring responsibilities should be a part of the discussion within the project proposal, with key dates/times being avoided if possible. Provision of a crèche should be considered if possible within the dynamics of the research.

Participants discussed the difficulties associated with completing standard tests repeatedly (such as the Autistic Diagnostic Observation Schedule) when taking part in studies at different institutions. They were unclear about whether to respond as they originally had, or to change their response according to their knowledge of the test. Researchers from different groups or universities should attempt to share details of these standard tests amongst themselves (with the participants' consent). These problems may be obviated by formal documentation of original diagnostic tests being sought and available.

“Actually finding the location of the place was pretty stressful, and it was in a building that was not easily accessible with a pram. So I could have done with a bit more help to get in. There were various sections locked off as well… just basic stuff sometimes.”

“I find the more times I do an ADOS or a DISCO or whatever, I find it quite difficult sticking to what I said the original first time… because I know what would be a more autistic answer.”

Reduce the anxiety and stress of getting to the research site by planning out how participants can best get to the venue. Provide clear, up-to-date instructions (including address and postcode) and pictures/videos so that participants can familiarise themselves with the area in advance.
Discuss access to the venue with the participant, including whether there is a need to arrange someone to meet the participant at a common arrival point.
Duration and frequency of planned breaks during the research should be flexible to allow extra time for those who need it. Refreshments should be provided before and during the research, for those participants who may wish or need it.
Provide a comfortable, quiet relaxation area with subdued lighting.
Consider childcare or other caring responsibilities when planning the research, such as adding to the budget in a grant proposal to cover the costs of childminding during research participation, or making provision for conducting the research at weekends or evenings.
Incorporate provision of data-sharing into ethics applications to allow sharing of screening tests amongst researchers, in order to reduce the burden on participants.

Participants discussed the need for improved communication after research projects.

Immediately after the research has finished, ensure a full debriefing is provided, including information on what the research was about, what will happen to the findings and when they can expect to hear about the outcomes of the study. It may be beneficial to share advertisements about other research projects from the research group or other institutions that the participant may be interested in, along with information for further support, if needed. Doing this on an ongoing basis would promote general understanding of research and the subject area, and encourage future participation.

Participants expressed a desire to be able to read research findings as a way of making sense of their or their child’s condition, but were greatly concerned about the unavailability of research outcomes, such as publications or knowledge developed, to the autism community. This is due to problems in locating relevant research, accessing published papers due to pay-wall restrictions, and understanding papers that are written in unfamiliar language. Researchers should write a lay summary of their findings and disseminate this to participants. A mixed approach to delivery of findings is suggested, using posters, videos, drawings, pictures and written media. Workshop participants suggested using social media and websites relevant to autism, as well as having a discussion arena where people can engage with the findings and comment on them.

Workshop participants particularly highlighted this final point relating to the discussion of findings. Opportunities to discuss research findings with researchers provide a way of making researchers more aware of autistic ideas and interpretations. Therefore, a more reciprocal and cyclical view is recommended, in which the researchers share their findings and receive feedback that may alter interpretation of results, and develop new ideas for research that are relevant to the experiences of the autism community.

“I think the downfall from my point of view, or any participant’s point of view, is that you are not able to get feedback. Otherwise it’s ‘thank you, here’s your money—bugger off.’ It’s the fact that it might be an opportunity for the participant to actually learn something about themselves.”

“I struggle with the concept of you doing all this research and having all this knowledge and expertise and then it not being shared. So it doesn't affect policy and it doesn't filter down to the professionals who are supposed to have knowledge but half the time don't. And those are the people who we really need to benefit from this experience.”

Post-research support is as important as procedural considerations, so information should always be provided to all participants as to ‘what happens next?’ regarding the research findings. If possible, indicate when participants might expect to receive a summary of the findings.
Disseminate a lay summary of the study findings to participants. Consider disseminating to non-participating but relevant stakeholder groups, such as the National Autistic Society and autism support groups or societies.
Publish findings in open access journals. Where this is not possible, make pre-prints of the work available. Share published research with all study participants (if consent has been given).
Consider using a variety of media: videos were proposed as a particularly valuable way of communicating findings.
Use a variety of dissemination methods, such as emailing participants, directing participants to a website, using social media or, in particular, having a discussion forum.
Arrange open seminars and workshops related to the research project to enable discussion of research findings. Support for these should be included in grant applications.

This guidance covers the considerations that researchers should take into account when conducting research with the autism community. It promotes effective communication and equal partnerships between the autism and research communities, to ensure that the needs of participants pre-, during and post- study are taken into account and that they are supported through the research pathway. Key messages include the need to have participatory involvement at all stages in research, communication about the real-world impact of the research, clear information around the background of the research and what will occur during the research visit, accessible dissemination of accessible findings, and the ability to discuss research findings.

It is recommended that researchers read these guidelines alongside the Shaping Autism Research project starter pack for participatory autism research ( Pellicano et al ., 2017 ) and familiarise themselves with wider literature on the application, relevance and benefit of participatory research ( Chown et al . 2017 ; Milton, 2012 ; 2014 ; Milton and Bracher, 2013 ; Shippee et al . 2013 ; Walmsley, 2004; Walmsley, Strnadová and Johnson, 2018 ). These guidelines compliment this literature in terms of the need for early and sustained reciprocal partnership, but they additionally provide succinct and practical recommendations for putting this into place with a particular emphasis on biology, brain and cognition research.

Furthermore, there is a growing movement in the quantitative social sciences towards a more transparent model of how research is conducted, including making methods and datasets openly available, in order to produce more reliable, replicable findings (the Open Science Movement: see Mufano et al , 2017 ; Nosek et al ., 2015 ). As practices (gradually) change, this creates an opportunity to demand new standards of inclusive research in parallel. Indeed, the intended outcome of producing transparent and reliable research with real meaning for the autism community is closely aligned with the goals of Open Science. One example relates to the “replication crisis” ( Button et al . 2013 ; Ioannidis, 2005 ; Macleod et al., 2014 ) where published studies are often underpowered (small participant numbers) and consequently do not replicate. Autism research tends to involve very small participant numbers, which is a particular problem in producing reliable findings, as within-group variance in autism is high. We expect that by making the aims of research more interesting to the autism community and improving their experiences of and involvement in research, this will encourage greater trust in researchers and more participation in research studies (see also Haas et al ., 2016 ).

It is hoped that the concise, practical layout of these guidelines in a way that reflects the research pathway will enable researchers less familiar with working with autistic participants to implement many of the recommendations. Although it may not always be possible to follow all the guidelines for every project due to limited resources, there are a number of recommendations that all researchers should be able to implement, and which should be expected as a minimum requirement for autism studies.

It is also anticipated that the recommendations will be helpful for all research participants, not just those with autism. The experience of participants is an often-neglected aspect of study design, but emphasizing that researchers should reflect more on the participant’s experience during research is a simple way to reduce some of the variability inherent in human data. Indeed, some of the recommendations, such as sharing advance information (e.g. photos), fit with the Universal Design for Learning (UDL) framework ( CAST, 2011 ), which is a set of principles that aims to provide equal opportunities to learn through flexible, supportive and individual approaches.

Limitations and future directions

We would like to highlight that these guidelines are by no means exhaustive, and it is anticipated that they will be reviewed and modified, and will evolve with further discussion over time. In addition, they do not cover how to capture and incorporate the view of those less able to contribute in traditional ways, such as children or those with learning or communication disabilities. In view of the underrepresentation of autistic individuals with learning difficulties in research ( Russell et al ., 2019 ; Warner, Cooper and Cusack, 2019 ), guidelines that include this group are essential to increase participation and reduce selection bias that threatens the generalisation of research findings.

It is also important to highlight that these guidelines are based on individuals in the UK, so certain recommendations may be less applicable in other countries. We did not record demographics relating to income, education or ethnic background, but it is likely that demographics may affect interpretation and content of the guidelines. A useful next step would be to undertake a wider consultation including different demographics and nationalities.

In the current study we investigated the views of autistic adults and non-autistic parents together. Overall, the opinions expressed by both groups were closely aligned. However, it is important to note that there are diverse perspectives on neurodiversity between parents, and these perspectives can conflict with those of autistic people ( Bagatell, 2010 ; Lagan, 2011 ). It is possible that the current sample of parents was insufficient for any differences in opinion to emerge. It would be valuable to conduct focused studies exploring the views of larger groups of parents and autistic adults separately, to better understand any subtle differences in their perspectives on how autism research should be conducted (see also Kapp et al ., 2012 ).

This research indicates a number of other future directions to work towards. First, initiatives should be developed to encourage more autistic individuals to become autism researchers. Supporting autistic people to lead autism research is the best way to ensure that the direction of autism research is focused on autistic people’s priorities. The UK charity Autistica has moved in this direction with the introduction of the Charles Sharland scheme, which funds autistic individuals to carry out their own research project in an autism research lab. Additionally, universities need to provide a supportive environment for autistic people ( Lei et al. 2018 ), and there needs to be links between university autism researchers and younger autistic individuals who are considering their career options. A related consideration is that researchers could look to create work experience opportunities for autistic people, even those who are not necessarily considering a career in autism research. Underemployment of autistic people is a major concern ( National Autistic Society, 2016 ) and there are many opportunities for generic skills development when working in a research setting, which would bolster a person’s CV and may increase their prospects of finding more permanent work. In addition, having a variety of autistic people working in a research team and involved in discussions around research is likely to have a positive impact on the way that non-autistic researchers understand autism and approach research. At Autism@Manchester, we have paired up with the Disability and Advisory Support Service and the Careers Service at the University of Manchester to create a short internship for autistic university students to work in an autism research lab.

Second, universities need to work together. Achieving certain standards of practice in working and relating to the autism community is important, as participants can be put off research generally following bad experiences in a particular study. Greater collaboration in recruitment and data-sharing is needed to produce more reliable research findings.

Third, lobbying ethics boards to require participatory approaches before studies can be approved would incorporate participatory standards into university governance.

Fourth, and most importantly, researchers should ensure that adequate resources are factored into grants to pay for participatory research practices (e.g. consultancy of the autism community, experts by experience advisory groups). Many funders require realistic impact statements, and by incorporating participatory methods into their projects, researchers may be able to influence funder attitudes to supporting participatory research ( Fletcher-Watson et al ., 2018 ).

Currently, biological, cognitive and behavioural research are the most widely funded areas of autism research. We have provided practical guidelines for researchers who conduct studies in which autistic people and their families may be asked to go to a research site. We hope that by implementing transparent and participatory approaches to their work, researchers can reduce some of the dissatisfaction that members of the autism community feel towards research, leading to greater participation of autistic people, and higher quality research in terms of design, and ethical and epistemological integrity.

Acknowledgements

We would like to thank the workshop participants for their time and input towards the project.

The project was funded by a Wellcome Trust Institutional Support Fund award (reference no. 105610). Thomas Bleazard was supported by a Medical Research Council Doctoral Training Partnership award.

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Open access
Published: 02 March 2023

Comprehensive ABA-based interventions in the treatment of children with autism spectrum disorder – a meta-analysis

Theresa Eckes 1 ,
Ulrike Buhlmann 1 ,
Heinz-Dieter Holling 1 &
Anne Möllmann 1 , 2

BMC Psychiatry volume 23 , Article number: 133 ( 2023 ) Cite this article

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Many studies display promising results for interventions that are based on Applied Behavior Analysis (ABA) in the treatment of autism spectrum disorder (ASD). Methods: This meta-analysis assessed the effects of such treatments on developmental outcomes in children with ASD and on parental stress based on 11 studies with 632 participants. Results: Compared to treatment as usual, minimal or no treatment, comprehensive ABA-based interventions showed medium effects for intellectual functioning (standardized mean difference SMD = 0.51, 95% CI [0.09; 0.92]) and adaptive behavior (SMD = 0.37, 95% CI [0.03; 0.70]). Language abilities, symptom severity or parental stress did not improve beyond the improvement in control groups. Moderator analyses indicate that language abilities at intake could influence the effect sizes and the influence of treatment intensity might decrease with older age. Conclusions: Practical implications and limitations are discussed.

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by (a) difficulties in social communication and interaction across multiple contexts and (b) restricted, repetitive behavior, activities, and interests. It is often associated with intellectual impairment, language impairment, and motor deficits, such as odd gait or clumsiness [ 1 ]. According to the clinical criteria of ASD laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; [ 1 ]), the prevalence of ASD is approximately 1.0% and people on the autistic spectrum need intensive, sometimes life-long care and support [ 2 ].

Behavioral interventions for ASD target the increase of functional independence of individuals on the autistic spectrum. They are firmly linked to Applied Behavior Analysis (ABA) [ 2 , 3 ]. ABA is the science of analyzing how the individual’s environment influences their behavior [ 4 ] and describes interventions applying the findings of such analyses to change behavior [ 5 , 6 ]. It is theoretically based on operant conditioning and aims to assess and change challenging behavior as well as to promote and generalize more adaptive behavior, for example, by using systematic reinforcement [ 5 ]. While ABA-based methods can be used to target specific behaviors (e.g,. toilet training), comprehensive ABA-based interventions are characterized by (a) beginning in early childhood, when possible between 3 to 4 years of age; (b) having a high intensity (20 – 40 h/week); (c) being personalized to meet the individual needs of each child; (d) addressing several skills at the same time instead of promoting just one specific skill (e.g., joint attention); and (e) using multiple behavior analytic methods. Additionally, comprehensive ABA-based interventions (f) use a one-to-one format that is gradually supplemented with group activities and transferred to naturalistic contexts, and (g) require parental participation ([ 7 ] as cited in [ 8 ]). Well-known examples for comprehensive ABA-based interventions are Early Intensive Behavioral Interventions (EIBI) [ 4 ], which make up the majority of the studies considered in the present study. However, since some comprehensive, intensive ABA-based methods are not called EIBI, for instance the Verbal Behavior approach (ABA-VB, for a detailed description see [ 9 ]), we will use the term comprehensive ABA-based interventions rather than EIBI in our study. While treatment goals in behavioral interventions are most often in line with typical sequences of development (e.g., the promotion of more adaptive behavior), another group of interventions is explicitly designed on applying behavioral methods (e.g., methods based on ABA) and developmentally-based strategies in naturalistic settings, deriving individual learning objectives from developmental sequences [ 10 ]. Those interventions are called Naturalistic Developmental Behavioral Interventions (NDBI) [ 10 ]. A prominent example for NDBI is the Early Start Denver Model (ESDM). This group of treatment interventions shows good evidence of efficacy in recent meta-analyses [ 11 , 12 ]. Because of conceptual differences, NBDIs are not included in the present meta-analysis.

