Assessment & Research

Problems with "problem behavior": A secondary systematic review of intervention research on transition-age autistic youth.

Bottema-Beutel et al. (2024) · Autism : the international journal of research and practice 2024
★ The Verdict

Most behavior-reduction studies in transition-age autistic youth lack clear definitions, functional assessment, and side-effect checks—treat their claims as weak evidence.

✓ Read this if BCBAs writing behavior-reduction plans for autistic teens or young adults.
✗ Skip if Clinicians who only teach skill acquisition and never target reduction.

01Research in Context

01

What this study did

Bottema-Beutel et al. (2024) read 48 studies that tried to reduce behaviors in autistic teens and young adults. They checked if authors said exactly what the behavior looked like, if they did a functional assessment, and if they watched for side effects.

02

What they found

Most papers never defined the behavior in clear, countable terms. Few ran a real functional assessment. Almost none tracked side effects. Many targeted harmless stims like hand-flapping.

03

How this fits with other research

Bottema‐Beutel et al. (2025) looked at 102 early-childhood studies and saw the same gaps. The field keeps repeating the same mistakes across age groups.

Wynne et al. (1988) warned us 36 years ago that aggression and SIB studies lacked functional work. The problem is old, not new.

Thom et al. (2026) show the label “problem behavior” is fading, but swapping words without fixing definitions does not help.

04

Why it matters

Before you write a behavior plan, write one sentence anyone can read that says exactly what the behavior looks like. Then run at least one functional probe and pick one side effect to track. These three steps turn weak evidence into something you can trust.

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Pick one behavior in a current plan, write an operational definition that a substitute could score, and add one data column for side effects.

02At a glance

Intervention
not applicable
Design
systematic review
Population
autism spectrum disorder
Finding
not reported

03Original abstract

In a previous study, we looked at research done on strategies to support autistic people who were between 14 and 22 years old. For this study, we looked at all of the studies in our previous study that tried to decrease or stop autistic people from doing certain things-many researchers call these things "problem behavior." There were 48 studies that tried to reduce problem behavior, and most of them used strategies like prompting and reinforcement to try get autistic people to change their behavior. We found many things wrong with these studies. Most of them did not define the group of behaviors they were trying to stop autistic people from doing. None of the studies looked at whether any side effects happened when they tried the strategy they were studying. Also, most of the studies tried to stop autistic people from doing behaviors that probably were not harmful, like stereotypic behavior. Most of the studies did not say how they decided that the behaviors they tried to stop were a problem for the autistic people in the study, and most studies did not try to figure out why the autistic people in the study did the behaviors the researchers were trying to stop them from doing.

Autism : the international journal of research and practice, 2024 · doi:10.1177/13623613241229159