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required to complete a specific activity. Schedules are often supplemented by other i
reinforcement. Schedules can take several forms including written words, pictures or
Self-management: These interventions involve promoting independence by teaching
regulate their behavior by recording the occurrence/nonoccurrence of the target behav
for doing so. Initial skills development may involve other strategies and may include
goals. In addition, reinforcement is a component of this intervention with the individu
seeking and/or delivering reinforcers. Examples include the use of checklists (using c
wrist counters, visual prompts, and tokens.
Story-based Intervention Package: These treatments involve a written description o
specific behaviors are expected to occur. Stories may be supplemented with additiona
reinforcement, discussion, etc.). Social Stories are the most well-known story-base
answer the who, what, when, where, and why in order to improve perspec
Applied Behavior Analysis is a field of practice, not a specific treatment. Treatment p
Intervention, Lovaas Therapy, Lovaas UCLA Program, Intensive Behavior Analysis,
should not be used interchangeably with the term Applied Behavior Analysis. The af
treatment approaches and methodologies that incorporate strategies and procedures frBehavior Analysis.
Other treatments for autism spectrum disorders for the purpose of this review are con
ABA. This includes the following:
1. Relationship Development Intervention (RDI),2. TEACCH or structured teaching,3. the Early Start Denver Model, and4. DIR/Floortime.
These treatments are not considered to be components of Applied Behavior Analysis
treatments for ASD.
C:\Documents andSettings\kthom98\De
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Practicum: Supervised at least weekly for 10% (7.5% minimum) of the total hour
Practicum. Total supervision must be at least 100 hours (75 minimum). A superv
Intensive Practicum: supervised at least twice weekly for 15% (10% minimum) o
Intensive University Practicum. Total supervision must be at least 112.5 hours (7
period is one week.
Individuals do not start accumulating experience until they have begun the coursewor
coursework requirements.
Supervisor Qualifications:
During the experience period, the supervisor must be:
1. A Board Certified Behavior Analyst in good standing, or2. Approved University Experience: A faculty member who has been approved
in the universitys approved course sequence.
The supervisor may not be the student's relative, subordinate or employee during the
supervisor will not be considered an employee of the student if the only compensatio
from the student consists of payment for supervision.
Nature of Supervision:
The supervisor must:
a. observe the clinician engaging in behavior analytic activities in the natural e
two weeks.
b. the supervisor must provide specific feedback on their performance.
c. during the initial half of the total experience hours, observation is concentrainteractions. This observation may be conducted via web-cameras, videotap
means in lieu of the supervisor being physically present.
d. supervision may be conducted in small groups of 10 or fewer for no more th
hours in each supervisory period. The remainder of the total supervision ho
must consist of direct one-to-one contact. Supervision hours may be counte
experience hours required.
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The behavior analyst:
designs programs that are based on behavior analytic principles, including asintervention methods,
involves the client or the client-surrogate in the planning of such programs,
obtains the consent of the client, and
respects the right of the client to terminate services at any time.
Describing Conditions for Program Success.
The behavior analyst describes to the client or client-surrogate the environmenecessary for the program to be effective.
Environmental Conditions that Preclude Implementation.
If environmental conditions preclude implementation of a behavior analytic precommends that other professional assistance (i.e., assessment, consultation
other professionals) be sought.
Environmental Conditions that Hamper Implementation.
If environmental conditions hamper implementation of the behavior analytic
seeks to eliminate the environmental constraints, or identifies in writing the o
Approving Interventions.
The behavior analyst must obtain the clients or client-surrogates approval iintervention procedures before implementing them.
Reinforcement/Punishment.
The behavior analyst recommends reinforcement rather than punishment wheprocedures are necessary, the behavior analyst always includes reinforcemen
behavior in the program.
Avoiding Harmful Reinforcers.
The behavior analyst minimizes the use of items as potential reinforcers that health of the client or participant (e.g., cigarettes, sugar or fat-laden food), or
marked deprivation procedures as motivating operations.
On-Going Data Collection.
The behavior analyst collects data, or asks the client, client-surrogate, or desineeded to assess progress within the program.
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maladaptive behavior by the clinicians or support staff could have adverse effects.
Potential results from malfunctioning of the technology
The technology cannot malfunction; only be misapplied.
Risk management processes for ABA practitioners?
Risk management procedures for practitioners involved in behavior analytic treatmen
Requirement of 36 continuing education credits and recertification every threrequirements are to ensure competency in the practitioners respective field a
analytic treatments of ASD (e.g., BACB approved CEUs, APA approved CE
Reportability and accountability to the Behavior Analyst Certification BoardProfessional Conduct Guidelines.
AND/OR
Reportability and accountability to the practitioners respective state licensing board
Professional conduct as outlined by that board
Key Issues to beanswered by theevidence
1) What is the strength of the evidence for specific ABA intervention treatments
Autism Spectrum Disorders (ASD)?
2) For which populations are each of these interventions appropriate?
3) What are the limitations of the treatment research reviewed?
Clarification of the review process
The CTAC review of Applied Behavior Analysis (ABA) as a treatment methodology for autism spectrumtechnical reviews of the literature completed in three publications:
1) The National Standards Project (NSP), published by the National Autism Center
2) The Technical Review of Published Research on Applied Behaviour Analysis Interventions fSpectrum Disorder published by Auckland Uniservices Limited for the New Zealand Ministryof Health (the New Zealand Review)
3) A 2010 meta-analysis by Javier Virus-Ortega published in the Journal of Clinical Psycholog
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number of studies reviewed by the NSP for that category and the corresponding number of studies that m
established (e.g. score of 3, 4, 5) which was based on the NSPs Scientific Merit Rating Scale (SMRS)
studies meeting the emerging category were included in this description for the purpose of clarity and the written paper published by the NSP.