Comprehensive ABA-based interventions are widely used in North America in the treatment of ASD. In Europe, however, comprehensive ABA-based programs are rarely applied [ 13 ], among other things due to the claim that they are not evidence-based [ 2 ]. This claim is rooted in the fact that many studies that investigate comprehensive ABA-based therapies are of poor methodological quality [ 2 , 14 ]. As Reichow and colleagues [ 14 ] showed in their meta-analysis, many studies investigating the effects of EIBI in autistic children have small samples, a non-optimal design and a high risk of bias according to the GRADE system. Additionally, other reasons like financial or cultural obstacles when implementing comprehensive ABA-based treatments are discussed [ 13 ]. It should not be neglected that some aspects (e.g., the intensive use of reinforcement) of comprehensive ABA-based treatments raised ethical concerns about this approach [ 13 , 15 ]. However, comprehensive ABA-based interventions, like EIBI, provide a substantiated theoretical basis.

Nine meta-analyses on the effects of comprehensive ABA-based interventions on intellectual functioning, adaptive behavior (e.g., communication skills and socialization) and language abilities were published between 2009 and 2018 [ 8 , 16 – 23 ]. Eight meta-analyses found comprehensive ABA-based interventions to be more effective in the treatment of children with ASD than standard care [ 8 , 16 , 1 , 18 – 22 ]. Solely Spreckley and Boyd [ 22 ] concluded that the interventions are not superior to standard care.

The meta-analyses have some methodological problems, such as a risk for biased effect sizes, the inclusion of studies without an appropriate control group or the use of fixed-effect models. Specifically, the use of uncontrolled pre-post-comparisons to calculate an effect size (as used in [ 8 , 17 , 18 , 21 ]) is susceptible for threats of validity and may lead to overestimation of the effect size [ 16 ]. Effect sizes can also be biased, if they are not standardized (as seen in [ 21 ]). The use of fixed-effect models while including studies with more than one control group (e.g., [ 24 ]) is problematic because these models do not control for the dependence of effect sizes (as seen in [ 16 ]). Finally, an underestimation of effect sizes can occur from primary studies that compare two intensive ABA-based treatments, like the study from Sallows and Graupner [ 25 ] or the study by Smith, Groen and Wynn [ 26 ] (as seen in [ 14 , 19 , 22 ]). Considering the limitations of previous meta-analyses, applying a more rigorous meta-analytic methodology appears warranted.

Adding to this, the methodological quality of many primary studies investigating interventions for autistic children is low [ 14 , 27 ]. This could result in inflated effect sizes and, thus, bias the meta-analytic conclusions drawn from those studies. Some (e.g., [ 14 , 19 , 27 ]) but not all previous meta-analyses have considered the risk of bias of primary studies in order to assess the certainty of the results. However, this procedure is essential when conducting a meta-analysis in a research field with many primary studies that are limited in their methodological quality.

Further, several studies (primary studies and meta-analyses) have pointed towards potential factors, that might moderate the impact of comprehensive ABA-based treatments on developmental outcomes. Potential moderators are especially relevant for the improvement and personalization of treatment methods. Possible moderators are higher intellectual functioning (e.g., [ 28 ]), higher language abilities [ 27 ], more adaptive behavior, and less severe psychopathology at intake [ 28 , 29 , 30 , 31 ]. Some studies discuss age as a potential moderator of the effectiveness of comprehensive ABA-based interventions (e.g., [ 27 , 29 , 30 , 31 , 32 ]). Furthermore, treatment intensity and duration, cumulative intervention intensity as well as parental training and participation (as therapists) could impact the outcome [ 17 , 20 , 27 , 31 , 32 , 33 , 34 ]. A recent meta-analysis on the effects of early interventions on social communication in autistic children [ 35 ] showed that interventions with parental participation had slightly smaller effect sizes than interventions provided by clinicians only. This result contrasts earlier results [ 36 ] in which interventions provided by parents and clinicians seemed to improve the effect of treatment compared to parent-only or clinician-only interventions. Further, there is evidence that maternal involvement in comprehensive ABA-based treatments is connected to mothers’ personal strain [ 37 ]. That is, the necessity of parental participation is unclear and might be associated with negative consequences for the parents. Overall, findings from meta-analyses [ 8 , 17 , 20 ] as well as findings in primary literature regarding potential moderators are heterogeneous and thus rather inconclusive. For example, Makrygianni and Reed [ 18 ] showed that treatment intensity is correlated with treatment gains in intellectual functioning and adaptive behavior, whereas Reichow and Wolery [ 20 ] did not find evidence for any impact of treatment intensity or duration.

In the current meta-analysis, we first aim to replicate findings of previous studies regarding impacts of comprehensive ABA-based interventions on adaptive behavior, intellectual functioning, language abilities, and symptom severity, applying a more rigorous methodology. Based on the results of preceding meta-analyses, we assume that comprehensive ABA-based (vs. control group) interventions improve adaptive behavior, intellectual functioning, language abilities (expression and comprehension), and symptom severity.

Second, we aim to investigate possible moderators of treatment outcomes. We hypothesize that comprehensive ABA-based interventions are more effective for younger children (e.g., [ 32 ]), with fewer impairments in adaptive behavior (e.g., [ 28 ]), intellectual functioning (e.g., [ 28 ]), language abilities (e.g., [ 31 ]), and with lower symptom severity (e.g., [ 30 ]) at intake. Additionally, we assume that parental participation (e.g., [ 36 ]), longer treatment duration (e.g., [ 34 ]), higher treatment intensity (e.g., [ 17 ]), and higher cumulative intervention intensity (e.g., [ 32 ]) increase the effectiveness of comprehensive ABA-based interventions. Finally, we hypothesize that the impact of treatment duration and (cumulative) intensity is higher in younger children (based on the findings of [ 32 ]).

Third, we aim to investigate whether this kind of intervention has an impact on parental stress. Parents of children with ASD experience greater stress than parents of typically developing children or children with other disabilities [ 38 ]. Thus, we hypothesize that comprehensive ABA-based interventions might reduce parental stress by reducing children’s symptom severity. But, as mentioned above, involvement in comprehensive ABA-based interventions can decrease parental well-being [ 37 ]. Accordingly, parental stress might be increased due to the high demands of comprehensive ABA-based interventions (for example, delivering treatment to the child in “almost all of the subjects' waking hours, 365 days a year” [ 39 ]).

Eligibility criteria

Studies included in this meta-analysis had to meet the following criteria: 1) ASD was diagnosed according to the International Statistical Classification of Diseases and Related Health Problems (ICD 10) or DSM IV criteria; 2) studies provided a control group (i.e. randomized controlled trials (RCTs), quasi-randomized trials and controlled clinical trials); 3) treatment groups had at least five participants; 4) at least one group had to receive a comprehensive ABA-based intervention, as defined previously, for more than 10 h per week Footnote 1 ; 5) control groups received treatment as usual (TAU) or an alternative active intervention (no comprehensive ABA-based intervention with more than 10 h of treatment per week); 6) at least one child-related outcome (adaptive behavior, intellectual functioning, language abilities or symptom severity) was reported; 7) mean and standard deviation for each outcome were reported, computable or provided by the authors of the study; 8) the study was published in English or German in a peer-reviewed journal or as part of a doctoral dissertation. We did not include retrospective or epidemiological studies, merely qualitative studies or studies without standardized outcome measures. Additionally, although many studies in the field of comprehensive ABA-based interventions for autistic children are single case experimental studies [e.g., 12], we decided to only include studies with a controlled design in order to reduce heterogeneity of included studies and, thus, promoting the validity of the integrated results.

Search methods for identification of studies

We conducted a literature search in the databases Medline, Psyndex, PsycInfo, and PsycArticles from January 1 2018 until March 6 2018 and updated this search from March 5 2020 until March 9 2020. Additionally, we searched Google Scholar and considered relevant studies from reference lists of preceding meta-analyses [ 8 , 15 – 22 ]. We did not restrict study obtainment by publishing date. We used following search terms (English and German equivalents): ASD , autism , or autism spectrum disorder AND EIBI , ABA , early intensive behavio(u)r intervention , applied behavio(u)r analysis , comprehensive ABA , early intensive behavio(u)r treatment , UCLA-model , Lovaas , intensive or behavio(u)r training . Our search term also included Early Start Denver Model and pivotal response training to broaden the results of our literature search. However, studies that only focused on those (NDBI) interventions were not included in our analysis. The full search strategy is listed in the supplementary material A.

Data collection and quality assessment

Title and abstract of all distinct reports were screened, and all potentially applicable studies were coded. A second independent rater assessed and coded nine (12%) of the 75 potentially applicable studies. The inter-rater agreement for eligibility was low (Cohen’s κ = 0.4), so discrepancies were discussed among the authors and studies in question were reassessed. Additionally, eight more studies were assessed by the second rater, so that in total 22% of studies were rated by two independent raters. After discussion, reassessment and additional coding, inter-rater agreement for study eligibility reached Cohen’s κ = 1.0. Both raters used a data collecting form (supplementary material A). We calculated inter-rater agreement before and after the discussion for all relevant outcomes and moderators (see supplementary material B). Please note, that the moderators were only rated after discussion and reassessment.

To assess risk of bias for each study, we used the “Cochrane Collaboration’s tool for assessing risk of bias” [ 23 ]. A brief description of this tool can be seen in supplementary material C.

Statistical analyses

We calculated standardized mean differences (SMDs) between groups as effect size for each outcome as recommended by Viechtbauer [ 40 ] for continuous data and measures with different scales and corrected SMDs for bias resulting from small sample sizes [ 41 ]. As recommended by the Cochrane handbook of systematic reviews [ 23 ], we used post-treatment comparisons in the effect size calculation. Table 1 provides a summary of formulas used in this meta-analysis.

In studies with multiple intervention groups, we included the comparison between the two most relevant intervention groups only to prevent an uneven weighting of the sample used in those comparisons. We investigated heterogeneity of the included studies by computing Q statistics, assessing variation of the true effect sizes between studies through ${\upsigma }_{B}^{2}$ , and calculating I 2 . We evaluated the risk for publication bias by a visual inspection and a test of funnel plot asymmetry, according to Egger and colleagues [ 42 ]. We conducted this test only for outcomes with more than 10 effect sizes and with univariate models, as recommended by Sterne and colleagues [ 43 ].

We calculated a random effects model because we assumed varying true effect sizes due to differences between specific treatments. To address the fact that most outcomes were measured in different dimensions, we used a multilevel meta-analysis model. We computed this meta-analysis using the R-package “metafor” (package version: 1.9–4, R-studio version: 1.1.447) [ 40 , 44 ].

We conducted moderator analyses with children’s age and abilities (intellectual functioning, adaptive behavior, language before treatment), treatment intensity, and duration. Further, we computed an additional variable called cumulative intervention intensity (hours/week × 4,33 × duration in months). Because the number of studies reporting symptom severity at intake was too low and treatment was delivered by parents and therapists in all studies, we had to drop the moderators symptom severity and parental participation from the analyses.

Study and sample characteristics

Fourteen studies from the initial literature search met the eligibility criteria. Two of those studies were excluded because they assessed follow-up samples of other included studies [ 45 , 46 ]. Thereby we avoided including the same sample multiple times. Furthermore, we were not able to obtain the pre-treatment measurement for one study [ 47 ]. The update of the literature search in 2020 did not reveal additional eligible studies. Thus, we included 11 studies with 632 participants in our meta-analysis. Figure 1 illustrates the study selection process.

Flow chart of study obtainment process

Most included studies were clinical controlled trials with a quasi-experimental design. Only the study from Shawler [ 48 ] was a RCT. As Table 2 shows, eight out of 11 studies, compared comprehensive ABA based treatments to treatment as usual (TAU). Specifically, TAU contained eclectic treatment strategies combining a variety of interventions mostly from Treatment and Education of Autistic and Related Communication Handicapped Children principles (TEACCH principles, [ 58 ]), Picture Exchange Communication System (PECS, [ 59 ]), ABA-based interventions, Makaton [ 60 ], and speech and occupational therapies. No study provided a quantification of the extent to which each intervention was applied. One study [ 24 ] included two control groups. We only considered one control group, specifically the eclectic educational program, which was more similar to the TAU control groups.

One study compared an ABA-based treatment to another active treatment [ 53 ]. However, other than the studies by Sallows and Graupner [ 25 ] and Smith and colleagues [ 26 ], this study did not use intensive, comprehensive ABA-based treatment in the control group, but instead used low-intensity, targeted ABA-based training. Finally, one study used a waitlist control design. On average, comprehensive ABA-based interventions had an intensity of 21.84 h per week ( SD = 5.90, ranging from 13.6 to 32.4 h/week) and the control group treatments 17.19 h per week ( SD = 10.83, ranging from 0 to 29.8 h/week). For a detailed study and participant description see Table 2 .

Outcome measures

The outcomes were assessed with many different measures (see supplementary material D for a complete list of all instruments). The most frequently used instruments will be described in the following. Adaptive behavior was mostly measured with the Vineland Adaptive Behavior Scale (VABS I or II) [ 61 , 62 ] on the four scales communication, socialization, daily living, and motor skills. To assess intellectual functioning, most studies administered the Mullen Scales of Early Learning (MSEL) [ 63 ], the Bayley Scales of Infant Development (BSID) [ 64 , 65 ], the Stanford-Binet Intelligence Scale: Fourth Edition (SB:FE) [ 66 ], the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) [ 67 ], or the Wechsler Intelligence Scale for Children (WISC-R, WISC-III) [ 68 , 69 ] . The MSEL and BSID mainly examine motor skills, language, and behavioral abilities, the WPPSI-R, SB:FE, and WISC-R rather assess verbal comprehension, reasoning, knowledge, and memory. The Reynell Developmental Language Scale (RDLS, RDLS III) [ 70 , 71 ] was used to measure language comprehension and expression in most studies. Symptom severity was assessed by the Autism Diagnostic Observation Schedule (ADOS) [ 72 ], the Autism Diagnostic Interview – Revised (ADI-R) [ 73 ], or the Autism Screening Questionnaire (ASQ) [ 74 ]. ADOS is based on ratings of an assessor, ADI-R is a structured parent interview and the ASQ is a questionnaire for parents. Parental stress was measured with the self-report questionnaires Parenting Stress Index (PSI) [ 75 ] and the Parent and Family Problems subscale of the Questionnaire on Resources and Stress–Friedrich short form (QRS-F) [ 76 ]. Studies that applied more than one measure for a construct, provided a mean value for that construct across all instruments (e.g., on the IQ scale), which was used for the effect size calculation.

Risk of bias

Table 3 displays an overview of risk of bias in each study.

Selection bias (sequence generation and allocation sequence concealment)

One included study used a randomized procedure to assign participants to groups [ 48 ]. All other studies used quasi-experimental designs and thus had a higher risk of selection bias. However, Shawler [ 48 ] did not provide enough information about the randomization process and allocation concealment, so the real risk of selection bias remains unclear for this study.

