Evidence-Based Practice

While reading about Applied Behavior Analysis (ABA), it will quickly become apparent that there is an emphasis on using evidence-based practice. But why is this an essential aspect of ABA?

The short answer is that evidence-based practices work. That is, the teaching procedures have withstood stringent testing and have resulted in clinically significant changes in behavior. However, an emphasis on evidence-based practice goes beyond this; it ensures quality control for our field. This quality control holds behavior analysts to an ethical standard for providing the most effective and efficient teaching protocols.

There are many different types of interventions for children with Autism. In fact, a quick google search for “autism interventions” will yield thousands of results, and it may be difficult to sift through to identify procedures that may work for your child. However, some treatments are more or less effective than others, and behavior analysts (and parents alike) must be able to identify which programs will lead to the best outcomes for their children. Unfortunately, sometimes popular interventions are not always evidence-based.

In the early 1990s, a communication system known as “facilitated communication” (FC) became a popular intervention for increasing communication for children with intellectual and developmental disabilities. The teaching system asserts that children with developmental disabilities have the cognitive ability to communicate, but their diagnosis prevents them to be able to effectively express their thoughts and feelings. FC involves providing the child with a means to communicate (e.g., keyboard, alphabet board), and a therapist-facilitator that gently guides the child’s arm or hand towards the letters. Initially, it seemed like a promising intervention, as children that previously had no means of communicating were forming coherent sentences.

However, controlled studies testing the effectiveness of FC quickly demonstrated that it was an ineffective method. For example, one study investigated FC by showing children and facilitators a series of objects that they were asked to label. Anytime the facilitator saw the same object as the child, the child correctly labeled the object. However, when the child was shown a different object than the facilitator, the child incorrectly labeled the object. Simply put, the children only responded correctly when the facilitator saw the correct image, suggesting that the facilitator was influencing communication – not the child. Similar tests have replicated these findings, providing evidence that the intervention is ineffective at teaching communication skills for children with developmental disabilities.

Despite these findings, FC is still being offered as a communication program for children with Autism. But why is this problematic? Unsurprisingly, using ineffective interventions can be costly, as they take away from the time that the child could be benefiting from evidence-based practices. Therefore, it is in the best interest of our children to provide them with positive outcomes using interventions that have been validated by empirical research.

American Psychological Association (November 20th, 2003). Facilitated communication: Sifting the psychological wheat from the chaff. American Psychological Association. Retrieved from http://www.apa.org/research/action/facilitated.aspx

Mostert, M.P. (2001). Facilitated communication since 1995: A review of published studies. Journal of Autism and Developmental Disorders 31, 287-313.