Antecedent Package:
Summary of Strength of Evidence Classification: (Proven level vs. Emerging level vs. Unproven level)
1) Quantity of Evidence:
PROVEN: 3 or more published, peer-reviewed studies -
Study design ranking will rely on UHC hierarchy of
evidence
Total studies reviewed in this category: 109*
Number of studies meeting established rating: 4 Single
Subject Research Design (SSRD)
* the NSP report listed the antecedent package as having 99studies; a total of 109 were sent for final tally
2) SMRS Score:
PROVEN: average of at least 4.0;EMERGING: average of at least 3.0
Of the 109 studies reviewed: average SMRS score of
1.38 (range: 0-4)
Of the 4 studies: average SMRS score of 3.25 (range:3-4)
Hierarchy of Clinical Evidence (list number of studies
reviewed for each category):
***Note*** for specific breakdown of what SMRS scores
indicate at both group and single-subject level, please refer
to PPT titled CTAC Levels of Evidence and Mapping to
NSP slides 6-11
___ CMS Natl Coverage Decisions
___ Statistically robust, well-designed RCTs
___ Group observational studies (SMRS = 4)
___ Group observational studies (SMRS = 3)_1_ Single-subject observational studies (SMRS = 4)
_3_ Single-subject observational studies (SMRS = 3)
___ Natl Guidelines & Consensus Statements
___ Evidence-based guidelines from Natl Societies
3) Treatment Effects:
PROVEN: group - statistically significant effects reported in
favor of the treatment; single - functional relationship
established and replicated at least two times
This intervention category demonstrated favorableoutcomes with the following age groups:
o 3-5 yrso 6-9 yrso 10-14 yrs
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PROVEN: average of at least 4.0;
EMERGING: average of at least 3.0)
Of the 4 studies: average SMRS score of 3.25 (range3-4)
Hierarchy of Clinical Evidence (list number of studies
reviewed for each category):
***Note*** for specific breakdown of what SMRS scores
indicate at both group and single-subject level, please refer
to PPT titled CTAC Levels of Evidence and Mapping to
NSP slides 6-11
___ CMS Natl Coverage Decisions
___ Statistically robust, well-designed RCTs___ Group observational studies (SMRS = 4)
_1_ Group observational studies (SMRS = 3)
_1_ Single-subject observational studies (SMRS = 4)_2_ Single-subject observational studies (SMRS = 3)
___ Natl Guidelines & Consensus Statements
___ Evidence-based guidelines from Natl Societies
3) Treatment Effects:
PROVEN: group - statistically significant effects reported in
favor of the treatment; single - functional relationship
established and replicated at least two times
This intervention category demonstrated favorableoutcomes with the following age groups:
o 0-2 yrso 3-5 yrs
These interventions involve building foundational skills involved in regulating the behaviors of others. Jo
teaching a child to respond to the nonverbal social bids of others or to initiate joint attention interactionsobjects, showing items/activities to another person, and following eye gaze.
Modeling:
Summary of Strength of Evidence Classification: Proven level vs. Emerging level vs. Unproven level)
1) Quantity of Evidence:
PROVEN: 3 or more published, peer-reviewed studies -
Study design ranking will rely on UHC hierarchy of
evidence
Total studies reviewed in this category: 56*Number of studies meeting established rating:14 Single
Subject studies
*the NSP report listed the modeling package as having 50 studies; atotal of 56 were sent for final tally
2) SMRS Score:
PROVEN: average of at least 4.0;
Of the 56 studies reviewed: average SMRS score of
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EMERGING: average of at least 3.0
Of the 14 studies: average SMRS score of 3.14(range: 3-4)
Hierarchy of Clinical Evidence (list number of studies
reviewed for each category):
***Note*** for specific breakdown of what SMRS scores
indicate at both group and single-subject level, please refer
to PPT titled CTAC Levels of Evidence and Mapping to
NSP slides 6-11
___ CMS Natl Coverage Decisions
___ Statistically robust, well-designed RCTs___ Group observational studies (SMRS = 4)
___ Group observational studies (SMRS = 3)
_2_ Single-subject observational studies (SMRS = 4)_12 Single-subject observational studies (SMRS = 3)
___ Natl Guidelines & Consensus Statements
___ Evidence-based guidelines from Natl Societies
3) Treatment Effects:
PROVEN: group - statistically significant effects reported in
favor of the treatment; single - functional relationship
established and replicated at least two times
This intervention category demonstrated favorableoutcomes with the following age groups:
o 3-5 yrso 6-9 yrso 10-14 yrs
o 15-18 yrs
These interventions rely on an adult or peer providing a demonstration of the target behavior that should
target behavior by the individual with ASD. Modeling can include simple and complex behaviors. This i
with other strategies such as prompting and reinforcement. Examples include live modeling and video m
Naturalistic Teaching Strategies:
Summary of Strength of Evidence Classification: (Proven level vs. Emerging level vs. Unproven level)
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1) Quantity of Evidence:
PROVEN: 3 or more published, peer-reviewed studies -
Study design ranking will rely on UHC hierarchy of
evidence
Total studies reviewed in this category: 32
Number of studies meeting established rating: 2 groupdesign, and 5 Single Subject studies
2) SMRS Score:
PROVEN: average of at least 4.0;
Of the 32 studies reviewed: average SMRS score of1.94 (range: 0-4)
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EMERGING: average of at least 3.0 Of the 7 studies: average SMRS score of 3.29 (range3-4)
Hierarchy of Clinical Evidence (list number of studies
reviewed for each category):