Performance and detection bias (Masking of participants and personnel/ outcome assessment)

Participants (and their parents) as well as personnel were not masked in any study. Outcome assessors were truly masked in one study [ 49 ]. In one study [ 51 ], only 60% of cases were evaluated by a masked assessor but they controlled for the other 40% and found no evidence of bias. Thus, we labeled this study with a low risk of detection bias.

Attrition bias (incomplete data)

The risk of incomplete data and therefore of attrition bias was low in four studies [ 48 , 49 , 54 , 55 ]. Four studies did not report how many participants were reassessed after the intervention. Therefore, risk of bias is unclear [ 51 , 52 , 56 , 57 ]. High risk for attrition bias emerges from four studies. In one study [ 50 ], data for the post-treatment-measurement was available for only 25% (adaptive behavior) or 22% (symptom severity) of children. Fernell and colleagues [ 53 ] reported that 10 out of 208 children were not assessed after the intervention. Several other children participated only in some of the required outcome measurements. Neither reasons for this lack of participation nor the amount of withdrawals for each group were stated. In the study of Howard and colleagues [ 24 ], 22% of participants (17 out of 78) dropped out for unknown reasons. Additionally, some of the remaining children did not complete all outcome measurements.

Reporting bias (selective reporting)

We did not find selective reporting in most studies. Eikeseth and colleagues [ 50 ] reported symptom severity for the treatment group only and did not conduct a between-group comparison for this outcome. Therefore, this study might be affected by reporting bias.

Other risks of bias

Six studies reported that the control group received or might have received some treatment based on ABA-techniques [ 24 , 49 – 53 ]. Furthermore, intervention groups differed substantially at baseline in five studies [ 24 , 49 , 53 , 54 , 56 ]. In studies by Fernell and colleagues [ 53 ], Howard and colleagues [ 24 ], and Remington and colleagues [ 56 ], children in the treatment group were significantly younger than children in the control group. Magiati and colleagues [ 24 , 54 ] reported that children in treatment group scored higher in intellectual functioning (83 vs. 62.5 [IQ scale], p = 0.04), in the composite score of adaptive behavior (60.3 vs. 56.6 [standard score], p = 0.05) and in the socialization subscale of adaptive behavior (59.6 vs. 55.4 [standard score], p = 0.04) at intake.

Effects of intervention

Adaptive behavior.

For this analysis, we included 28 comparisons from nine studies with 547 participants at pre-treatment measurement. Figure 2 illustrates evidence that comprehensive ABA-based treatments improve adaptive behavior more strongly compared to TAU, minimal or no treatment (SMD = 0.37, 95% confidence interval (CI) [0.03; 0.70]). We found substantial variance between studies ( ${\upsigma }_{B}^{2}$ = 0.24) but no variance within the studies ( ${\upsigma }_{W}^{2}$ = 0.00). The tests for heterogeneity indicated substantial heterogeneity ( Q ( df = 27) = 106.18, p < 0.001; I 2 = 72.95). Statistical testing ( z = 3.36, p < 0.001) and funnel plot inspection (Fig. 7 ) indicated a publication bias.

Forrest plot of pooled SMD in post-treatment scores in adaptive behavior

Intellectual functioning

Eight studies assessed intellectual functioning ( N = 293 at pre-treatment assessment). As displayed in Fig. 3 , participants in treatment groups show significantly more improvement in intellectual functioning than participants in control groups ( SMD = 0.51, 95% CI [0.09, 0.92]). There is considerable variance between studies ( ${\upsigma }_{B}^{2}$ = 0.22). The Q statistic, Q (7) = 17.87, p = 0.013; I 2 = 63.59%, indicates heterogeneity between studies. Visual inspection of a funnel plot does not lead to the assumption of publication bias (Fig. 7 ).

Forrest plot of pooled SMD in post-treatment scores in intellectual functioning

Language abilities

We did not find a significant difference in post-treatment scores between treatment and control group regarding language abilities ( SMD = 0.30, 95% CI [-0.13; 0.72]; Fig. 4 ). We included five studies from which we calculated nine effect sizes ( N = 210 at pre-treatment assessment). Analyses show no variance between the dimensions of language abilities (expression and comprehension; ${\upsigma }_{W}^{2}$ = 0.00). Again, there is substantial variance between studies ( ${\upsigma }_{B}^{2}$ = 0.17) as well as substantial heterogeneity Q (8) = 16.81, p = 0.03; I 2 = 61.94%. Visual inspection of the funnel plot indicates no funnel plot asymmetry (see Fig. 7 ).

Forrest plot of pooled SMD in post-treatment scores in language abilities

Symptom severity

There is no strong evidence for lower levels of symptom severity in children receiving comprehensive ABA-based treatments compared to children in other treatment conditions after intervention ( SMD = -0.26, 95% CI [-0.60, 0.07]; see Fig. 5 ). This analysis is based on four comparisons from three different studies with 107 participants at pre-treatment assessment. There is neither variance between dimensions (mother’s and father’s rating of child’s symptoms; ${\upsigma }_{B}^{2}$ = 0.00) nor between studies ( ${\upsigma }_{B}^{2}$ = 0.00). Based on the Q statistic, we assume no substantial heterogeneity, Q (3) = 2.39, p = 0.50; I 2 = 0.00%. We found no evidence for funnel plot asymmetry (see Fig. 7 ), but the low number of studies limits a proper interpretation of the funnel plot.

Forrest plot of pooled SMD in post-treatment scores in symptom severity

Parental stress

For this analysis, five comparisons from three studies with 128 participants at pre-treatment assessment were included. As Fig. 6 displays, there is no evidence for a substantial difference in stress ratings between parents in each intervention condition ( SMD = 0.38, 95% CI [-0.26, 1.01]).

Forrest plot of pooled SMD in post-treatment scores in parental stress

There is no variance between dimensions of the construct (mother’s and father’s stress rating; ${\upsigma }_{W}^{2}$ = 0.00) but substantial variance between studies ( ${\upsigma }_{B}^{2}$ = 0.19). The Q statistic indicates no heterogeneity, Q (4) = 5.23, p = 0.26. The calculation of I 2 resulted in I 2 = 52.24%. The funnel plot does not hint toward publication bias (see Fig. 7 ). Again, validity of this plot is limited, because of the low number of included studies.

Funnel plots used for publication bias assessment

Moderator analyses

Table 4 shows the results of moderator analyses. Due to the small number of eligible studies, we were not able to conduct all planned moderator analyses. We found a significant influence of language abilities (comprehension) at intake on the effect size in intellectual functioning and adaptive behavior. Further, the moderator analyses indicate that abilities of language expression at intake influence the effect size in intellectual functioning and language abilities. Additionally, we inspected possible interactions between treatment duration, intensity as well as total amount of time spent in comprehensive ABA-based interventions and age. Evaluating tests of moderators on the basis of Q statistics indicate an interaction between age and treatment intensity for adaptive behavior, which indicates that the influence of treatment intensity on post-treatment adaptive behavior decreases with older age ( β = - 0.01, [-0.01, -0.00], Q M (3) = 74.45, p < 0.001). The validity of all described examinations is restricted due to the small number of eligible studies. Therefore, results should have no more than an indicative value.

Table 5 displays that some variables considered as moderators are highly correlated. Therefore, it would be necessary to conduct moderator analyses controlling for the influence of other potential moderators. The low number of included studies prevents such analyses. Still, the high correlations have to be kept in mind when drawing conclusions from those moderator analyses.

The current meta-analysis investigated the effect of comprehensive, intensive interventions based on Applied Behavior Analysis (ABA) for ASD versus treatment as usual (TAU), minimal or no treatment on adaptive behavior, intellectual functioning, language abilities, symptom severity, and parental stress. Additionally, the current meta-analysis focused on the potential moderating influence of treatment and demographic characteristics while updating previous meta-analyses and overcoming their methodological limitations. Most studies (with the exception of Shawler [ 48 ] and Molnár and Eldevik [ 55 ]) included in our meta-analysis were also included in previous meta-analysis, however, no meta-analysis focused on all eleven studies. Our meta-analysis revealed that most studies that were eligible to be included in this review were of low methodological quality. Therefore, the results of our meta-analysis might be affected by the high risk of bias in the included studies. We discuss this issue in greater detail in the limitations section of our discussion.

The results based on post-treatment comparison effect sizes reveal that comprehensive ABA-based interventions (compared to TAU, minimal or no treatment) have a medium effect on intellectual functioning (8 effect sizes) and small effect on adaptive behavior (28 effect sizes), according to Cohen’s conventions [ 77 ]. Thus, children who receive comprehensive ABA-based treatments tend to show stronger improvements in intellectual functioning and adaptive behavior than children receiving TAU, minimal or no treatment, which is in line with previous meta-analyses (e.g., [ 8 , 12 , 14 ]). Our results did not indicate differences between treatment and control group in post-treatment scores for language abilities, symptom severity or parental stress. The current analyses revealed overall smaller effect sizes than most previous meta-analyses (e.g., [ 8 , 16 – 18 ]). This is most probable caused by the more conservative inclusion criteria. In contrast, Sandbank et al. [ 12 ] reported a smaller effect size (estimated summary effects) for behavioral interventions on intellectual functioning (effect size = 0.29* vs. 0.51*, study N = 21 vs. 9) and a similar effect size for adaptive behavior (effect size = 0.38* vs. 0.37*, study N = 21 vs. 9). However, in their comprehensive study on seven different types of early interventions for ASD, they applied a broader definition of behavioral interventions and assigned more studies to this intervention type, accordingly (besides EIBI, the Lovaas Model, and Verbal Behavior also studies on PECS, Discrete Trial Training, and Autism Partnership). Opposed to Virués-Ortega [ 8 ] and Reichow and Wolery [ 20 ], we found no evidence for publication bias for intellectual functioning and language abilities. However, our analyses indicated publication bias for adaptive behavior.

Five studies were included to investigate the effects on symptom severity and parental stress. The analyses also did not reveal effects of comprehensive ABA-based treatments versus control group treatments indicating that none of the treatments are superior to each other in reducing symptom severity and parental stress. The lack of evidence for a reduction in symptom severity due to comprehensive ABA-based interventions beyond the effect of other treatments found in this study is in line with findings in the updated review of Reichow and colleagues [ 14 ] but different from Sandbank et al.’s [ 12 ] findings, who reported an effect size of 0.45 [0.26; 0.68].

To our knowledge, no other meta-analysis besides our own has calculated an effect size for parental stress yet. Even though Schwichtenberg and Poehlmann [ 37 ] found that parental involvement in comprehensive ABA-based interventions increased maternal strain, we did not find evidence for impact of comprehensive ABA-based interventions on parental stress beyond the impact of treatment as usual, no or minimum treatment. However, because of the small number of studies included in these analyses a negative or non-detected positive effect for parental stress and symptom severity has to be considered. Therefore, a definite conclusion would be premature.

As outlined above, previous research regarding moderating variables in comprehensive ABA-based treatments is inconsistent. Because of several aspects discussed in the limitation section, results of moderator analyses in this study have to be interpreted with caution. The current moderator analyses indicated that higher language abilities at intake are beneficial for gains in intellectual functioning and adaptive behavior. This finding supports findings of previous primary studies (e.g., [ 31 ]) and meta-analyses (e.g., [ 27 ]). The interaction between age and treatment intensity for adaptive behavior indicates a decreasing influence of treatment intensity on adaptive behavior with older age. A replication of our results is needed, before sound conclusions can be drawn. However, if the finding on a decreased influence of treatment intensity on adaptive behavior with older age replicated, this might inform decisions on treatment indications.

Limitations

Primary studies are the basis of every meta-analysis. The studies included in the present meta-analysis investigated children with a mean age between 2.2 and 5.5 years at intake, mostly without comorbidities and mostly from western countries, limiting generalization of results to these demographic characteristics. Another source of bias could be parents’ acceptance of treatment, since group assignment was based on parental preference in most studies. Besides limitations regarding participant characteristics, included primary studies and, thus, this meta-analysis are limited by a very low quality of evidence determined with the approach from Higgins and Green [ 23 ]. Concerns regarding the influence of selection and performance biases are raised by the facts that no study reported an adequate randomization procedure, allocation was not concealed, and personnel and participants were not masked. However, not masking personnel and participants is a limitation that can hardly be overcome in future studies, since it is incompatible with training parents and personnel to apply intensive ABA-based treatments. Another source of bias lies within the control groups, which are only vaguely defined and varied a lot in their intensity ( M = 17.19 h/week, SD = 10.83). Thus, they are hardly comparable and prone to contamination. For instance, if TAU groups applied ABA-based methods to a large extent (e.g., 9 h per week) without reporting this clearly, the effect size for comprehensive, intensive ABA-based interventions could be underestimated. Future studies should precisely report which interventions were delivered to which extent. Several studies reported baseline imbalances between groups, which indicates possible confounding variables. Furthermore, some outcome measures, for example VABS or ASQ, are based on parental reporting. These reports might be biased since group assignment was based on parental preference. The low quality of evidence appears to be a common problem within the research on treatment for autistic children (see [ 14 ] and [ 12 ]). This limits the informative value of meta-analyses in this field. Therefore, Sandbank and colleagues [ 12 ] recommend several approaches that could help to increase the methodological quality of studies with autistic children. For example, they recommend that outcomes are assessed by trained assessors and not parents or teachers. We support the statement of Sandbank and colleagues that researchers should continue to strive to conduct high-quality studies. Another starting point to improve methodological quality, is the assessment of intellectual functioning (a core developmental outcome). Most studies used instruments measuring IQ with verbal tasks [ 78 ]. Therefore, better scoring in those instruments might also reflect improved language abilities. Additionally, several studies used more than one instrument and calculated average IQ scores over all instruments. This would only be legitimate, if all used instruments measured the exact same construct — an assumption none of the studies validated. It can be difficult to find one instrument that is valid for all study participants, as they vary regarding age and intellectual impairment. However, we suggest that future studies may use as few instruments as possible to ensure comparability between participants. Finally, it has to be considered, that young autistic children often underperform in tests on intellectual functioning, for example, due to motivational reasons. Another limitation is, that some relevant studies could not be included because required data were not reported and could not be obtained by the authors.

