Efficacy of behavioral interventions for reducing problem behavior in persons with autism: an updated quantitative synthesis of single-subject research.

Problem or challenging behaviors are highly prevalent among persons with autism and bring along major risks for the individual with autism and his/her family. In order to reduce the problem behavior, several behavioral interventions are used. We conducted a quantitative synthesis of single-subject studies to examine the efficacy of behavioral interventions for reducing problem behavior in persons with autism. Two hundred and thirteen studies representing 358 persons with autism met the inclusion criteria and were included in the statistical analyses. Overall, we found that behavioral interventions were on average effective in reducing problem behavior in individuals with autism, but some interventions were significantly more effective than others. The results further showed that the use of positive (nonaversive) behavioral interventions was increasing over time. The behavioral interventions were on average equally effective regardless of the type of problem behavior that was targeted. Interventions preceded by a functional analysis reduced problem behavior significantly more than interventions not preceded by a functional analysis. Finally, treatment and experimental characteristics, but not participant characteristics, were statistically significant moderators of the behavioral treatment effectiveness.

[1]  J. Matson,et al.  Trends and topics in autism spectrum disorders research , 2009 .

[2]  Thomas E. Scruggs,et al.  The Quantitative Synthesis of Single-Subject Research , 1987 .

[3]  Diana Boer,et al.  Updating a meta-analysis of intervention research with challenging behaviour: Treatment validity and standards of practice , 2009, Journal of intellectual & developmental disability.

[4]  M. Heyvaert,et al.  A meta-analysis of intervention effects on challenging behaviour among persons with intellectual disabilities. , 2010, Journal of Intellectual Disability Research.

[5]  M. Heyvaert,et al.  Psychosocial interventions for reducing vocal challenging behavior in persons with autistic disorder: a multilevel meta-analysis of single-case experiments. , 2013, Research in developmental disabilities.

[6]  Daniel M. Maggin,et al.  A Quantitative Synthesis of Methodology in the Meta-Analysis of Single-Subject Research for Students with Disabilities: 1985–2009 , 2011 .

[7]  Kimberly J. Vannest,et al.  Effect Size in Single-Case Research: A Review of Nine Nonoverlap Techniques , 2011, Behavior modification.

[8]  Karrie A. Shogren,et al.  The Effect of Choice-Making as an Intervention for Problem Behavior , 2004 .

[9]  J. Schooler Unpublished results hide the decline effect , 2011, Nature.

[10]  J. R. Scotti,et al.  A meta-analysis of intervention research with problem behavior: treatment validity and standards of practice. , 1991, American journal of mental retardation : AJMR.

[11]  Patrick Onghena,et al.  Systematic review of restraint interventions for challenging behaviour among persons with intellectual disabilities: focus on effectiveness in single-case experiments. , 2014, Journal of applied research in intellectual disabilities : JARID.

[12]  Jonathan M. Campbell,et al.  Efficacy of behavioral interventions for reducing problem behavior in persons with autism: a quantitative synthesis of single-subject research. , 2003, Research in developmental disabilities.

[13]  Kimberly J. Vannest,et al.  Percentage of All Non-Overlapping Data (PAND) , 2007 .

[14]  Richard I. Parker,et al.  Evaluating Single-Case Research Data: A Comparison of Seven Statistical Methods , 2003 .

[15]  Robert H. Horner,et al.  Single-Case Designs Technical Documentation. , 2010 .

[16]  Hsen-Hsing Ma An Alternative Method for Quantitative Synthesis of Single-Subject Researches , 2006, Behavior modification.

[17]  William R. Shadish,et al.  Using UnGraph to extract data from image files: Verification of reliability and validity , 2009, Behavior research methods.

[18]  Johnny L. Matson,et al.  A Review of Behavioral Treatments for Self-Injurious Behaviors of Persons With Autism Spectrum Disorders , 2008, Behavior modification.

[19]  Geraldine Leader,et al.  Risk Factors for Challenging Behaviors among 157 Children with Autism Spectrum Disorder in Ireland. , 2009 .

[20]  M. Heyvaert,et al.  A multilevel meta-analysis of single-case and small-n research on interventions for reducing challenging behavior in persons with intellectual disabilities. , 2012, Research in developmental disabilities.

[21]  Megan E. Tudor,et al.  Predictors of Parent Stress in a Sample of Children with ASD: Pain, Problem Behavior, and Parental Coping. , 2013 .

[22]  Oliver Bridget Wendt,et al.  Quality Appraisal of Single-Subject Experimental Designs: An Overview and Comparison of Different Appraisal Tools , 2012 .

[23]  Leanne Togher,et al.  Rating the methodological quality of single-subject designs and n-of-1 trials: Introducing the Single-Case Experimental Design (SCED) Scale , 2008, Neuropsychological rehabilitation.