***Note*** for specific breakdown of what SMRS scoresindicate at both group and single-subject level, please refer
to PPT titled CTAC Levels of Evidence and Mapping to
NSP slides 6-11
___ CMS Natl Coverage Decisions
___ Statistically robust, well-designed RCTs___ Group observational studies (SMRS = 4)
_2_ Group observational studies (SMRS = 3)_2_ Single-subject observational studies (SMRS = 4)_3_ Single-subject observational studies (SMRS = 3)
___ Natl Guidelines & Consensus Statements
___ Evidence-based guidelines from Natl Societies
3) Treatment Effects:
PROVEN: group - statistically significant effects reported in
favor of the treatment; single - functional relationship
established and replicated at least two times
This intervention category demonstrated favorableoutcomes with the following age groups:
o 0-2 yrso 3-5 yrso 6-9 yrs
These interventions involve using primarily child-directed interactions to teach functional skills in the na
interventions often involve providing a stimulating environment, modeling how to play, encouraging con
and direct/natural reinforcers, and rewarding reasonable attempts. Examples of this type of approach inclfocused stimulation, incidental teaching, milieu teaching, embedded teaching, and responsive education
teaching.
Peer Training Package:
Summary of Strength of Evidence Classification: (Proven level vs. Emerging level vs. Unproven level)
1) Quantity of Evidence:PROVEN: 3 or more published, peer-reviewed studies -
Study design ranking will rely on UHC hierarchy of
evidence
Total studies reviewed in this category: 33
Number of studies meeting established rating:1 group
design, and 6 Single Subject studies
2) SMRS Score:
PROVEN: average of at least 4.0;
Of the 33 studies reviewed: average SMRS score of
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EMERGING: average of at least 3.0
Of the 7 studies: average SMRS score of 3.0 (range:3)
Hierarchy of Clinical Evidence (list number of studies
reviewed for each category):
***Note*** for specific breakdown of what SMRS scores
indicate at both group and single-subject level, please refer
to PPT titled CTAC Levels of Evidence and Mapping to
NSP slides 6-11
___ CMS Natl Coverage Decisions
___ Statistically robust, well-designed RCTs___ Group observational studies (SMRS = 4)
_1_ Group observational studies (SMRS = 3)
___ Single-subject observational studies (SMRS = 4)_6_ Single-subject observational studies (SMRS = 3)
___ Natl Guidelines & Consensus Statements
___ Evidence-based guidelines from Natl Societies
3) Treatment Effects:
PROVEN: group - statistically significant effects reported in
favor of the treatment; single - functional relationship
established and replicated at least two times
This intervention category demonstrated favorableoutcomes with the following age groups:
o 3-5 yrso 6-9 yrso 10-14 yrs
These interventions involve teaching children without disabilities strategies for facilitating play and socia
on the autism spectrum. Peers may often include classmates or siblings. When both initiation training an
components of treatment in a study, the study was coded as peer training package. These interventionsother treatment packages (e.g., self-management for peers, prompting, reinforcement, etc.). Common nam
include peer networks, circle of friends, buddy skills package, Integrated Play Groups, peer initiation t
social interactions.
Pivotal Response Treatment:
Summary of Strength of Evidence Classification: (Proven level vs. Emerging level vs. Unproven level)
1) Quantity of Evidence:
PROVEN: 3 or more published, peer-reviewed studies -
Study design ranking will rely on UHC hierarchy of
evidence
Total studies reviewed in this category: 14
Number of studies meeting established rating:4 Single
Subject studies
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2) SMRS Score:
PROVEN: average of at least 4.0;
EMERGING: average of at least 3.0
Of the 14 studies reviewed: average SMRS score of2.0 (range: 0-3)
Of the 4 studies: average SMRS score of 3.0 (range:3)
Hierarchy of Clinical Evidence (list number of studies
reviewed for each category):
***Note*** for specific breakdown of what SMRS scores
indicate at both group and single-subject level, please refer
to PPT titled CTAC Levels of Evidence and Mapping to
NSP slides 6-11
___ CMS Natl Coverage Decisions
___ Statistically robust, well-designed RCTs
___ Group observational studies (SMRS = 4)
___ Group observational studies (SMRS = 3)
___ Single-subject observational studies (SMRS = 4)_4_ Single-subject observational studies (SMRS = 3)
___ Natl Guidelines & Consensus Statements
___ Evidence-based guidelines from Natl Societies
3) Treatment Effects:
PROVEN: group - statistically significant effects reported in
favor of the treatment; single - functional relationshipestablished and replicated at least two times
This intervention category demonstrated favorableoutcomes with the following age groups:
o 3-5 yrs
o 6-9 yrs
This treatment is also referred to as PRT, Pivotal Response Teaching, and Pivotal Response Training. PR
pivotal behavioral areas such as motivation to engage in social communication, self-initiation, self-
responsiveness to multiple cues, with the development of these areas having the goal of very widespreadcollateral improvements. Key aspects of PRT intervention delivery also focus on parent involvement in th
on intervention in the natural environment such as homes and schools with the goal of producing natural
improvements. This treatment is an expansion of Natural Language Paradigm which is also included in t
Schedules:
Summary of Strength of Evidence Classification: (Proven level vs. Emerging level vs. Unproven level)
1) Quantity of Evidence:
PROVEN: 3 or more published, peer-reviewed studies -
Study design ranking will rely on UHC hierarchy of
evidence
Total studies reviewed in this category: 12
Number of studies meeting established rating:4 Single
Subject studies.