An important limitation of our study is the effect size selection. As described above, it is recommended by the Cochrane Handbook [ 23 ] to use post-treatment comparisons, if standard deviations for change scores are not reported in primary studies. However, it is also stated that this procedure should be unproblematic for randomized trials. It should be noted, that effect sizes based on post-treatment comparisons could be biased due to baseline differences in treatment and control group if most primary studies applied a quasi-experimental design. The results of the moderator analyses may be interpreted as preliminary, as the number of primary studies including these moderators was low. Especially symptom severity at intake was assessed rarely and with different measures in primary studies. Most measures were not originally designed to quantify symptom severity, even though higher scores in ADI-R and ADOS indicate more deficits [ 74 , 79 ]. The guidelines for the diagnostics of ASD from the Association of the Scientific Medical Societies (AMWF) recommend to use the ADI-R and the ADOS in order to support the diagnostic process in children with ASD (for the detailed recommendation see [ 80 ]). If future studies endorse this recommendation, they should report the results of those assessments. Nevertheless, the development of a reliable instrument for the assessment of symptom severity in children with ASD would be preferable. Furthermore, the number of studies including parental stress was too low to conduct moderator analyses. To sum up, results from our moderator analyses, especially the examination of interactions between moderators, are merely indicative at the time being and have to be replicated. Additionally, further and more complex analyses have to be conducted, for example to account for the correlation between investigated variables. Therefore, we conclude that moderators and their interactions cannot be investigated properly until more studies contribute to the analysis.

This study excluded single case experimental design studies, even though they are commonly administered in the research on treatments for autistic children (e.g., [ 12 ]). However, while we think that single case designs are important, since there is a large heterogeneity in autistic individuals, which is better addressed in single case studies, we also agree with Sandbank and colleagues [ 12 ], that studies with a controlled design are needed to explore the generalizability of the effects of comprehensive ABA-based interventions. Next to the concerns expressed in Sandbank et al. [ 12 ], we believe that the inclusion of single case studies in our meta-analysis would have added to the already high heterogeneity in studies included in our meta-analysis, thus further limiting the conclusiveness of our results.

Importantly, besides the understanding of ASD as a neurodevelopmental disorder, as can be found in the ICD or DSM, autism is also conceptualized in a neurodiversity framework by many autistic individuals, researchers and clinicians, namely as a natural variation of neurological diversity [e.g., 81 ]. It is being discussed whether early interventions in general are at all compatible in this framework, as they are usually focused on curing or reducing impairments rather than on the strengths associated with neurodiversity [e.g., 82 , 83 ]. An in-depth discussion of the conceptualization of autism as well as ethical considerations regarding comprehensive ABA-based interventions in children with ASD is limited in this meta-analysis because it is beyond the scope. Nevertheless, 1) addressing concerns which are held against comprehensive ABA-based treatments and investigating undesirable side effects in behavioral treatments, as recommended by the National Institute for Health and Care Excellence [ 84 ], as well as 2) considering changes in comprehensive ABA-based interventions acknowledging the neurodiversity framework appear important to improve the support for autistic children and their families.

Conclusions

Several meta-analyses, including the current study, revealed evidence for a medium effect of comprehensive ABA-based interventions (vs. treatment as usual, minimal or no treatment) on intellectual functioning and adaptive behavior. However, the current meta-analysis did not revealed support for effects on language abilities, symptom severity, and parental stress beyond the control group treatments. Methodological limitations of primary studies and, thus, this meta-analysis may bias these results (e.g., low number of studies for analysis on symptom severity). However, the effect of comprehensive ABA-based interventions on core features of ASD may be comparable to the effects of the control group treatments. As comprehensive ABA-based interventions investigated in this meta-analysis contained more treatment hours (ABA 21.85 h/week, SD = 5.90 vs. CG 17.19 h/week, SD = 10.82), one may conclude that they are overly extensive and not justified. But then, if comprehensive ABA-based treatments (compared to no or minimal treatment or TAU) lead to higher levels of adaptive behavior and intellectual functioning as our study indicates, they would decrease the differences between the developmental and actual age of children on the autistic spectrum in these areas. Improvements of this kind can make major differences in the daily life of the children and their families.

Still, to answer the question, whether comprehensive ABA-based interventions are valid treatments for ASD, to full extent, more methodological sound studies are needed. Thus, robust conclusions on the effectiveness are still limited by a low number and rather low quality of primary studies. This applies also to the moderating influence of treatment characteristics, such as treatment intensity, and child characteristics, such as age. Conclusive knowledge in regard to effectiveness and moderators would help professionals to decide about indication of different treatment options and would help parents of children with ASD to make an informed decision. Other statistical approaches, e.g. growth curve analyses as seen in the study by Tiura and colleagues [ 31 ], might help to develop personalized treatment options [ 85 ]. Additionally, future research may aim to overcome limitations of previous studies. For example, the (further) development and evaluation of diagnostic procedures in children with ASD is sorely needed [ 80 ]. This would lower the risk for biases in meta-analytic methods. Further, the ethical concerns for RCTs on ASD treatment, namely the concern that critical developmental stages of the children might pass during the treatment in potentially non-profitable treatment groups, may be addressed by either comparing two potentially helpful interventions [ 78 ] or using new methodological approaches, such as adaptive rolling designs [ 86 ].

Availability of data and materials

The datasets generated and/or analyzed during the current study are available in the OSF repository, https://osf.io/wfgu3/ .

In line with Virués-Ortega [ 8 ], we chose to set the limit for intensity lower than it should be according to the definition of ABA-based treatments. Thus, we were able to achieve more variety in treatment intensity. This was necessary to conduct a moderator analysis considering treatment intensity.

Abbreviations

Applied Behavior Analysis

Applied Behavior Analysis—Verbal Behavior Approach

Autism Diagnostic Interview – Revised

Autism Diagnostic Observation Schedule

Association of the Scientific Medical Societies

American Psychiatric Association

Autism Spectrum Disorder

Autism Screening Questionnaire

Bayley Scales of Infant Development

Confidence Interval

Diagnostic and Statistical Manual of Mental Disorders

Early Intensive Behavioral Interventions

Early Start Denver Model

International Statistical Classification of Diseases and Related Health Problems

Naturalistic Developmental Behavioral Interventions

National Institute for Health and Care Excellence

Picture Exchange Communication System

Parenting Stress Index

Questionnaire on Resources and Stress–Friedrich Short Form

Randomized Controlled Trial

Reynell Developmental Language Scale

Stanford-Binet Intelligence Scale: Fourth Edition

Standardized Mean Difference

Treatment as Usual

Treatment and Education of Autistic and Related Communication Handicapped Children

Vineland Adaptive Behavior Scale

Wechsler Intelligence Scale for Children

Wechsler Preschool and Primary Scale of Intelligence

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We thank Isabel Dziobek for critically reviewing a draft of the manuscript. Correspondence concerning this article should be addressed to Anne Möllmann, University of Bremen, Institute of Psychology, Clinical Psychology and Psychotherapy, Grazer Str. 6, D – 28359 Bremen, Germany, [email protected]

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Concerns About ABA-Based Intervention: An Evaluation and Recommendations

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Justin B. Leaf ORCID: orcid.org/0000-0001-8315-7203 1 ,
Joseph H. Cihon 1 ,
Ronald Leaf 1 ,
John McEachin 1 ,
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A Correction to this article was published on 20 July 2021

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For over 50 years, intervention methods informed by the principles of applied behavior analysis (ABA) have been empirically researched and clinically implemented for autistics/individuals diagnosed with autism spectrum disorder (ASD). Despite the plethora of evidence for the effectiveness of ABA-based interventions, some autism rights and neurodiversity activists have expressed concerns with ABA-based interventions. Concerns have included discontent with historical events and possible harm from the procedures and goals targeted. The purpose of this manuscript is to examine some expressed concerns about ABA-based intervention and suggest productive ways of moving forward to provide the best outcomes for autistics/individuals diagnosed with ASD. The authors represent stakeholders from multiple sectors including board certified behavior analysts, licensed psychologists, parents, and autistics/individuals diagnosed with ASD.

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Wolf and colleagues ( 1964 ) provided one of the first empirical evaluations of the application of behavior analytic principles to address the behavior of autistics/individuals diagnosed with autism spectrum disorder Footnote 1 (ASD). In this seminal study, Wolf and colleagues examined the effectiveness of several operant conditioning procedures (e.g., extinction, shaping) to decrease the frequency of interfering behavior (e.g., tantrums) and increase the frequency of pro-social behavior (e.g., wearing glasses, bedtime behavior, communication skills) for a young autistic boy Footnote 2 who was at risk of permanent vision loss and institutional placement. The results of the study indicated that the procedures, based on behavior analytic principles, were effective for developing a variety of skills and ameliorating interfering behavior. Furthermore, six months following the study the participant’s mother reported that her son “continues to wear his glasses, does not have tantrums, has no sleeping problems, is becoming increasingly verbal, and is a new source of joy to the members of his family” (Wolf et al., 1964 , p. 312).

In the decades following Wolf et al. ( 1964 ) there have been numerous studies demonstrating the effectiveness of procedures based on behavior analytic principles for autistics/individuals diagnosed with ASD. These studies have included evaluating the effectiveness of shaping (Koegel et al., 2012 ), discrete trial teaching (DTT; Cihon et al., 2020 ), incidental teaching (McGee et al., 1985 ), pivotal response training (PRT; Koegel et al., 1987 ), naturalistic developmental behavioral interventions (NDBIs; Schreibman et al., 2015 ), group instruction (Ledford et al., 2008 ), behavioral skills training (Gunby & Rapp, 2014 ), functional communication training (Durand & Carr, 1991 ), functional analysis (Jessel et al., 2016 ), extinction (Hoffman & Falcomata, 2014 ), and response cost (Falcomata et al., 2004 ). Studies have also evaluated the effectiveness of comprehensive behavioral interventions for autistics/individuals diagnosed with ASD (e.g., Howard et al., 2005 ; Koegel et al., 1987 ; Leaf et al., 2011 ; Lovaas, 1987 ; Lovaas et al., 1973 ; Sallows & Graupner, 2005 ; Schreibman et al., 2015 ) as well as follow-ups and replications of these studies (e.g., Howard et al., 2014 ; Koegel et al., 1999 ; McEachin et al., 1993 ).

This substantial body of literature has led to the methods informed by applied behavior analysis (ABA) being considered evidence-based practices (National Autism Center, 2015 ), ABA-based interventions being widely recognized as the most effective interventions for autistics/individuals diagnosed with ASD (Smith, 2012 ), and endorsements from multiple organizations (e.g., Autism Speaks, The Association for Behavior Analysis International, the United States Surgeon General, National Institute of Mental Health, the American Psychological Association). It should be noted that although some communities equate the term ABA to DTT or Lovaas, within this paper, ABA refers to that which Baer et al., ( 1968 , 1987 ) defined—one of the three branches of the science of behavior analysis (see Table 1 for descriptions and examples of terms/concepts used within this manuscript). Therefore, ABA, as a practice, refers to the application of behavior analytic principles to improve socially important behaviors, which can include multiple types of interventions (e.g., behavioral skills training, social skills groups, NDBIs).

Despite the plethora of evidence for the effectiveness of ABA-based interventions, some autism rights and neurodiversity activists have expressed concerns with the use of ABA-based interventions for autistics/individuals diagnosed with ASD (e.g., Bascom, 2014 ; Devita-Raeburn, 2016 ; Latimer, 2019 ; Lynch, 2019 ; Ram, 2020 ; Sequenzia, 2016 ). Terms and phrases such as anti-ABA , ABA reform , dismantle and rebuild ABA , and all ABA is abuse are common within this opposition, which can be found on social media, blog posts, non-peer reviewed journals, and peer-reviewed journals. Concerns have ranged from discontent with historical events within behavior analysis (e.g., Lynch, 2019 ) to current procedures and goals (e.g., Sequenzia, 2016 ) to all ABA-based interventions are abuse. The expressing of these concerns may be connected to responses from behavior analysts (e.g., Hanley, 2020 ), cancelation of behavior analytic conferences, petitions to change our practices (e.g., Cobbaert, n.d.), and alterations to ABA-based interventions (e.g., not addressing self-stimulatory behaviors, not attempting to improve attention and eye contact, not attempting to address cooperation).

The works of Wolf ( 1978 ), Holland ( 1978 ), Bannerman et al. ( 1990 ) and many others have illustrated the importance of evaluating the social significance of our interventions, listening to consumers’ judgements, and upholding clients’ rights and dignity. As such, concerns from consumers and those we are actively invested in helping need to be heard, reflected upon, and addressed. Given the expressed concerns about ABA-based interventions from some autism rights and neurodiversity activists, a closer examination of the some of the more commonly expressed concerns among consumers and advocates seems warranted. Therefore, the purpose of this manuscript is two-fold: 1) examine commonly expressed concerns from some autism rights and neurodiversity activists about the application of ABA-based interventions for autistics/individuals diagnosed with ASD, and 2) recommend possible pathways for behavior analysts to continually improve and progress ABA-based interventions, and, in turn, help improve the lives of autistics/individuals diagnosed with ASD and their families.

While there is no intent to dismiss or invalidate lived experiences with ABA-based interventions of autistics/individuals diagnosed with ASD, we understand that critical evaluations can sometimes be viewed through that lens. Our intention, however, is quite the opposite. We hope to provide an evaluation and discussion of expressed concerns to help determine potential pathways forward, which is why the authors of this manuscript represent stakeholders from multiple sectors including board certified behavior analysts, licensed psychologists, parents of individuals diagnosed with ASD, and autistics/individuals diagnosed with ASD. It is also important to note that all of the authors support neurodiversity, promote acceptance and accommodation, and hope that everyone would agree that autistics/individuals diagnosed with ASD have the same rights as neurotypicals. We hope this manuscript opens a dialogue between behavior analysts and those we serve about ways applied behavior analysts can proceed in the wake of the ever-increasing concerns about our science and practice.

Concerns Over Ivar Lovaas and the UCLA Young Autism Project

Commonly expressed concerns by some autism rights and neurodiversity activists about ABA-based interventions relate directly to the research and clinical work of Ivar Lovaas and the Young Autism Project (YAP). The third and fourth authors spent collectively 20 years implementing treatment, training, supervising therapists, and conducting research with Lovaas and have written extensively to detail the history, positive and negative, of the YAP (e.g., Leaf & McEachin, 2016 ). They are, therefore, in a unique position to provide insight on what occurred at the YAP. Prior to the YAP, there was a widely held belief that autistics/individuals diagnosed with ASD were incapable of change and were destined to a life of institutionalization (Eikeseth, 2001 ). At the time there were no comprehensive intervention(s) that were found to be successful for decreasing aberrant behavior or increasing pro-social behavior for autistics/individuals diagnosed with ASD. The work by Lovaas and colleagues might appear antiquated by today’s standards and the field of ABA has surely improved since these early days. During the time period of YAP, children were literally dying or experiencing 24 h restraint to keep them from harming themselves, and many were destined to spend their entire lives in an institution (Koegel, 2015 ). Lovaas, however, demonstrated an approach to improve the quality of life for autistics/individuals diagnosed with ASD. Children made tremendous progress in areas such as language, social behavior, and educational goals. With this progress, institutionalization was no longer the norm or outcome for autistics/individuals diagnosed with ASD. Although ABA has certainly progressed in the past 40 years, it is still important to address the concerns about Lovaas and UCLA YAP.

