Applied Behavior Analysis and Autism: EIBI Research Review

Introduction to ABA and Early Intensive Behavioral Intervention

Reichow, B., & Wolery, M. (2008, June). Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA Young Autism Project model. Journal of Autism and Developmental Disorders, 39, 23–41. https://doi.org/10.1007/s10803-008-0596-0

The use of applied behavior analysis as a treatment intervention for young children with autism is a frequently used and widely applauded model. The researcher most commonly associated with applied behavior analysis is Ivar Lovaas of the University of California at Los Angeles. Lovaas's work with applied behavior analysis, commonly referred to as ABA, began in the 1960s. Eventually, his work culminated in the establishment of Early Intensive Behavioral Intervention (EIBI) programs for young children with autism, independent of UCLA but based on Lovaas's Young Autism Project (YAP).

A comprehensive review of 10 intervention programs by the Committee on Educational Interventions for Children with Autism of the National Research Council (NRC) did not result in recommendations for any of the programs. Rather, the committee cited a need for more research and issued a set of general program guidelines.

Study Methodology

The purpose of the study by Reichow and Wolery was to provide a comprehensive synthesis of research conducted on EIBI. The authors utilized three methods for analysis of the EIBI programs: descriptive analysis, effect size analysis, and meta-analysis. The study methodology is robust in its examination of experimental methods, selection and assessment of participants, and intervention program design.

Study Selection

Articles were selected for analysis based on criteria that associated them with the YAP program, with Lovaas's methods, or with funding from the National Institute of Mental Health Multi-Site Young Autism Program (MYAP). A second set of criteria was used to ensure that the research included in the analysis demonstrated content validity with regard to participant characteristics, participant diagnoses, duration of programming, and experimental design. Finally, all research was required to have been published in a peer-reviewed journal in the English language.

Coding of Data and Reliability

All data were manually coded, and inter-observer agreement — assessed across 4 of 14 samples by two independent recorders — was found to be 91.6%, a level sufficiently high to consider the data coding reliable. Outcome data and three levels of study characteristics (research methods, participant characteristics, and intervention characteristics) were defined and coded.

Descriptive Analysis Findings

In order to evaluate the influence of experimental methods on study outcomes, the following five methodological areas were analyzed: (1) experimental rigor; (2) study design; (3) method of group assignment; and (4) procedural fidelity. The overall rigor of the studies analyzed was acceptably high; however, the studies had important methodological limitations.

Data collection often occurred after the intervention had concluded or, in other instances, intervention was begun before data collection started. Random group assignment — a fundamental tenet of empirical studies — was used in only 2 of the 13 studies. Little data could be ascertained about the comparison treatment conditions, and uniformity did not exist across the studies. Furthermore, standardization across the comparison groups was lacking, there were no measures of procedural fidelity, and data on whether subjects in the groups received supplemental intervention was absent.

Assessment of procedural fidelity was mixed across the studies. Other studies of EIBI have shown that parents and therapists may find it difficult to achieve adequate levels of procedural fidelity. The authors suggest that parametric studies of the level of precision needed for EIBI to be effective should be established in order for these measures to be empirically meaningful.

Perhaps the most important finding in this portion of the analysis was that the constructs of academic placement and diagnostic reclassification — commonly referred to as "recovery" — were questioned as measures of outcome. Academic placement was found to be a flawed outcome measure that should not be used as an indication of the effectiveness of interventions. Diagnostic reclassification, meanwhile, must be determined through the use of valid instruments designed specifically for the diagnosis of autism, and such testing must be conducted by qualified professionals who are unaware of the subject's earlier diagnosis or membership in an experimental group.