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2) SMRS Score:
PROVEN: average of at least 4.0;
EMERGING: average of at least 3.0
Of the 12 studies reviewed: average SMRS score of2.08 (range: 1-4)
Of the 4 studies: average SMRS score of 3.25 (range:3-4)
Hierarchy of Clinical Evidence (list number of studies
reviewed for each category):
***Note*** for specific breakdown of what SMRS scores
indicate at both group and single-subject level, please refer
to PPT titled CTAC Levels of Evidence and Mapping to
NSP slides 6-11
___ CMS Natl Coverage Decisions
___ Statistically robust, well-designed RCTs
___ Group observational studies (SMRS = 4)
___ Group observational studies (SMRS = 3)
_1_ Single-subject observational studies (SMRS = 4)_3_ Single-subject observational studies (SMRS = 3)
___ Natl Guidelines & Consensus Statements
___ Evidence-based guidelines from Natl Societies
3) Treatment Effects:
PROVEN: group - statistically significant effects reported in
favor of the treatment; single - functional relationshipestablished and replicated at least two times
This intervention category demonstrated favorableoutcomes with the following age groups:
o 3-5 yrs
o 6-9 yrso 10-14 yrs
These interventions involve the presentation of a task list that communicates a series of activities or steps
specific activity. Schedules are often supplemented by other interventions such as reinforcement. Scheduincluding written words, pictures or photographs, or work stations.
Self-management:
Summary of Strength of Evidence Classification: (Proven level vs. Emerging level vs. Unproven level)
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1) Quantity of Evidence:
PROVEN: 3 or more published, peer-reviewed studies -
Study design ranking will rely on UHC hierarchy of
evidence
Total studies reviewed in this category: 22*
Number of studies meeting established rating: 6 Single
Subject studies
*the NSP report listed the self-management package as having
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21 studies; a total of 22 were sent for final tally
2) SMRS Score:
PROVEN: average of at least 4.0;
EMERGING: average of at least 3.0
Of the 22 studies reviewed: average SMRS score of1.83 (range: 1-3)
Of the 6 studies: average SMRS score of 3.0 (range:3)
Hierarchy of Clinical Evidence (list number of studies
reviewed for each category):
***Note*** for specific breakdown of what SMRS scores
indicate at both group and single-subject level, please refer
to PPT titled CTAC Levels of Evidence and Mapping to
NSP slides 6-11
___ CMS Natl Coverage Decisions
___ Statistically robust, well-designed RCTs
___ Group observational studies (SMRS = 4)
___ Group observational studies (SMRS = 3)
___ Single-subject observational studies (SMRS = 4)_6_ Single-subject observational studies (SMRS = 3)
___ Natl Guidelines & Consensus Statements
___ Evidence-based guidelines from Natl Societies
3) Treatment Effects:
PROVEN: group - statistically significant effects reported infavor of the treatment; single - functional relationship
established and replicated at least two times
This intervention category demonstrated favorableoutcomes with the following age groups:
o 3-5 yrso 6-9 yrso 10-14 yrso 15-18 yrs
These interventions involve promoting independence by teaching individuals with ASD to regulate their
occurrence/nonoccurrence of the target behavior, and securing reinforcement for doing so. Initial skills dother strategies and may include the task of setting ones own goals. In addition, reinforcement is a comp
with the individual with ASD independently seeking and/or delivering reinforcers. Examples include the
checks, smiley/frowning faces), wrist counters, visual prompts, and tokens.
Story-based Intervention Package:
Summary of Strength of Evidence Classification: (Proven level vs. Emerging level vs. Unproven level)
1) Quantity of Evidence:
PROVEN: 3 or more published, peer-reviewed studies -
Total studies reviewed in this category: 21
Number of studies meeting established rating: 4 Single
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Study design ranking will rely on UHC hierarchy of
evidence
Subject studies
2) SMRS Score:
PROVEN: average of at least 4.0;
EMERGING: average of at least 3.0
Of the 21 studies reviewed: average SMRS score of1.81 (range: 0-4)
Of the 4 studies: average SMRS score of 3.25 (range:3-4)
Hierarchy of Clinical Evidence (list number of studies
reviewed for each category):
***Note*** for specific breakdown of what SMRS scores
indicate at both group and single-subject level, please refer
to PPT titled CTAC Levels of Evidence and Mapping to
NSP slides 6-11
___ CMS Natl Coverage Decisions
___ Statistically robust, well-designed RCTs
___ Group observational studies (SMRS = 4)___ Group observational studies (SMRS = 3)
_1_ Single-subject observational studies (SMRS = 4)
_3_ Single-subject observational studies (SMRS = 3)
___ Natl Guidelines & Consensus Statements
___ Evidence-based guidelines from Natl Societies
3) Treatment Effects:
PROVEN: group - statistically significant effects reported in
favor of the treatment; single - functional relationship
established and replicated at least two times
This intervention category demonstrated favorableoutcomes with the following age groups:
o 6-9 yrso 10-14 yrs
These treatments involve a written description of the situations under which specific behaviors are expecsupplemented with additional components (e.g., prompting, reinforcement, discussion, etc.). Social Stori
story-based interventions and they seek to answer the who, what, when, where, and why in or
taking.