The Use of Shock

One concern about Lovaas is that he “used electric shocks to stop children from engaging in their obsessive, repetitive behaviours” (Lynch, 2019 , para. 11). It is true that Lovaas used electric shock as part of the intervention in his practice at UCLA in the 1960s (pre-YAP). However, electric shock was not used for “obsessive, repetitive behaviours” (Lynch, 2019 , para. 11), but for addressing life threatening self-injurious behaviors (Smith & Eikeseth, 2010 ). The quest for the rapid elimination of harmful behavior led Lovaas to seek procedures that allowed precise quantification of intensity and ensured brevity, which made shock the primary option at the time. By the 1970s, shock was replaced with a spank (Lovaas, 1987 ). The spank was implemented at the YAP in the early 1970s and was discontinued by the late 1970s. While punishment-based procedures were used, participants accessed more reinforcing than punishing consequences, and physical punishment was no longer used by the end of the YAP study (Larsson & Wright, 2011 ). In fact, a guiding principle of the YAP was that the ratio of reinforcement to punishment had to be at least 100:1 (Leaf & McEachin, 2016 ). As Rimland ( 1978 ) pointed out, “Like all behavior modification programs, his [Lovaas] was 98% positive reinforcement, with only a trace of aversive control” (p. 100).

Concerns espousing that Lovaas used physical punishment, such as shock, are accurate based on published research (e.g., Lovaas et al., 1973 ) and the personal experiences of those involved in his work at UCLA and the YAP. However, if those concerns are generalized to ABA-based interventions today (i.e., shock is used within modern day, progressive ABA), they lose their validity (e.g., Ram, 2020 ). There are no data to support that shock is commonly used within ABA-based intervention for autistics/individuals diagnosed with ASD. While there may be few examples of the contrary (e.g., the Judge Rotenberg Center), those represent exceptions and not the rule. Ultimately, it is important to acknowledge the historical uses of punishment-based procedures, why those procedures were selected, how the use of those procedures evolved over time, and ABA-based interventions, more generally, have evolved. For example, there has been an increase in the number of non-aversive/invasive alternatives to traditionally aversive/invasive procedures (e.g., Cihon et al., 2021 ; Ellis et al., 2006 ; Koegel et al., 1987 ; Schreibman et al., 2015 ). This research has demonstrated that many behaviors, once thought to only be changed through aversive/invasive procedures, can be effectively changed through non-aversive/invasive methods.

Intervention Intensity

A second concern relates to the recommended number of hours of intervention (Latimer, 2019 ; Lynch, 2019 ). For example, “40 h a week is too much for me so I can’t imagine how a small child manages it” (Lynch, 2019 , 40 h a week section). Concerns about children receiving 40 h a week of intervention appear to be related to misconceptions of Lovaas’ ( 1987 ) landmark study (Leaf & McEachin, 2016 ). That is, there appears to be a belief that participants within the YAP received exactly 40 h per week of intervention. However, intervention was not set at 40 h per week. Rather, participants received an average of 40 h based upon individual needs. Some received more than 40 h per week while some received much less (Lovaas, 1987 ).

While there is validity in that some children from the Lovaas ( 1987 ) study and within the YAP received an average of 40 h, concerns regarding this number of hours seem unfounded within the published literature. To date, there is no data to support that any number of hours of ABA-based intervention is associated with any undesired or harmful results. Furthermore, meta-analyses of outcome studies indicate that more hours of ABA-based intervention at an early age are correlated with improvements on a wide variety of measures (e.g., Eldevik et al., 2009 ; Roth et al., 2014 ; Virués-Ortega, 2010 ). Therefore, available data seems to indicate evidence in direct opposition of concerns related to the number of hours of intervention. It should also be noted that the average number of hours children attend school ranges from 30 to 35 h per week, which closely resembles the recommended number of hours of ABA-based intervention for autistics/individuals diagnosed with ASD.

Rigid, Formulaic Intervention

A third concern related to Lovaas is that “Lovaas ABA was formulaic, a one-size-fits all therapy in which children for the most part started on the same lesson, no matter what their developmental age” (Devita-Raeburn, 2016 , para. 26). This concern also seems to be related to misconceptions about the Lovaas ( 1987 ) study and the YAP. As Leaf and McEachin ( 2016 ) noted,

Let me assure you, it was not rigid whatsoever. You saw the film from 50 years ago. It was not rigid back then and was not rigid during our generation either. And we were certainly not protocol driven. In fact, Ivar did not believe in protocols. He wanted us to be innovative, creative, and always changing. He wanted us to probe and of course evaluate if what we were doing was effective. If it was not effective then we would change the program. “Do not adhere to protocols!” (Chance & Lovaas, 1974) Similar to an outstanding cook, you may use a recipe as a guide but be creative and improvise as you deem necessary. With the children in the study we had a structure, a plan, but were always willing, encouraged and expected to change so as to meet the needs of our children. Individualization was critical and rigid protocols were antithetical to responding to the unique and ever changing needs of the child (p. 20).

The third and fourth authors of this manuscript, as well as others, have discussed in various outlets how therapy was ever-changing, dynamic, and flexible during the YAP (e.g., Eikeseth, 2001 ; Larsson & Wright, 2011 ; Leaf & McEachin, 2016 ; Smith & Eikeseth, 2010 ). Procedures were individualized for their clients and those procedures would change moment-to-moment, which continues to be a large part of the philosophy of this progressive approach to ABA (Leaf et al., 2016 ).

It should be noted, however, that the repertoires and skill level across professionals in any field is likely to greatly vary. Even with minimum standards in place, this variance is likely. For example, anyone who drives is likely familiar with the varied skill level in drivers, even though a driver’s license is required to drive legally. The field of ABA, as it relates to practice, is no different. There are varied repertoires and skill levels across practicing behavior analysts that are likely to impact the quality of the intervention they provide. Training methods that produce the repertoires necessary for those providing intervention to be analysts that can “assess, adjust, and continually examine the effectiveness of their instructions” (Leaf et al., 2016 , p. 722) are likely to be key. Nonetheless, continued research evaluating training methods that produce the most effective practicing behavior analysts will be helpful in improving the quality of intervention for autistics/individuals diagnosed with ASD.

A final concern related to UCLA YAP is the outcomes of Lovaas ( 1987 ) and behavior analysts trying to achieve similar outcomes today. In a paper evaluating the line between intervention and abuse, Kirkham ( 2017 ) illustrated the feelings of some in the neurodiversity movement about the outcomes of ABA-based intervention. For example, Kirkman stated “Prominent self-advocate Amy Sequenzia has similarly criticized ABA for unjustifiably holding up neurotypical behaviour as an ideal, arguing that its attempt to ‘change how an autistic acts, reacts or interacts with the world’ is wrong” (p. 117). Kirkman further stated “Amanda Vivian (2012) has concluded that it is wrong to say ‘cure autism now’” (p. 117).

There have been many different terms within the research on early intensive behavioral intervention (EIBI) to describe outcomes for autistics/individuals diagnosed with ASD including cure (e.g., Lovaas et al., 1973 ), recovery (e.g., Stubbs et al., 1976 ), best outcome (McEachin et al., 1993 ), and indistinguishable (McEachin et al., 1993 ). These terms were used to represent a subgroup of autistics/individuals diagnosed with ASD who, after receiving EIBI, no longer met the diagnostic criteria for ASD. The term “cure” is a particularly problematic term, because it implies that the cause of a disorder has been identified and removed. Even in the 1970s, Lovaas disavowed the notion of cure. “Recovery” may have seemed like a more appropriate term, but may still be problematic because of the negative connotations associated with recovery. These terms are only as meaningful as the definition that is attached to them using objective, measurable criteria. Of note is that researchers did not rely on subjective self-reports, but, rather, objective and standardized measures such as IQ scores (in the normal range). Additionally, the measures included placement (e.g., general education classrooms) and behaviors associated with the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013 ). There are some who have invoked the concept of masking as described by Ekman ( 1972 ), claiming that all individuals diagnosed with ASD learn to mask their behavior to conform to societal norms but remain essentially autistic. However, given measures of the outcomes of EIBI are standardized and objective, it is difficult to support the claim of masking. Further, regardless of the terminology used, it is probable that increasing cognition (Harris et al., 1991 ), language (Smith et al., 2000 ), play (Ben-Itzchak & Zachor, 2007 ), social behavior (Lovaas et al., 1973 ), and adaptive behavior (Anderson et al., 1987 ), while decreasing aberrant behavior (Lovaas et al., 1973 ) improves quality of life through the development of repertoires that empower and enhance options.

Recommendations

There are several potential pathways forward with respect to concerns related to the research and clinical work of Ivar Lovaas and the YAP. First, continued development of practicing behavior analysts’ knowledge of past research, including that of Lovaas, will permit more accurate identification of strengths, weaknesses, positives, and mistakes within this research. This will, in turn, permit continual evolution, improvements, and refinements of the methods informed by our science. Second, it is imperative that practicing behavior analysts continue to implement and advocate positive reinforcement-based contingencies when possible while designing interventions for autistics/individuals diagnosed with ASD. Which will hopefully lead to members of the neurodiversity movement and other professionals to be more accepting of ABA-based interventions.

Third, the intensity of intervention should be determined at the individual level. Pre-determined or automatically recommending 40 h per week based on averages found in the literature should be avoided. It should be noted, however, that meta-analyses have found that more hours of ABA-based intervention at an early age are correlated with improvements (e.g., Eldevik et al., 2009 ; Roth et al., 2014 ; Virués-Ortega, 2010 ). Nonetheless, intensity of intervention should be individualized and frequently assessed for responsiveness to intervention, affect, and consumer happiness. Future research should evaluate variables associated with the relationship between demographics and intensity as well as ancillary measures associated with intensity (e.g., long-term outcome data, consumer judgements across time).

Fourth, behavior analysts should continue to evolve and progress the methods informed by our science. This progression should include a move away from rigidly adhering to protocols and a move toward the use of in-the-moment analysis in more naturalistic contexts. That is not to say that since the time of the UCLA YAP, the methods informed by our science have not evolved or progressed—quite the contrary. For example, PRT is one intervention type based on behavior analysis that uses natural instructions and materials to optimize instruction for autistics/individuals diagnosed with ASD (Koegel et al., 1987 ). There has been a plethora of experimental studies which have demonstrated the effectiveness of PRT (Koegel et al., 1999 ). Another example of the evolution of behavioral intervention comes in the form of NDBIs (Schreibman et al., 2015 ). NDBIs combine best-practices from developmental science and ABA to promote engagement, social motivation, and synchrony between the parent and child, while using operant learning strategies to teach specific skills. Finally, Progressive ABA is an approach in which interventionist behavior is controlled by in-the-moment assessment of environmental variables (e.g., client affect, past client performance), sometimes referred to as clinical judgement (Leaf, Leaf, et al., 2018a , 2018b ). Ultimately, the goal of a progressive approach to ABA is to consistently evolve and progress our methods and outcomes which should continue to be a focus for all interventions and methods informed by behavior analysis.

Punishment- and Extinction-based Procedures

Some autism rights and neurodiversity activists have expressed that the use of punishment-based procedures within ABA-based interventions (e.g., Devita-Raeburn, 2016 ; Ram, 2020 ) is inhumane and harmful. For example, Ram ( 2020 ) posed the question “In what world is it okay to attach a shock device to someone and give the power to shock them to other humans?” (Judge Rotenberg Center section). It is, perhaps, unfortunate that our field adopted the term punishment , because to the general public punishment has numerous connotations, including retribution (i.e., “an eye for an eye”) and pain. As such, it is important to preface this discussion that behavior analysts define punishment differently than the general public. Punishment, from a behavior analytic perspective, describes any context in which a response is followed by an event (i.e., stimulus change) that results in a decrease in the probability of similar responses in similar situations. Punishment, just like reinforcement, is a naturally occurring principle of behavior. As Vollmer ( 2002 ) noted, “punishment occurs like the wind and the rain” (p. 469). Absent from this definition are things like pain, fear, discomfort, and the like. Suppose a person parks their car taking up two spaces and a passerby comments, “That’s inconsiderate.” If the probability of taking up two spaces while parking subsequently decreases, we can reasonably presume that punishment occurred. This is not to say that examples of punishment cannot, or do not, include situations in which pain or discomfort occur such as Ram’s example of the use of shock.

The field of ABA has had a precarious history with the use and research of punishment-based procedures (Baer, 1970 ; Dinsmoor, 1977 ; Horner, 2002 ; Lerman & Vorndran, 2002 ; Miltenberger, 2001 ; Vollmer, 2002 ). Early in the history of ABA, a variety of punishment-based procedures were evaluated and implemented including electric shock (Risley, 1968 ), water misting (Dorsey et al., 1980 ), spankings (Foxx & Azrin, 1973 ), and restriction of movement (Green & Striefel, 1988 ). Since those early days, for the most part, practitioners have decreased the reliance on using such procedures in favor of more preferred, reinforcement-based procedures. In fact, the Professional and Ethical Compliance Code for Behavior Analysts requires exhausting the use of reinforcement procedures prior to the use of punishment-based procedures (Behavior Analyst Certification Board, 2014 ). Some agencies and clinicians refuse to implement any punishment-based procedures while other agencies still implement non-invasive punishment-based procedures (e.g., saying “No, not that is not it, try again” following an incorrect response, removal of preferred items, time-out; Leaf et al., 2019 ). Yet, even today, some agencies still implement more invasive punishment-based procedures (e.g., electric shock; Blenkush, 2017 ). Even Positive Behavior Support guidelines included the use of strong aversives under some circumstances (Brown et al., 2008 ), and Electric Convulsive Therapy (ECT) is often the recommended intervention with severe depression (The UK ECT Review Group, 2003 ).

While research has demonstrated the effectiveness of punishment-based procedures in reducing the likelihood of similar behavior occurring (adaptive or aberrant), many have associated punishment, more generally, with occasioning undesired side effects (Lerman & Vorndran, 2002 ; Risley, 1968 ). In their extensive review of basic and applied findings related to punishment, Lerman and Vorndran ( 2002 ) noted that textbooks and literature reviews commonly discuss aggression, escape behavior, and emotional reactions among these side effects. However, Lerman and Vorndran also noted that applied research has demonstrated a variety of desirable effects from the use of punishment-based procedures. Nonetheless, the possibility of side effects is likely a reason some autism rights and neurodiversity activists have expressed opposition to the use of any punishment-based procedures.

