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Interventions based on early intensive applied behaviour analysis for autistic children: a systematic review and
Mark Rodgers1, David Marshall1, Mark Simmonds1
1Centre for Reviews and Dissemination, University of York, York, UK.
Health Technology Assessment (Winchester, England)
|July 21, 2020
Summary
Early intensive applied behaviour analysis (ABA) interventions show potential for improving cognitive ability and adaptive behavior in autistic children. However, long-term effectiveness and cost-effectiveness remain uncertain due to limited data.
Area of Science:
- Autism Spectrum Disorder Interventions
- Behavioral Science
- Developmental Psychology
Background:
- Early intensive applied behaviour analysis-based interventions (ABA) are intensive, one-to-one therapies for autistic children, typically 20-50 hours/week.
- Evidence on the clinical and cost-effectiveness of these interventions is crucial for guiding clinical practice and policy.
Purpose of the Study:
- To systematically review and meta-analyze the clinical effectiveness of early intensive ABA interventions for autistic children.
- To evaluate the cost-effectiveness of these interventions based on existing evidence and new economic modeling.
Main Methods:
- A systematic review and individual participant data meta-analysis of 20 studies were conducted.
- Economic analysis involved reviewing existing models and developing a new cost-effectiveness model.
Main Results:
- Interventions favored adaptive behavior (MD 7.00) and cognitive ability/IQ (MD 9.16 at 1 year, 14.13 at 2 years).
- Cost-effectiveness analysis indicated interventions are unlikely to be cost-effective unless significant long-term benefits or educational placement changes are demonstrated.
- Limited data and heterogeneity across studies necessitate caution in interpreting results.
Conclusions:
- Limited evidence suggests early intensive ABA may improve cognitive ability and adaptive behavior in autistic children.
- The long-term impact and cost-effectiveness are currently unclear, requiring further investigation.
- Future research should focus on identifying effective components and utilizing robust comparators and outcome measures.
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