Per the New Zealand Review:
The review method and evidence ranking by the New Zealand team was consistent with the NSP process
was based on an analysis of the specific components of the behavioral intervention package, the type of b
Ministry of Education supplied classification see table 4) and the impact of the interventions utilized (b
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community. This is based on the heavy reliance on continuous and more objective measurement of the re
demonstrate effectiveness on an individual level and give clearer indications of when treatment plan chan
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of early intensive behavioral intervention: Outcomes for children with autism and their parents after two
American Journal of Mental Retardation, 112, 418438.
Sallows, G. O.,& Graupner, T. D. (2005). Intensive behavioral treatment for children with autism
predictors. American Journal of Mental Retardation, 110, 417438.
Satcher, D. (1999). Mental health: A report of the surgeon general. U.S. Public Health Service. B
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Schreibman, L., & Koegel, R. L. (2005). Training for parents of children with autism: Pivotal res
individualization of interventions. In E. D. Hibbs & P. S. Jensen (Eds.), Psychosocial treatment for child
Empirically based strategies for clinical practice (2nd Edition). (pp. 605-631). Washington, D. C.: AmeriAssociation.
Volkmar, F., Cook, E.H., Pomeroy, J., Realmuto, G. & Tanguay, P. (1999). Practice parameters ftreatment of children, adolescents, and adults with autism and other pervasive developmental disorders. J
Academy of Child and Adolescent Psychiatry, 38 (Supplement), 32s-54s
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Appendix A
Cross Walk Grids
Grid Key
National Standards ProjectNew Zealand Review
Virues-Ortega Review
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Table 1. Established treatments by behavioral domains as outlined in the National Standards Project.
AntecedentPackage
BehavioralPackage
ComprehensiveBehavioralPackage
J ointAttentionPackage
Modeling NaturalisticTeaching
PeerTraining
PivotalResponseTraining
Schedule
Communication
Higher CognitiveLearning
Readiness
Placement
Interpersonal
PersonalResponsibility
Self-Regulation
Problem BehaviorsRestricted,Repetitive, Non-functional
General SymptomsSensory or EmotionalRegulation
Play
Antecedent
Package
Behavioral Package
Comprehensive Behavioral
Package
J ointAttentio
nPackage
Modeling
Naturalistic Teaching
PeerTrainin
g
PivotalResponse Training
Schedules M
Autism
Aspergers
NOS
Table 2. Established treatments by ASD diagnosis as outlined in the National Standards Project
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AntecedentPackage
BehavioralPackage
ComprehensiveBehavioralPackage
J ointAttentionPackage
Modeling NaturalisticTeaching
PeerTraining
PivotalResponseTraining
Schedules Man
0-2
3-56-910-1415-1819-21
Table 3. Established treatments by age group as outlined in the National Standards Project
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Antecedent
Package
Behavioral
Package
Comprehensive
Behavioral
Package
Joint
Attention
Package
Modeling Naturalistic
Teaching
Peer
Training
Antecedent
Exposure
Behavioural
FCT
Social skills
PECS
Verbal behaviour
Reductive
Early IBI [intensive behavioural intervention]
Joint attention
Modelling
Naturalistic teaching
Peer training
PRT [pivotal response training]
Schedules
Self-management
Scripting
Table 4. NSP treatment packages mapped to NZR treatment approaches
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Com
munication
Hig
herCognitive
Lea
rning
Rea
diness
Placement
Interpersonal
Per
sonal
Res
ponsibility
Self-Regulation
Pro
blem
Beh
aviors
es
trcte,
Rep
etitive,Non-
functional
Gen
eral
Sym
ptoms
Sen
soryor
Em
otional
Reg
ulation
Play
Development of functional and
spontaneous communication
Development of cognitive
(thinking) skills
Social development and relating to
others
Development of independent
organizational skills and other
behaviors
Prevention of challenging
behaviors and substitution with
more appropriate andconventional behaviors
Reducing challenging behaviors
Engagement and Flexibility in
Developmentally Appropriate
Tasks and Play and Later
Engagement in Vocational
Activities
Receptive Language
Expressive Language
General language skills
Communication
General IQ
Non-verbal IQ
Daily living skills
Socialization
Motor skills
Adaptive Behavior CompositeTable 5. National Standards Project behavioral domains matched to New Zealand Review
and Virues-Ortega meta-analysis behavioral domains.
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Appendix B
Reference Listing of Critical Studies for Intervention Packages
Antecedent PackageBaker, M.J . (2000). Incorporating the thematic ritualistic behaviors of children with autism into games:
Increasing social play interactions with siblings. Journal of Positive Behavior Interventions, 2(2), 66-84.
Davis, C. A., Brady, M. P., Hamilton, R., McEvoy, M. A., & et al. (1994). Effects of high probability requests onthe social interactions of young children with severe disabilities. Journal of Applied Behavior Analysis,27(4), 619-637.
Ducharme, J .M., Sanjuan, E., & Frain, T. (2007). Errorless compliance training : Success-focused behavioraltreatment of children with asperger syndrome. Behavioral Modification, 31(3), 329-344.