Based upon the literature, there is some validity to concerns with the use of punishment-based procedures for autistics/individuals diagnosed with ASD. That is, if punishment-based procedures have been documented to result in undesired side effects, there may be cause for concern with the use of those punishment-based procedures within the same conditions. However, as Lerman and Vorndran ( 2002 ) noted, “The prevalence of these side effects is unknown, however, because relatively few studies have directly examined the effects of punishment on unpunished behavior in clinical settings” (p. 454). As such, to fully evaluate concerns of the use of punishment-based procedures for autistics/individuals diagnosed with ASD, more research is necessary. This research could help to (1) examine if there are differences in possible side effects when comparing more and less invasive punishment-based procedures (e.g., saying “no” for incorrect responses in comparison to time out from positive reinforcement; see Leaf et al., 2019 for an example), (2) identify if there are conditions under which more invasive punishment-based procedures may be necessary, (3) prevent the misuse of punishment-based procedures under the guise of ABA-based intervention, and (4) inform effective reinforcement-based alternatives.

Concerns about ABA-based procedures are not limited to punishment-based procedures, as some autism rights and neurodiversity activists have expressed concerns with the use of extinction procedures (e.g., Ram, 2020 ). Ram ( 2020 ) noted, “Extinction (including planned ignoring) goes against what all the research is showing us about child and human development. Extinction doesn’t care about trauma, in fact it can cause trauma” (use of punishment, extinction, shock section). Ram did not expand on how extinction is at odds with research on child and human development, making it difficult to further examine this claim. It is possible, however, to further examine the claim that extinction causes trauma. Similar to the aforementioned discussion surrounding punishment, it is important to note that behavior analysts define extinction functionally as termination of a response-reinforcer contingency, which is commonly done through non-delivery of a previously delivered reinforcer. Said differently, extinction involves withholding a reinforcer contingent upon a response that previously resulted in access to the same reinforcer.

Procedures involving the use of extinction are, perhaps, more prevalent in the literature addressing self-injurious behavior, aggression, and pediatric feeding disorders. Over 30 years ago Lerman et al. ( 1999 ) analyzed 41 data sets of individuals who received treatment for self-injurious behavior that included extinction for possible side effects (i.e., extinction bursts or aggression). Lerman et al. found that 15 of the 30 participants showed extinction bursts or aggression, and that the occurrence of these side effects was mitigated when extinction was combined with differential reinforcement. While there was no mention of trauma, Lerman and colleagues were only evaluating the literature for the occurrence of extinction bursts or aggression, and the authors of this manuscript are unaware of any extensive literature reviews on the use of extinction and trauma. In fact, many studies evaluating procedures with an extinction component have documented favorable outcomes. For example, Grow et al. ( 2008 ) found that extinction within functional communication training promoted response variability to identify a response to reinforce as an alternative to problem behavior. Relatedly, Hanley et al. ( 2005 ) found that both children with severe behavior disorders who participated in their study preferred the functional communication training (which included an extinction component) condition that also included a punishment contingency for problem behavior. Piazza et al. (2003) found that reinforcement alone was less effective when compared to reinforcement plus escape extinction with four children diagnosed with a pediatric feeding disorder. Furthermore, positive reinforcement combined with escape extinction reduced extinction bursts, inappropriate behavior, and crying for some participants (Piazza et al., 2003).

Currently, the research evaluating procedures involving extinction do not seem to provide evidence that extinction results in trauma. However, most literature reviews and studies evaluating procedures involving extinction did not include direct evaluations of possible trauma. As such, future research will be necessary to fully evaluate claims of extinction induced trauma. This could take the form of literature reviews of studies examining the effectiveness of procedures involving extinction and scanning for any mention or indication of trauma. Research could also explicitly evaluate conditions that do or do not include and extinction component while evaluating participant preference and measures of trauma. Ultimately this research is likely to identify the conditions under which procedures involving extinction are appropriate and necessary. For instance, if an otherwise healthy child engages in food refusal to the point of malnourishment, escape-extinction may be, at least initially, necessary. While if an otherwise healthy child engages in food selectivity, it may be appropriate to avoid the use of escape-extinction altogether (Riordan et al., 1980 ).

While awaiting the results of more research on punishment and extinction, an approach behavior analysts might take to help address any confusion and concerns is to have meaningful discussions with stakeholders and autistics/individuals diagnosed with ASD. These discussions may benefit from including a behavior analytic conceptualization of punishment (i.e., a functional relationship) and how that contrasts with traditional conceptualizations of punishment. Hopefully these discussions can be informed by our field’s history related to the use of punishment- and extinction-based procedures and the most current and relevant research. As such, blanket statements from behavior analysts that all punishment-based procedures are to be abandoned should be avoided within these discussions as they do not align with the research or take into consideration the functional definition of punishment and the naturally occurring behavioral phenomenon that is punishment. This is not to say that others within these discussions (e.g., autistics/individuals diagnosed with ASD) could not make similar statements, as these should open discussions in an attempt to listen and learn. Including several professionals, organizations (e.g., CASP, ABAI, APBA), and autistics/individuals diagnosed with ASD could lead to the development of guidelines about the conditions under which various punishment- and extinction-based procedures are acceptable and necessary as well as whether there are any punishment- and extinction-based procedures that are never acceptable or necessary. These guidelines could then be reflected in ethical codes for certified and licensed behavior analysts.

Self-Stimulatory and Stereotypic Behavior

Some autism rights and neurodiversity activists have expressed concerns with addressing stereotypic behavior (sometimes referred to as “stimming”) within ABA-based intervention. Examples have included, “stimming helps decrease anxiety and stress in autistics” (Ram, 2020 , Masking section) and “stimming is a comforting self-soothing behavior which helps us reduce stress, feel more comfortable in uncomfortable environments, and regulate our emotions” (Lynch, 2019 , ABA is not designed section). Furthermore, surveys of autistic adults “reported [stimming] to be a useful behaviour, serving to contain or control excess emotion” (Kapp et al., 2019 , p. 1788). As such, concerns about ABA-based interventions addressing stereotypic behavior often involve claims that behavior analysts do not understand why autistics/individuals diagnosed with ASD engage in stereotypic behavior (Fahrenheit, 2020 ), society should be accepting of stereotypic behavior (Kapp et al., 2019 ), and targeting stereotypic behavior is abusive (Fahrenheit, 2020 ).

Behavior analysts view stereotypic behavior as functionally related to observable environmental variables. As a result, through a behavior analytic lens, stereotypic behavior is a product of its circumstances. Behavior analytic research supports the common presumption that stereotypic behavior serves an automatic or non-social function; however, research has also shown stereotypic behavior to be multiply determined and the result of positive social reinforcement and escape and avoidance contingencies (Cunningham & Schreibman, 2008 ). World views that offer competing or alternative explanations for behavior are likely to result in concerns such as behavior analysts not understanding why autistics/individuals diagnosed with ASD engage in stereotypic behavior.

It is our hope that all behavior analysts support building a more inclusive world where people are more accepting of differences, behaviorally or otherwise. However, behavior analysts also have an obligation to best prepare their clients for the world in which they currently live, which is, unfortunately, less accepting than desired. Research has documented that engaging in stereotypic behavior often has a negative impact on the person engaging in the stereotypic behavior (Bodfish et al., 2000 ; Goldman et al., 2009 ; Koegel et al., 1974 ) as well as negative perceptions from those observing the person engaging in the stereotypic behavior (Cook & Rapp, 2020a ; Welsh et al., 2019 ). To align with the research and best prepare clients for the environments in which they will find themselves, behavior analysts will likely be required to address stereotypic behavior. However, ABA-based interventions should work toward empowering and enhancing options rather than achieving conformity. Developing the repertoires necessary to choose whether or not to adapt to different situations based on an analysis of the possible outcomes.

All claims of abuse should be taken seriously and claims that targeting stereotypic behavior is abusive are no different. If a person indicates they were abused, they should take all possible actions in accordance with local and federal laws. With respect to the purpose of this manuscript, of importance is evidence of abuse within the research on interventions addressing stereotypic behavior. Literature reviews indicate that “reducing stereotypy generally leads to [desirable] changes in other behaviors” (Lanovaz et al., 2013 , p. 1240) such as item engagement (Zhou & Goff, 2000 ), vocalizations (Celiberti et al., 1997 ), communication (Anderson et al., 2010 ), sitting (Lanovaz et al., 2013 ), play (Bennett et al., 2011 ), correct responding (Rosenthal-Malek & Mitchell, 1997 ), and academic tasks (Cook & Rapp, 2020b ). None of the reviews of studies that have evaluated interventions for addressing stereotypic behavior (e.g., Akers et al., 2020 ; Chebli et al., 2016; DiGennaro-Reed et al., 2012 ; Lanovaz et al., 2013 ; Rapp & Vollmer, 2005 ; Wang et al., 2020 ) have indicated harm or abuse experienced by participants. While not discounting others lived experiences, it seems as though participants of studies evaluating interventions to address stereotypic behavior have not made these claims within the research. Nonetheless, more research is necessary to fully evaluate claims of harm, trauma, and abuse as a result of ABA-based interventions addressing stereotypic behavior. This research could include continued evaluation of the conditions under which stereotypic behavior occurs as well as what forms may interfere with the development of friendships, obtaining and maintaining employment, and preventing others from working and learning in the same environment. This research will be essential in identifying if some forms of stereotypic behavior may be best to engage in while others are not present as not to decrease opportunities, better understand which forms of stereotypic behavior are more or less socially acceptable, and how we can teach society to be more understanding and tolerant of stereotypic behavior.

Goal Selection and the Goals of Therapy

Expressed concerns about goal selection within ABA-based intervention are multi-faceted. They have included that autistics/individuals diagnosed with ASD are not included in the goal selection process, selected goals are inappropriate (e.g., eye contact), and ABA-based interventions fundamentally change the individuality and personality of the client (Devita-Raeburn, 2016 ; Lynch, 2019 ; Ram, 2020 ; Sequenzia, 2016 ). For example, Lynch ( 2019 ) noted, “Most ABA therapists don’t set out to hurt children. And yet, despite making ABA therapy fun and positive, the underlying goals of ABA have not changed. And it is these goals that, like gay conversion therapy, do long-term damage to the human psyche” (15 th paragraph) and “They [behavior analysts] don’t see how weird it is to try systematically to shape a child’s behaviour to teach them to play with a toy the ‘right’ way” (But I do know what autism feels like section). In another example Sequenzia, 2016 claimed that, “Because ABA proponents, as their philosophy dictates, never accept a ‘no’ from Autistics, and will relentless pursue the goal of making us comply with what they believe is the desirable way of being, their next argument was to say that ‘neurotypical people comply all the time’, [sic] that’s why it is vital that Autistics learn compliance too” (11 th paragraph).

Goal Selection Process and Selected Goals

Early in the conceptualization of the ABA, Baer et al. ( 1968 ) noted that the goals within ABA research should be of importance to society; a point expanded upon by Baer et al. ( 1987 ). Wolf ( 1978 ) further contended that behavior analysts should actively seek consumer evaluations of the acceptability of their goals, procedures, and results. Collectively, Wolf referred to this as social validity , which has long been a hallmark of ABA. In fact, this is so central to ABA-based interventions that it is included in the Professional and Ethical Compliance Code for Behavior Analysts (Behavior Analyst Certification Board, 2014 ). Several reviews of the inclusion of social validity measures within behavior analytic research have been published (i.e., Carr et al., 1999 ; Ferguson et al., 2019 ; Kennedy, 1992 ). Based upon these reviews, there is validity to the concern that autistics/individuals diagnosed with ASD are not commonly included in the goal selection process, at least within the published literature. Equally concerning is the lack of improvements in the reporting of social validity measures within the research across these reviews. What remains unclear is if the results of literature reviews on the inclusion of social validity measures is reflective of clinical, home, and community settings in which ABA-based intervention commonly occurs.

Changes to Individuality and Personality

It is important to preface this section with a discussion of personality through a behavior analytic lens. Skinner ( 1974 ) described personality as a way to describe “…a repertoire of behavior imparted by an organized set of contingencies” (p. 164). From this perspective, then, personality is simply a term used to describe commonly displayed patterns of behavior. As such, behavior is not attributed to or caused by a personality, as behavior occurs independent of a description of personality. If viewed through a behavior analytic lens, through which changes in behavior do not equate changes in personality, then there is little validity the claim that ABA-based intervention fundamentally changes the personality of autistics/individuals diagnosed with ASD. While the goal of ABA-based intervention for autistics/individuals diagnosed with ASD is to develop repertoires that empower and enhance options, some will likely continue to view their behaviors or patterns of behavior as part of their identity. In these situations, those individuals are likely to view any intervention that changes behavior as a threat to their identity, behavior analytic or otherwise. These are likely to be most difficult situations for behavior analysts to navigate when confronted with these concerns.

The behavior analytic view of personality differs from traditional views in which behavior is said to be caused by personalities. For instance, a delinquent child acts out due to a disorderly personality or an adult avoids social situations due to an anti-social personality. From a more traditional view of personality and behavior, there is validity to the concern that ABA-based intervention fundamentally changes the personality of autistics/individuals diagnosed with ASD. This view purports that any change in behavior would, in turn, be a change to one’s personality. It is probable that this traditional view is related to concerns from autism rights and neurodiversity activists about ABA-based intervention fundamentally changing the personality of autistics/individuals diagnosed with ASD.

It is also important to note that ABA-based intervention involves teaching language so that a child may communicate their desires, express their affection to their parents, communicate with their peers or colleagues, self-advocate, and express their displeasure (e.g., “I don’t want to do that,” “I’m uncomfortable with that”). Social behaviors are targeted because doing so increases the opportunity for friendships, dating, collaboration with others (Bauminger & Kasari, 2000 ), or just getting along with others in the workplace or community. Doing so also decreases the likelihood of potential negative outcomes such as loneliness, depression, and suicide (Bauminger & Kasari, 2000 ). Targets such as imitation, receptive instructions, and sitting better prepare clients to learn on their own and have the foundational skills to become competent learners and accomplish more complex skills like reading, cooking, and balancing a checkbook. ABA-based intervention sometimes involves exposing clients to situations that require waiting, doing something in a different way, and tolerating disappointment because we know our clients are capable of developing those skills. Individuals who can tolerate adversity are better prepared to survive in an imperfect world and will have more opportunities for life-enriching experiences. These skills permit successfully navigating societal standards and rules, and to understand how one’s behavior might be an obstacle to achieving their goals. In this sense, behavior analysts are no different than teachers in general education settings, psychologists who work with clients who have paralyzing phobia, depression, or an unhappy marriage, nutritionists who help people maintain better health, or parents who teach their children right from wrong. The main goal across each of these is to teach skills that will lead to improvements in an individual’s life. Behavior analysts, like any other helping professional, should be teaching skills that will be valuable to their clients.

