Association for Behavior Analysis International

Recent American Psychological Association guidelines on empirically supported treatments (EST) suggest that treatments can be designated as "well established," "probably efficacious," or "experimental" based on the number of studies that have a good experimental design and demonstrate an effective outcome. Treatments with the most empirical support are designated as "well established." Although a multitude of reviews of behavior analytic procedures as effective treatment exist in the literature, few treatments have been examined using the EST criteria. The purpose of these studies was to apply the standard of empirically supported to several treatment areas. These areas included behavior associated with specific disabilities (e.g., autism and acquired brain injury) and specific behaviors (e.g., pica) across disorders. Results of these studies suggest that behavior analytic treatments are "well established" in the treatment of a number of behaviors. These results are discussed in reference to the larger field of psychology and the dissemination of behavior analytic treatments therein.

The scope of this meta-analysis was to complete a systematic evidence-based review of published behavioral treatment studies employing single-case designs with both children and adults with acquired brain injury. Peer-reviewed journals were searched using PsycINFO, Medline, and ERIC database search engines with combinations of terms such as brain injury, behavior disorder, behavior therapy, behavior modification, behavior analysis, and verbal behavior. A total of 115 acquisition and reduction studies met established inclusion criteria. The data extracted from each study included specific details about the participants, target behaviors, intervention characteristics, use of functional assessment, and outcome characteristics. A data extraction software program was also used to extract data from graphs to calculate multiple nonoverlap effect sizes such as the percentage of nonoverlapping data and Taunovlap. The studies were evaluated along several dimensions such as APA Division 12 guidelines, special education guidelines, and experimental control. A variety of methodological concerns and areas for future research are also discussed.

For a treatment to meet criteria as well-established and empirically validated (as defined by APA divisions 12 and 16) a large number of single-subject design studies displaying experimental control with baseline or other treatment comparisons must be examined. The current study critically reviewed 29 research articles examining the effects of applied behavior analytic treatment techniques for the severe problem behavior (e.g., aggression, self-injury, disruption) of those diagnosed with autism since 2005. The treatments included were either reinforcement based (e.g., differential reinforcement of an alternative response, noncontingent reinforcement) or included both reinforcement and punishment (e.g., time-out). Twenty-six of those studies conducted experimentally sound designs and 23 reduced problem behavior by at least 80%. Additionally, 15 of those 23 studies displayed reductions of 90% or higher. The results suggest the designation of applied behavior analytic techniques as well-established and empirically validated treatment for the severe problem behavior of those diagnosed with autism.

Pica as problem behavior is of particular concern because even one instance of the behavior may cause tremendous harm. A number of reviews have examined the effectiveness of behavior analytic treatments; however, none have done so using the American Psychological Association (APA) guidelines on empirically supported treatments. The purpose of the current study was to critically examine the existing literature on the treatment of pica displayed by individuals with intellectual disabilities. Criteria for empirically supported treatments as described by Divisions 12 and 16 of APA, and adapted for studies employing single-case designs were used to review this body of literature. A total of 34 treatment studies were identified, 25 of which were well-designed and reported at least an 80% reduction in pica (21 studies reported 90% or greater reduction in pica). Results indicated that behavioral treatments in general, and treatments involving the combination of reinforcement and response reduction procedures in particular, can be designated as well-established treatments for pica exhibited by individuals with intellectual disabilities.