Grindle, C.F., & Remington, B. (2004). Teaching children with autism using conditioned cue-value andresponse-marking procedures: A socially valid procedure. Research in Developmental Disabilities,25(5), 413-429.
Behavioral Package
Apple, A.L., Billingsley, F., & Schwartz, I.S. (2005). Effects of video modeling alone and with self-managementon compliment-giving behaviors of children with high-functioning ASD. Journal of Positive BehaviorInterventions, 7(1), 33-46.
Carr, E. G., & Carlson, J . I. (1993). Reduction of severe behavior problems in the community using amulticomponent treatment approach. Journal of Applied Behavior Analysis, 26(2), 157-172.
Charlop-Christy, M. H., & Haymes, L. K. (1996). Using obsessions as reinforcers with and without mildreductive procedures to decrease inappropriate behaviors of children with autism. Journal of Autismand Developmental Disorders, 26(5), 527-546.
Charlop-Christy, M. H., & Haymes, L. K. (1998). Using objects of obsession as token reinforcers for childrenwith autism. Journal of Autism and Developmental Disorders, 28(3), 189-198.
Durand, V. M., & Carr, E. G. (1991). Functional communication training to reduce challenging behavior:
Maintenance and application in new settings. Journal of Applied Behavior Analysis, 24(2), 251-264.
Gena, A., Couloura, S., & Kymissis, E. (2005). Modifying the affective behavior of preschoolers with autismusing in-vivo or video modeling and reinforcement contingencies. Journal of Autism andDevelopmental Disorders, 35(5), 545-556.
Haring, T. G., Kennedy, C. H., Adams, M. J ., & Pitts-Conway, V. (1987). Teaching generalization ofpurchasing skills across community settings to autistic youth using videotape modeling. Journal of
Applied Behavior Analysis, 20(1), 89-96.
Harris, S. L., Handleman, J . S., & Alessandri, M. (1990). Teaching youths with autism to offer assistance.Journal of Applied Behavior Analysis, 23, 297-305.
Lee, R., & Sturmey, P. (2006). The effects of lag schedules and preferred materials on variable responding instudents with autism. Journal of Autism and Developmental Disorders, 36(3), 421-428.
McConnachie, G., & Carr, E. G. (1997). The effects of child behavior problems on the maintenance ofintervention fidelity. Behavior Modification, 21(2), 123-158.
Nuzzolo-Gomez, R., Leonard, M. A., Ortiz, E., Rivera, C. M., & Greer, R. D. (2002).Teaching children with autism to prefer books or toys over stereotypy or passivity. Journal of PositiveBehavior Interventions, 4(2), 80-87.
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Pelios, L. V., MacDuff, G. S., & Axelrod, S. (2003). The effects of a treatment package in establishingindependent academic work skills in children with autism. Education & Treatment of Children, 26(1),1-21.
Rincover, A., & Newsom, C. D. (1985). The relative motivational properties of sensory and edible reinforcers inteaching autistic children. Journal of Applied Behavior Analysis, 18(3), 237-248.
Ross, D. E., & Greer, R. D. (2003). Generalized imitation and the mand: Inducing first instances of speech inyoung children with autism. Research in Developmental Disabilities, 24(1), 58-74.
Sidener, T. M., Shabani, D. B., Carr, J . E., & Roland, J . P. (2006). An evaluation of strategies to maintain atpractical levels. Research in Developmental Disabilities, 27(6), 632-644.
Thiemann, K. S., & Goldstein, H. (2001). Social stories, written text cues, and video feedback: Effects onsocial communication of children with autism. Journal of Applied Behavior Analysis, 34(4), 425-446.
CBTYC PackageCohen, H., Amerine-Dickens, M., & Smith, T. (2006). Early intensive behavioral treatment: Replication of the
UCLA model in a community setting. Journal of Developmental and Behavioral Pediatrics, 27(2), 145-155.
Eikeseth, S., Smith, T., J ahr, E., & Eldevik, S. (2007). Outcome for children with autism who began intensivebehavioral treatment between ages 4 and 7. Behavior Modification, 31(3), 264-278.
Harris, S. L., Handleman, J . S., Gordon, R., Kristoff, B., & Fuentes, F. (1991). Changes in cognitive andlanguage functioning of preschool children with autism. Journal ofAutism and DevelopmentalDisorders, 21(3), 281-290.
Lovaas, O. (1987). Behavioral treatment and normal educational and intellectual functioning in young autisticchildren. Journalof Consulting and Clinical Psychology, 55(1), 3-9.
Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-yearoutcome and predictors.American Journal of Mental Retardation: AJMR, 110(6), 417-438.
Smith, T., Eikeseth, S., Klevstrand, M., & Lovaas, O. (1997). Intensive behavioral treatment for preschoolerswith severe mental retardations and pervasive developmental disorder.American Journal on Mental
Retardation, 102(3), 238-249.
Smith, T., Buch, G. A., & Gamby, T. E. (2000). Parent-directed, intensive early intervention for children withpervasive developmental disorder. Research inDevelopmental Disabilities, 21(4), 297-309.
Joint Attention InterventionMartins, M. P., & Harris, S. L. (2006). Teaching children with autism to respond to joint attention initiations.
Child & Family Behavior Therapy, 28(1), 51-68.