Simply put, practicing behavior analysts must include clients when possible, or their proxy when not, in goal selection. If a client is too young or does not have well developed communication repertoires to articulate preferences related to goal selection, then the client’s caregivers/guardians should be involved in the goal-selection process. In situations in which communication repertoires may make obtaining consent directly from our clients difficult, other methods of assent may be employed (e.g., concurrent chains; Hanley, 2010 ). This does not, however, mean that only the goals that clients or caregivers identify as important are targeted or not, or that only the goals that the behavior analyst identifies as important are targeted or not. For instance, if a client was only interested in improving their videogame skills at the expense of improving other necessary adaptive skills, it may be beneficial to work with that client on the identification of other meaningful goals. As another example, a behavior analyst should not select goals solely because it will check off a box on a standardized assessment. Ultimately, reasonable efforts must be taken to ensure the goal selection is a collaborative process whenever possible.

It is important to note that the training behavior analysts complete prior to working as supervisors or obtaining certification involves, or should involve, the development of repertoires related to identifying meaningful, functional, adaptive, and developmentally appropriate curricula. As such, a behavior analyst’s level of expertise for determining goals for intervention should not be discounted. However, there may be situations in which clients and/or guardians disagree with a behavior analyst’s recommendation. In these situations, possible courses of action for the behavior analyst may include (a) listening to the client’s and/or guardian’s rationale for the disagreement, (b) discussing with the client and/or guardians why the proposed goals are important in the short and long term, (c) collaborating with the client and/or guardians to identify goals everyone agrees upon, (d) working to inform consumers about the activities and learning objectives that are correlated with quality outcomes, and, if necessary, (e) providing referrals to other service providers that may be more appropriate if unable to come to a mutual agreement on the selected goals.

Ultimately, including clients in the goal selection process, when possible, could assist researchers and clinicians in identifying which goals may be viewed as not socially valid to which individuals. It may be the case that some goals have been deemed socially acceptable by those receiving ABA-based interventions and/or their caregivers, but not those outside of the intervention context (e.g., some autism rights and neurodiversity activists). These discussions could assist in how to approach these disagreements and pathways forward. Relatedly, these discussions could assist in ensuring behavior analysts teach skills that are functional, applied, and meaningful for their clients. Ultimately, these discussions could lead to more meaningful goals being targeted more frequently that enhance choices and improve the quality of life of our clients.

Practicing behavior analysts must take active steps to live up to Wolf’s ( 1978 ) vision of social validity. This would mean assessing the social validity of goals in research as well as practice with a variety of consumer judges at each level of selection. Peer reviewed journals which publish studies on behavior analysis that relates to autistic/individuals diagnosed with ASD (e.g., Journal of Applied Behavior Analysis , Education and Training in Autism and Developmental Disabilities, or the Journal of Autism and Developmental Disorders) could assist in this endeavor by requiring measures of social validity prior to acceptance for publication. Graduate training programs, which commonly develop repertoires related to conducting and reporting research, should include explicit instruction on the assessment of social validity within research. The assessment of the social validity of goals within practice may already be frequently occurring, but there are no mechanisms in place for the reporting of social validity data in practice. It is possible that one method of assessing social validity in practice is reflected in retaining clients and obtaining new clients. Nonetheless, researchers could survey owners and employees of ABA-based service providers to identify practices related to the assessment of social validity to help in this endeavor.

Abuse and Long-Term Negative Outcomes

The final commonly voiced concern it is that ABA-based interventions and/or specific ABA-based procedures are abusive and lead to serious negative outcomes such as depression, anxiety, and/or post-traumatic stress disorder (PTSD; Kupferstein, 2018 ). This is evident by comments such as, “…children subjected to ABA have PTSD symptoms at a statistically higher rate than autistic people who had not had ABA” (Latimer, 2019 , first paragraph), “ABA for autism is institutional abuse…” (Cobbaert, n. d., first paragraph), and “These advocates, many of them childhood recipients of ABA, say that the therapy is harmful” (Devita-Raeburn, 2016 , 8 th paragraph). As previously stated, all claims of abuse should be taken seriously and evaluated thoroughly. There are two notable examples of peer-reviewed publications that appear to provide support for claims that ABA-based interventions are abusive or cause PTSD.

First, Kupferstein ( 2018 ), published in Advances in Autism , surveyed 460 respondents in an effort to evaluate a correlation between receiving and/or having received ABA-based intervention and the prevalence of posttraumatic stress symptoms (PTSS). This correlation was evaluated using a self-designed questionnaire. Kupferstein found that 46% of respondents met the diagnostic threshold for PTSD after ABA-based interventions. This number was also higher than those respondents receiving interventions with limited to no empirical base (e.g., Rapid Prompting Method, DIR/Floortime, Facilitated Communication). Second, Sandoval-Norton and Shkedy (2019), published an article entitled “How much compliance is too much compliance; is long-term ABA therapy abuse?” in Cogent Psychology . In this article, Sandoval-Norton et al. criticized the discipline and practice of ABA with accusations of unethical behavior, ineffectiveness, promoting learned helplessness, destruction of internal motivation, and psychological abuse and trauma. Ultimately, Sandoval-Norton and Shkedy came to the conclusion that “These children are the population that was chosen to be the subjects of an experimentally intense, lifelong treatment within a therapy where most practitioners are ignorant regarding the Autistic brain—categorically, this cannot be called anything except abuse” (p. 6).

Taken together, Kupferstein ( 2018 ) and Sandoval-Norton and Shkedy (2019) appear to provide validity to expressed concerns of abuse within ABA-based interventions. However, these articles have also been critically evaluated within the same journals. Sepcifically, Leaf, Ross, et al., ( 2018a , 2018b ) evaluated the methodology and Kupferstein’s discussion of their results and Gorycki et al. (2020) provided an analysis and response to the claims made by Sandoval-Norton and Shkedy. Leaf, Ross, et al. concluded “that service providers, behavior analysts, funding agencies, and parents should carefully and objectively evaluate this study [Kupferstein ( 2018 )] prior to avoiding making recommendations for ABA-based interventions for individuals diagnosed with ASD based upon the results” (p. 127). Gorycki et al. concluded that “Many of their [Sandoval-Norton and Shkedy’s] arguments are based on published reports for which there is little reliability or replication, with no connection to ASD or ABA, with literature existing that contradicts the claims made by Sandoval-North and Shkedy, but is conveniently ignored by them” (p. 9).

Based upon these evaluations, behavior analysts should remain compassionately skeptical when confronted with generalizations and broad statements that ABA is abusive (e.g., Latimer, 2019 ). This means showing compassion, listening and learning from lived experiences, and, if applicable, referring to appropriate services (e.g., psychological help). This does not mean negating lived experiences or the substantial evidence that supports the use of ABA-based interventions for autistics/individuals diagnosed with ASD. Currently there is a lack of reliable data and research that ABA-based interventions have resulted in a diagnosis of PTSD, anxiety, or depression. Well-designed research will be vital to know the characteristics, if any, of ABA-based interventions that might have led to these outcomes. We encourage researchers from the field of behavior analysis to work collaboratively with researchers from other fields (e.g., psychology, education, research methodology) and autistics/individuals diagnosed with ASD to design methodologically sound studies on the long term effects of ABA-based interventions with respect to PTSD, anxiety, or depression. Additionally, we should evaluate the positives of behavioral intervention (e.g., happiness or restrictiveness of living arrangements) This research should involve behavior analytic service providers and organizations representing service providers (e.g., CASP) recruiting a large number of autistics/individuals diagnosed with ASD who have received services and who are now adolescents or adults. To prevent bias, evaluators should be kept blind to the purpose of these studies and should not include behavior analysts. These studies should also be authored by individuals other than behavior analysts to prevent any perceived conflicts of interest. Developing and expanding this body of research will provide a clearer picture of the prevalence of PTSD as a result of ABA-based interventions which will, in turn, inform large-scale changes in ABA-based interventions.

Outcome measures used to assess the effectiveness of comprehensive ABA-based interventions in practice and research should also be expanded. Behavior analysts should include a variety of standardized assessments across a variety of domains as measured through intelligent quotient tests, the Vineland Adaptive Behavior Scales (Sparrow et al., 2016 ), Expressive One Word Picture Vocabulary test (Martin & Brownell, 2011 ), Peabody Picture Vocabulary test (Dunn & Dunn, 2007 ), Aberrant Behavior Checklist (Aman et al., 1985 ), Social Skills Improvement System (Gresham & Elliott, 2008 ), Social Responsiveness Scale (Constantino, 2002 ), Parenting Stress Index (Abidin, 1990 ), and the Gilliam Autism Rating Scale (Gilliam, 2014 ) within research as well as clinical settings. This will permit the assessment of progress and outcomes across settings as well as overtime. In addition to the standardized assessment of desired outcomes, researchers and clinicians should use standardized assessments of undesired outcomes such as the Spence Children’s Anxiety Scale (Spence, 1997 ). It should be noted, however, that many standardized assessments of constructs such as anxiety or trauma have not been normed with autistics/individuals diagnosed with ASD. Additionally, researchers and clinicians should include quality of life measures such as affect (e.g., Koegel et al., 2009 ), happiness (Thomas, Charlop, Lim, & Gumaer, 2021 ) and the development of social networks and friendships (Kasari et al., 2011 ).

In whichever area methodologies based upon the science of behavior analysis have been applied, improvements have occurred (cf. Friman, 2021 ). This is exemplified in the thousands of studies that have demonstrated positive outcomes of ABA-based interventions and procedures for autistics/individuals diagnosed with ASD. Despite these positive outcomes, concerns with the use of ABA-based interventions have been expressed by autism rights and neurodiversity activists in multiple outlets and some board certified behavior analysts have joined the discussion (e.g., Ram, 2020 ). Evaluating and discussing these concerns within the peer-reviewed literature provides an opportunity to identify potential solutions so the field can proceed in a productive, collaborative, and sensitive manner with the community for whom we are fortunate enough to serve. Based on our review of the concerns highlighted within this manuscript in light of the published literature, there is some validity to some of these expressed concerns (e.g., the collection of social validity measures in the published research) and limited to no validity to others (e.g., all ABA is abuse). Nonetheless, our field is not infallible, and we should continue to improve and progress our interventions. As Baer et al. ( 1968 ) so eloquently asserted, the continued examination of behavior analytic applications to solve problems of social significance will help assist in their refinement and, possibly, their replacement by better applications (p. 91).

Change history

20 july 2021.

A Correction to this paper has been published: https://doi.org/10.1007/s10803-021-05200-8

This terminology was selected to adhere to the 7 th edition of the American Psychological Association Publication Manual and to be inclusive of those who prefer person-first as well as identity-first language.

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Leaf, J.B., Cihon, J.H., Leaf, R. et al. Concerns About ABA-Based Intervention: An Evaluation and Recommendations. J Autism Dev Disord 52 , 2838–2853 (2022). https://doi.org/10.1007/s10803-021-05137-y

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8 Research Proposal Examples & Template to Use

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So you have a groundbreaking research idea you've spent months or even years developing, and now you're ready to take the next step.

How do you get funding for your research, and how should you approach potential funders? The answer is to create a convincing research proposal.

Unfortunately, most research proposals often get rejected. According to the European Research Council, the success rate for repeat proposal applications was only 14.8% in 2023 .

Pitching a novel research concept isn’t enough. To increase your chances of securing funding, your research proposal must check the right boxes in terms of clarity, feasibility, aesthetic appeal and other factors.

If you’re looking for inspiration to create a persuasive and feasible proposal, you’re in the right place. In this article, we have compiled a list of research proposal examples to help you create yours.

These examples will help you understand how to organize your proposal, what information to include and how to present it in a way that encourages others to support your project.

Let's dive in!

What is a research proposal, what to include in a research proposal, 8 research proposal examples & templates, research proposal faqs.

A research proposal is a document that outlines your proposed research project, explaining what you plan to study, why it's important and how you will conduct your research.
A well-structured research proposal includes a title page, abstract and table of contents, introduction, literature review, research design and methodology, contribution to knowledge, research schedule, timeline and budget.
Visme's research proposal examples and templates offer a great starting point for creating engaging and well-structured proposals.
Choose a template from Visme's research proposal examples and customize it to fit your needs.
With Visme’s proposal maker , you can create a research proposal that stands out. Access a drag-and-drop editor and advanced features like AI tools , collaboration features, brand wizard and more.

A research proposal is a structured document that outlines the core idea of your research, the methods you intend to use, the required resources and the expected results.

Think of it as a sales pitch for your research. It answers some big questions: What are you planning to explore? Why is it important to conduct the research? What are your research objectives and the methods you’ll use to achieve them? What are the potential outcomes or contributions of this research to the field?

A research proposal serves two primary purposes. First, it convinces funding bodies or academic committees to support your research project expected to bring new ideas and insights. Second, it provides a roadmap for your research journey, helping you stay focused, organized and on track.

Now, we'll discuss what to include in a research proposal. You'll learn about the important parts of a research proposal template and how they help present your research idea clearly.

Here’s an infographic that you can use to understand the elements of a research proposal quickly.

What Should a Research Proposal Include Infographic

1. Title Page

Start your research proposal with a title page that clearly states your research. The title page is like a book cover, giving the first impression of your project. Therefore, you must ensure the design is engaging enough to attract your audience at first glance.

Include the following details on your title page:

Title of your research
Contact Details
Name of the department or organization
Date of submission

2. Abstract and Table of Contents

After the title page comes the abstract and the table of contents.

The abstract is a concise summary of your project that briefly outlines your research question, the reasons behind the study and the methods you intend to use. It is a quick way for readers to understand your proposal without reading the entire document.

The table of contents is a detailed list of the sections and subsections in your proposal, with page numbers. It helps readers navigate through your document and quickly locate different parts they're interested in.

3. Introduction

The introduction of your research proposal sets the tone for the rest of the document. It should grab the reader's attention and make them want to learn more. It's your chance to make a strong case for why your research is worth investigating and how it can fill a gap in current knowledge or solve a specific problem.

Make sure that your introduction covers the following:

Background Information: Set the stage with a brief snapshot of existing research and why your topic is relevant.
Research Problem: Identify the specific problem or knowledge gap that your study will address.
Research Questions or Hypotheses: Present the central question or hypothesis that guides your research focus.
Aims and Objectives: Outline your research's main goal and the steps you'll take to achieve it.
Significance and Contribution: Explain how your research will add value to the field and what impact it could have.

4. Literature Review

A literature review is a list of the scholarly works you used to conduct your research. It helps you demonstrate your current knowledge about the topic.

Here's how this part works:

Summary of Sources: Talk about the main ideas or findings from your research materials and explain how they connect to your research questions.
Finding Gaps: Show where the current research falls short or doesn't give the full picture—this is where your research comes in!
Key Theories: Tell the readers about any theories or ways of thinking that help shape your research.
Learning from Methods: Discuss what previous researchers worked on and how their methods might guide your research.
Recognizing Authors and Studies: Honor the pioneers whose work has had a major influence on your topic.

