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Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes
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. Disa...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Nature Singapore
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9672611/ https://www.ncbi.nlm.nih.gov/pubmed/36394715 http://dx.doi.org/10.1007/s12519-022-00643-0 |
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author | Ostrovsky, Andrey Willa, Melissa Cho, Ted Strandberg, Maxwell Howard, Sage Davitian, Colin |
author_facet | Ostrovsky, Andrey Willa, Melissa Cho, Ted Strandberg, Maxwell Howard, Sage Davitian, Colin |
author_sort | Ostrovsky, Andrey |
collection | PubMed |
description | 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12519-022-00643-0. |
format | Online Article Text |
id | pubmed-9672611 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Nature Singapore |
record_format | MEDLINE/PubMed |
spelling | pubmed-96726112022-11-18 Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes Ostrovsky, Andrey Willa, Melissa Cho, Ted Strandberg, Maxwell Howard, Sage Davitian, Colin World J Pediatr Original Article 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12519-022-00643-0. Springer Nature Singapore 2022-11-17 2023 /pmc/articles/PMC9672611/ /pubmed/36394715 http://dx.doi.org/10.1007/s12519-022-00643-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Ostrovsky, Andrey Willa, Melissa Cho, Ted Strandberg, Maxwell Howard, Sage Davitian, Colin Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes |
title | Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes |
title_full | Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes |
title_fullStr | Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes |
title_full_unstemmed | Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes |
title_short | Data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes |
title_sort | data-driven, client-centric applied behavior analysis treatment-dose optimization improves functional outcomes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9672611/ https://www.ncbi.nlm.nih.gov/pubmed/36394715 http://dx.doi.org/10.1007/s12519-022-00643-0 |
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