Kasari, C., Freeman, S., & Paparella, T. (2006). J oint attention and symbolic play in young children withautism: A randomized controlled intervention study. Journal of Child Psychology and Psychiatry, and
Allied Disciplines, 47(6), 611-620.
J ones, E. A., Carr, E. G., & Feeley, K. M. (2006). Multiple effects of joint attention intervention for children withautism. Behavioral Modification, 30(6), 782-834.
Rocha, M. L., Schreibman, L., & Stahmer, A. C. (2007). Effectiveness of training parents to teach jointattention in children with autism. Journal of Early Intervention, 29(2), 154-172.
Modeling PackageApple, A. L., Billingsley, F., & Schwartz, I. S. (2005). Effects of video modeling alone and with self-
management on compliment-giving behaviors of children with high-functioning ASD. Journal ofPositive Behavior Interventions, 7(1), 33-46.
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Buffington, D. M., Krantz, P. J ., McClannahan, L. E., & Poulson, C. L. (1998). Procedures for teaching
appropriate gestural communication skills to children with autism. Journal of Autism andDevelopmental Disorders, 28(6), 535-545.
Buggey, T., Toombs, K., Gardener, P., & Cervetti, M. (1999). Training responding behaviors in students withautism: Using videotaped self-modeling. Journal of Positive Behavior Interventions, 1(4), 205-214.
Charlop-Christy, M. H., Le, L., & Freeman, K. A. (2000). A comparison of video modeling with in vivo modelingfor teaching children with autism. Journal of Autism and Developmental Disorders, 30(6), 537-552.
Charlop-Christy, M. H. & Daneshvar, S. (2003). Using video modeling to teach perspective taking to childrenwith autism. Journal of Positive Behavioral Interventions, 5(1), 12-21.
Gena, A., Krantz, P. J ., McClannahan, L. E., & Poulson, C. L. (1996). Training and generalization of affectivebehavior displayed by youth with autism. Journal of Applied Behavior Analysis, 29(3), 291-304.
Gena, A., Couloura, S., & Kymissis, E. (2005). Modifying the affective behavior of preschoolers with autismusing in-vivo or video modeling and reinforcement contingencies. Journal of Autism andDevelopmental Disorders, 35(5), 545-556.
Haring, T. G., Kennedy, C. H., Adams, M. J ., & Pitts-Conway, V. (1987). Teaching generalization of
purchasing skills across community settings to autistic youth using videotape modeling. Journal ofApplied Behavior Analysis, 20(1), 89-96.
J ahr, E., Eldevik, S., & Eikeseth, S. (2000). Teaching children with autism to initiate and sustain cooperativeplay. Research in Developmental Disabilities, 21(2), 151-169.
Nikopoulos, C. K. & Keenan, M. (2007). Using video modeling to teach complex social sequences to childrenwith autism. Journal of Autism and Developmental Disorders, 37(4), 678-693.
Reeve, S. A., Reeve, K. F., Townsend, D. B., & Poulson, C. L. (2007). Establishing a generalized repertoire ofhelping behavior in children with autism. Journal of Applied Behavior Analysis, 40(1), 123-136.
Schreibman, L., Whalen, C., & Stahmer, A.C. (2000). The use of video priming to reduce disruptive transitionbehavior in children with autism. Journal of Positive Behavior Interventions, 2(1), 3-11.
Sherer, M., Pierce, K. L., Paredes, S., Kisacky, K.L., Ingersoll, B., & Schreibman, L. (2001). Enhancingconversation skills in children with autism via video technology. Which is better, self or other as amodel? Behavior Modification, 25(1), 140-158.
Shipley-Benamou, R., Lutzker, J . R., & Taubman, M. (2002). Teaching daily living skills to children with autismthrough instructional video modeling. Journal of Positive Behavior Interventions, 4(3), 165-175.
Naturalistic Teaching StrategiesHancock, T. B., & Kaiser, A. P . (2002). The effects of trainer-implemented enhanced milieu teaching on the
social communication of children with autism. Topics in Early Childhood Special Education, 22(1), 29-54.
Ingersoll, B., & Schreibman, L. (2006). Teaching reciprocal imitation skills to young children with autism usinga naturalistic behavioral approach: Effects on language, pretend play, and joint attention. Journal of
Autism and Developmental Disorders, 36(4), 487- 505.
McGee, G. G., Krantz, P . J ., & McClannahan, L. E. (1986). An extension of incidental teaching procedures toreading instruction for autistic children. Journal of Applied Behavior Analysis, 19(2), 147-157.
McGee, G. G., & Daly, T. (2007). Incidental teaching of age-appropriate social phrases to children with autism.Research & Practice for Persons with Severe Disabilities, 32(2), 112-123.
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Olive, M. L., de la Cruz, B., Davis, T. N., Chan, J . M., Lang, R. B., OReilly, M. F., & Dickson, S. M. (2007). Theeffects of enhanced milieu teaching and a voice output communication aid on the requesting of threechildren with autism. Journal of Autism and Developmental Disabilities, 37, 1505-1513.
Wong, C. S., Kasari, C., Freeman, S., & Paparella, T. (2007). The acquisition and generalization of jointattention and symbolic play skills in young children with autism. Research & Practice for Persons withSevere Disabilities, 32(2), 101-109.
Yoder, P., & Stone, W. L. (2006). Randomized comparison of two communication interventions forpreschoolers with autism spectrum disorders. Journal of Consulting and Clinical Psychology, 74(3),426-435.
