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Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes

delete2022-11-17
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OA
AI
A
Andrey Ostrovsky *
M
Melissa Willa
T
Ted Cho
M
Maxwell Strandberg
S
Sage Howard
C
Colin Davitian
DOI:10.1007/s12519-022-00643-0delete
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Abstract

Abstract

En 中文
Background With increasing numbers of individuals diagnosed with autism spectrum disorder (ASD) and with affirmation of applied behavior analysis (ABA) as an evidence-based standard of care for ASD, there has been a proliferation of agencies offering ABA services over the last several decades. Disagreement exists among ABA providers and health plans that reimburse those providers on the optimal number of hours of ABA services that should be reimbursed. This study aims to understand whether children who receive more hours of ABA therapy achieve better outcomes and to evaluate the impact of the COVID-19-induced shift to telehealth clinical supervision on outcomes. Methods A retrospective cohort analysis was performed using data from the Vineland 3 Comprehensive Interview Form to assess function throughout ABA treatment. Paired sample t tests, independent sample t tests, Cohen's D, and Pearson correlations were used to determine relationships between Vineland scores and input variables including hours of service and modality of supervision (in-person vs. telehealth). Results While statistically and clinically significant improvements in function were observed, children appear to have improved outcomes independent of the number of hours of service received. There were also no significant associations between modality of supervision and Vineland standard scores. Conclusions These findings challenge prior research that demonstrated a linear dose-response relationship. By tailoring treatment dosage to the individual client's needs, providers may be able to better maximize functional progress of the client, to preserve family time, and to utilize health plan dollars more efficiently.
Keywords:
Autism spectrum disorder (ASD)
Autistic disorder
Autistic rehabilitation
Autistic therapy
Telemedicine
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World Journal of Pediatrics cover
World Journal of Pediatrics
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