5. Research Design and Methodology

This section outlines your plan for answering your research question. It explains how you intend to gather and analyze information, providing a clear roadmap of the investigation process.

Here are the key components:

Population and Sample

Describe the entire group you're interested in (the population). This could be all teachers in a specific state or all social media platform users. After that, you will need to explain how you will choose a smaller group, known as a sample, to study directly. This sample should be selected to accurately represent the larger population you are interested in studying.

To choose the right sampling method, you need to assess your population properly. For instance, to obtain general insights, you can use random sampling to select individuals without bias. If the population consists of different categories, such as professionals and students, you can use stratified sampling to ensure that each category is represented in the sample.

Other popular sampling methods include systematic, convenience, purposive, cluster, and probability sampling techniques.

Research Approach

There are three main approaches for the research: qualitative (focusing on experiences and themes), quantitative (using numbers and statistics), or mixed methods (combining both). Your choice will depend on your research question and the kind of data you need.

Data Collection

This section details the specific methods you'll use to gather information. Will you distribute surveys online or in person? Conduct interviews? Perhaps you'll use existing data sets. Here, you'll also explain how you'll ensure the data collection process is reliable and ethical.

Data Analysis

Once you have collected your data, the next step is to analyze it to obtain meaningful insights. The method you choose depends on the available data type.

If you have quantitative data, you can employ statistical tests to analyze it. And if you're dealing with qualitative data, coding techniques can help you spot patterns and themes in your collected data.

6. Contribution to Knowledge

In this section, you need to explain how your research will contribute to the existing knowledge in your field. You should describe whether your study will fill a knowledge gap, challenge conventional ideas or beliefs or offer a fresh perspective on a topic.

Clearly outline how your work will advance your field of study and why this new knowledge is essential.

7. Research Schedule and Timeline

Create a timeline with important milestones, such as finishing your literature review, completing data collection and finalizing your analysis.

This shows that you've carefully considered the scope of your project and can manage your time effectively. Furthermore, account for possible delays and be prepared to adapt your schedule accordingly.

To create this timeline, consider using a visual tool like a Gantt chart or a simple spreadsheet. These tools will help you organize individual tasks, assign deadlines, and visualize the project's overall progress.

Choose a Gantt chart template from Visme's library and customize it to create your timeline quickly. Here's an example template:

The budget section is your opportunity to show them that you've carefully considered all necessary expenses and that your funding request is justified.

Here's how you can approach this part:

Understand the Rules: Before making calculations, thoroughly review the funding agency's guidelines. Pay attention to what types of expenses are allowed or excluded and whether there are any budget caps.
Personnel: Salaries and benefits for yourself, research assistants, or collaborators.
Equipment: Specialized tools, software, or lab supplies.
Travel: Transportation, lodging and meals if data collection requires travel.
Dissemination: Costs for publishing results or presenting at conferences.
Provide Justifications: Don't just list a cost. Briefly explain why each expense is crucial for completing your research.
Be Thorough and Realistic: Research prices for specific items using quotes or online comparisons. Don't underestimate expenses, as this can raise troubles about the project's feasibility.
Don't Forget Contingencies: Include a small buffer (around 5% of your total budget) for unexpected costs that might arise.

Using these research proposal examples and templates, you can create a winning proposal in no time. You will find templates for various topics and customize every aspect of them to make them your own.

Visme’s drag-and-drop editor, advanced features and a vast library of templates help organizations and individuals worldwide create engaging documents.

Here’s what a research student who uses Visme to create award-winning presentations has to say about the tool:

Chantelle Clarke

Research Student

Now, let’s dive into the research proposal examples.

1. Research Proposal Presentation Template

This research proposal presentation template is a powerful tool for presenting your research plan to stakeholders. The slides include specific sections to help you outline your research, including the research background, questions, objectives, methodology and expected results.

The slides create a coherent narrative, highlighting the importance and significance of your research. Overall, the template has a calming and professional blue color scheme with text that enables your audience to grasp the key points.

If you need help creating your presentation slides in a fraction of the time, check out Visme's AI presentation maker . Enter your requirements using text prompts, and the AI tool will generate a complete presentation with engaging visuals, text and clear structure. You can further customize the template completely to your needs.

2. Sales Research Proposal Template

Sales research gives you a deeper understanding of their target audience. It also helps you identify gaps in the market and develop effective sales strategies that drive revenue growth. With this research proposal template, you can secure funding for your next research project.

It features a sleek and professional grayscale color palette with a classic and modern vibe. The high-quality images in the template are strategically placed to reinforce the message without overwhelming the reader. Furthermore, the template includes a vertical bar graph that effectively represents budget allocations, enabling the reader to quickly grasp the information.

Use Visme's interactive elements and animations to add a dynamic layer to your research proposals. You can animate any object and add pop-ups or link pages for a more immersive experience. Use these functionalities to highlight key findings, demonstrate trends or guide readers through your proposal, making the content engaging and interactive.

3. General Funding Research Proposal Template

This proposal template is a great tool for securing funding for any type of research project. It begins with a captivating title page that grabs attention. The beautiful design elements and vector icons enhance the aesthetic and aid visual communication.

This template revolves around how a specific user group adopts cryptocurrencies like Bitcoin and Ethereum. The goal is to assess awareness, gauge interest and understand key factors affecting cryptocurrency adoption.

The project methodology includes survey design, data collection, and market research. The expected impact is to enhance customer engagement and position the company as a customer-centric brand.

Do you need additional help crafting the perfect text for your proposal? Visme's AI writer can quickly generate content outlines, summaries and even entire sections. Just explain your requirements to the tool using a text prompt, and the tool will generate it for you.

4. Product Research Proposal Template

Creating a product that delights users begins with detailed product research. With this modern proposal template, you can secure buy-in and funding for your next research.

It starts with a background that explains why the research is important. Next, it highlights what the research is set to achieve, how the research will be conducted, how much it will cost, the timeline and the expected outcomes. With a striking color scheme combining black, yellow, and gray, the template grabs attention and maintains it until the last page.

What we love about this template is the smart use of visuals. You'll find a flowchart explaining the methodology, a bar graph for the budget, and a timeline for the project. But that’s just the tip of the iceberg regarding the visual elements you’ll find in Visme.

Visme offers data visualization tools with 30+ data widgets, such as radial gauges, population arrays, progress bars and more. These tools can help you turn complex data into engaging visuals for your research proposal or any other document.

For larger data sets, you can choose from 20+ types of charts and graphs , including bar graphs , bubble charts , Venn diagrams and more.

5. Tech Research Proposal Template

If you’re a tech researcher, we’ve got the perfect template for you. This research proposal example is about predictive analytics in e-commerce. However, you can customize it for any other type of research proposal.

It highlights the project's objectives, including the effectiveness of predictive analysis, the impact of product recommendations and supply chain optimization. The methods proposed for achieving these objectives involve A/B testing and data analysis, a comprehensive budget and a 12-month timeline for clear project planning.

The title page has a unique triptych-style layout that immediately catches the reader's attention. It has plenty of white space that enhances readability, allowing your audience to focus on the critical points.

Submitting to different funding agencies? You don’t have to manually make changes to your document. Visme's dynamic fields can help save time and eliminate repetitive data entry.

Create custom fields like project names, addresses, contact information and more. Any changes made to these fields will automatically populate throughout the document.

6. Marketing Research Proposal Template

Artificial intelligence (AI) is taking the world by storm and the marketing niche isn’t left out. With this eye-catching template, you can attract attention to your proposed marketing research project for an AI-driven platform.

The main goal of the research is to evaluate the platform's feasibility and marketing potential. To achieve this goal, the scope of work includes a comprehensive analysis of the market and competitors and pilot testing. The proposal also contains a budget overview that clearly outlines the allocation of funds, ensuring a well-planned and transparent approach.

Using Visme's Brand Design Tool , you can easily customize this template to suit your branding with just one click. Simply enter your URL into the brand wizard, and the tool will automatically extract your company logo, brand colors, and brand fonts . Once saved, you or your team members can apply the branding elements to any document. It's that simple!

7. Environmental Research Proposal Template

The environmental research proposal example focuses on carbon emissions, identifies their contributing factors, and suggests sustainable practices to address them. It uses an appropriate sample size and data collection techniques to gather and evaluate data and provide sustainable recommendations to reduce industrial carbon footprints and waste.

From a design standpoint, the green and white color combination matches the theme of nature and environmental friendliness. In addition to its aesthetic appeal, the proposal includes relevant images that support ecological advocacy, making it informative and visually aligned with its purpose.

A key feature of this template is its detailed breakdown of the project's timeline. It uses a Gantt chart to clearly present stages, milestones and deadlines.

Collaborate with your team members to customize these research proposal templates using Visme’s collaborative design features . These features allow you to leave feedback, draw annotations and even make live edits. Invite your teammates via email or a shareable link and allow them to work together on projects.

8. General Approval Research Proposal Template

This research proposal template is a total game-changer - you can use it for any research proposal and customize it however you want. It features a modern and refreshing color scheme that immediately makes it stand out, providing a contemporary look that can adapt to any project's needs.

The template's layout is thoughtfully designed with primary fields that users can easily personalize by changing text, adjusting colors, or swapping images. No matter the research topic, you can tailor the template to fit your specific needs.

Once you're done customizing your research proposal template on Visme, you can download, share and publish it in different ways. For offline usage, you may download the proposal in PDF, PNG, or JPG format. To share it online, you can use a private or public link or generate a code snippet that you can embed anywhere on the web.

Want to create other types of proposals? Here are 29 proposal templates that you can easily customize in Visme.

Q. What Are the Five Steps of Writing a Research Proposal?

Follow these steps to write a solid research proposal:

Choose a topic within your field of study that can be explored and investigated.
Research existing literature and studies to build a foundational understanding and prepare your research question.
Outline your research proposal: introduction, literature review, proposed methodology, budget and timeline.
Conduct more detailed studies to strengthen your proposition, refine your research question and justify your methodology.
Follow your outline to write a clear and organized proposal, then review and edit for accuracy before submitting.

If you want to learn more about creating an expert research proposal , we highly recommend checking out our in-depth guide.

Q. How Long Is a Research Proposal?

Research proposals can range from 1,000 to 5,000 words. For smaller projects or when specific requirements aren't provided, aim for a concise and informative proposal that effectively outlines your research plan.

However, the ideal length depends on these factors:

Projects with complex methodologies or multiple phases may require longer proposals to explain the scope and procedures in detail.
Universities, academic institutions and funding agencies often have guidelines of a specific length. Always check their requirements beforehand.
When writing a proposal, adjust the level of study based on the audience. Academic proposals may require comprehensive explanations, while business or non-profit proposals require a more streamlined approach.

Q. How Long Does It Take to Write a Research Proposal?

The time it takes to write a research proposal depends on a few factors:

Complex research with extensive data collection or analysis will naturally take longer to plan and write about.
If you're new to writing research proposals, expect to spend more time learning the format and best practices.
If you've already conducted some research or a thorough literature review, the writing process might go faster.
Funding applications often have strict deadlines that will dictate your timeline.

Set aside several weeks to a couple of months for researching, writing, and revising your proposal. Start early to avoid stress and produce your best work.

Q. What Not to Do for a Research Proposal?

There are several factors that can make a research proposal weak. Here are some of the most common errors that you should avoid while preparing your research proposal:

Don’t choose a topic that’s too broad. Focus on a specific area you can thoroughly explore within your proposal’s limits.
Don’t ignore the rules for formatting and submitting your proposal. Always adhere to the requirements set by your institution or funding body.
Don’t forget to conduct a thorough literature review. It's crucial to show your grasp of existing research related to your topic.
Don't be vague about your methods. Ensure they're clearly defined and suitable for answering your research question.
Don't overlook errors in grammar, typos or structure. A well-proofread proposal reflects professionalism, so review it carefully before submitting it.

Craft Professional & Engaging Proposals with Visme

Writing a compelling research proposal takes effort, but with the right tools, the process becomes a breeze. Use the research proposal examples and templates in this article as a launching point to write your own proposal.

The best part? Visme provides easy-to-use tools with a vast collection of customizable templates, design elements and powerful features.

Whether you're a seasoned researcher or a student, Visme has the resources to help you create visually appealing and well-structured research proposals. In addition to research proposals, Visme helps you create many other document types, such as presentations , infographics , reports and more.

Ready to create your own research proposal? Check out Visme's proposal maker and start crafting professional and engaging proposals in minutes!

Create professional research proposals with Visme

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About the Author

Raja Antony Mandal is a Content Writer at Visme. He can quickly adapt to different writing styles, possess strong research skills, and know SEO fundamentals. Raja wants to share valuable information with his audience by telling captivating stories in his articles. He wants to travel and party a lot on the weekends, but his guitar, drum set, and volleyball court don’t let him.

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Using Single Subject Experimental Designs

What are the Characteristics of Single Subject Experimental Designs?

Reversal Design/Withdrawal Design/A-B-A

Multiple Baseline Design/Multiple Probe Design

Alternating Treatment Design

Changing Criterion Design

Summary of Single Subject Experimental Designs

Applied Behavior Analysis Theses and Dissertations

Theses/Dissertations from 2008 2008

Theses/Dissertations from 2007 2007

Theses/Dissertations from 2006 2006

Theses/Dissertations from 2005 2005

Theses/Dissertations from 2004 2004

Theses/Dissertations from 2003 2003

Useful Links

Single-Subject Research Designs

General Features of Single-Subject Designs

Reversal Designs

Multiple-Baseline Designs

Data Analysis in Single-Subject Research

Long Descriptions

Share This Book

Applied Behavior Analysis

Basics of a Literature Review

Useful Books

Applied Behavior Analysis

Two Ways to Find Single Subject Research Design (SSRD) Articles

Types of Single Subject Research Design

Guidelines for conducting research studies with the autism community

Rachel Taylor

Peter Baimbridge

Daniel Poole

Introduction

Research participation

Research procedure and aims

Methodology

Focus group schedule

Results: Recommendations

Pre-study considerations

Sample quotes

Key recommendations

Limitations and future directions

Acknowledgements

Comprehensive ABA-based interventions in the treatment of children with autism spectrum disorder – a meta-analysis

Eligibility criteria

Search methods for identification of studies

Data collection and quality assessment

Statistical analyses

Study and sample characteristics

Outcome measures

Risk of bias

Selection bias (sequence generation and allocation sequence concealment)

Performance and detection bias (Masking of participants and personnel/ outcome assessment)

Attrition bias (incomplete data)

Reporting bias (selective reporting)

Other risks of bias

Effects of intervention

Intellectual functioning

Language abilities

Symptom severity

Parental stress