Peer TrainingKamps, D. M., Royer, J ., Dugan, E., Kravitz, T., Gonzalez-Lopez, A., Garcia, J ., et al. (2002). Peer training to
facilitate social interaction for elementary students with autism and their peers. Exceptional Children,78, 173-187.
Kohler, F. W., Strain, P. S., Hoyson, M., & J amieson, B. (1997). Merging naturalistic teaching and peer-basedstrategies to address the IEP objectives of preschoolers with autism: An examination of structural andchild behavior outcomes. Focus on Autism and Other Developmental Disabilities, 12(4), 196-206.
Lee, S., Odom, S. L. & Loftin, R. (2007). Social engagement with peers and stereotypic behavior of children
with autism. Journal of Positive Behavior Interventions, 9(2), 67-79.
Nelson, C., McDonnell, A. P., J ohnston, S. S., Crompton, A., & Nelson, A. R. (2007). Keys to play: A strategyto increase the social interactions of young children with autism and their typically developing peers.Education and Training in Developmental Disabilities, 42(2), 165-181.
Sainato, D. M., Goldstein, H., & Strain, P. S. (1992). Effects of self-evaluation on preschool childrens use ofsocial interaction strategies with their classmates with autism. Journal of Applied Behavior Analysis,25(1), 127-141.
Thiemann, K. S., & Goldstein, H. (2004). Effects of peer training and written text cueing on socialcommunication of school-age children with pervasive developmental disorder. Journal of Speech,Language, and Hearing Research: JSLHR, 47(1), 126-144.
Tsao, L., & Odom, S. L. (2006). Sibling-mediated social interaction intervention for young children with autism.
Topics in Early Childhood Special Education, 26(2), 106-123.
Pivotal Response TrainingHarper, C. B., Symon, J . B. G., & Frea, W. D. (2008). Recess is time-in: Using peers to improve social skills of
children with autism. Journal of Autism and Developmental Disorders, 38, 815-826.
Pierce, K., & Schreibman, L. (1995). Increasing complex social behaviors in children with autism: Effects ofpeer-implemented pivotal response training. Journal of Applied Behavior Analysis, 28(3), 285-295.
Stahmer, A. C. (1995). Teaching symbolic play skills to children with autism using pivotal response training.Journal of Autism and Developmental Disorders, 25(2), 123-141.
Thorp, D. M., Stahmer, A. C., & Schreibman, L. (1995). Effects of sociodramatic play training on children withautism. Journal of Autism and Developmental Disorders, 25(3), 265-282.
SchedulesKrantz, P. J ., MacDuff, M. T., & McClannahan, L. E. (1993). Programming participation in family activities for
children with autism: Parents use of photographic activity schedules. Journal of Applied BehaviorAnalysis, 26(1), 137-138.
Hume, K., & Odom, S. (2007). Effects of an individual work system on the independent functioning of studentswith autism. Journal of Autism and Developmental Disabilities, 37, 1166-1180.
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MacDuff, G. S., Krantz, P. J ., & McClannahan, L. E. (1993). Teaching children with autism to use photographicactivity schedules: Maintenance and generalization of complex response chains. Journal of AppliedBehavior Analysis, 26(1), 89-97.
Morrison, R. S., Sainato, D. M., Benchaaban, D., & Endo, S. (2002). Increasing play skills of children withautism using activity schedules and correspondence training. Journal of Early Intervention, 25(1), 58-72.
Self-ManagementDelano, M. E. (2007). Improving written language performance of adolescents with asperger syndrome.
Journal of Applied Behavior Analysis, 40(2), 345-351.
Newman, B., Buffington, D. M., OGrady, M. A., McDonald, M. E., et al. (1995). Self-management of schedulefollowing in three teenagers with autism. Behavioral Disorders, 20(3), 190-196.
Newman, B., Reinecke, D. R., & Meinberg, D. L. (2000). Self-management of varied responding in threestudents with autism. Behavioral Interventions, 15(2), 145-151.
Sainato, D. M., Strain, P. S., Lefebvre, D., & Rapp, N. (1990). Effects of self-evaluation on the independentwork skills of preschool children with disabilities. Exceptional Children, 56(6), 540-549.
Stahmer, A. C., & Schreibman, L. (1992). Teaching children with autism appropriate play in unsupervised
environments using a selfmanagement treatment package. Journal of Applied Behavior Analysis,25(2), 447-459.
Strain, P. S., Kohler, F. W., Storey, K., & Danko, C. D. (1994). Teaching preschoolerswith autism to self-monitor their social interactions: An analysis of results in home and school settings. Journal ofEmotional and Behavioral Disorders, 2(2), 78-88.
Story-based Intervention PackageBock, M. A. (2007). The impact of social-behavioral learning strategy training on the social interaction skills of
four students with asperger syndrome. Focus on Autism and Other Developmental Disabilities, 22(2),88-95.
Delano, M., & Snell, M. E. (2006). The effects of social stories on the social engagement of children withautism. Journal of Positive Behavior Interventions, 8(1), 29-42.
Sansosti, F. J ., & Powell-Smith, K. A. (2006). Using social stories to improve the social behavior of childrenwith asperger syndrome. Journal of Positive Behavior Interventions, 8, 43-57.
Scattone, D., Wilczynski, S. M., Edwards, R. P., & Rabian, B. (2002). Decreasing disruptive behaviors ofchildren with autism using social stories. Journal of Autism and Developmental Disorders, 32(6), 535-543.