Efficacy of behavioral interventions for reducing problem behavior in persons with autism: an updated quantitative synthesis of single-subject research.
Across 358 autistic individuals, behavioral interventions cut problem behavior, but those preceded by a functional analysis work significantly better.
01Research in Context
What this study did
Heyvaert et al. (2014) pooled 213 single-subject studies that tested behavioral interventions for problem behavior in people with autism. They compared two groups: plans that started with a functional analysis and plans that did not.
The team used meta-analysis to find the average effect across all studies. They wanted to see if doing an FA first made the treatment work better.
What they found
Behavioral interventions cut problem behavior overall. The big news: plans that began with a functional analysis worked significantly better than plans that skipped the FA step.
The result held for 358 autistic participants across the 213 studies.
How this fits with other research
This paper is a direct update of Campbell (2003). The earlier review looked at 181 cases and found the same pattern—FA-based plans won. Mieke et al. added 32 newer studies and the pattern stayed put, giving the field a decade-plus replication.
McHugh et al. (2023) extends the idea to adults. They found self-management plans also reduced problem behavior in adults with autism/ID, showing the FA-first rule may reach beyond kids.
Mammarella et al. (2022) sounds like it disagrees. Only 7 of 55 school-based studies measured ecological validity, so we can’t tell if real teachers stuck with the plans. The apparent contradiction is about reporting quality, not about whether FA-based plans work—Mieke’s numbers still say they do.
Why it matters
If you write a behavior plan without an FA, you leave points on the table. This synthesis gives you clear permission to insist on an assessment phase before treatment, even if the schedule is tight. Share the numbers with administrators who want to skip the FA to save time—213 studies say that move weakens results.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Before you write the next BIP, block time for a brief functional analysis or at least a brief FA—then use the data to pick your intervention.
02At a glance
03Original abstract
Problem or challenging behaviors are highly prevalent among persons with autism and bring along major risks for the individual with autism and his/her family. In order to reduce the problem behavior, several behavioral interventions are used. We conducted a quantitative synthesis of single-subject studies to examine the efficacy of behavioral interventions for reducing problem behavior in persons with autism. Two hundred and thirteen studies representing 358 persons with autism met the inclusion criteria and were included in the statistical analyses. Overall, we found that behavioral interventions were on average effective in reducing problem behavior in individuals with autism, but some interventions were significantly more effective than others. The results further showed that the use of positive (nonaversive) behavioral interventions was increasing over time. The behavioral interventions were on average equally effective regardless of the type of problem behavior that was targeted. Interventions preceded by a functional analysis reduced problem behavior significantly more than interventions not preceded by a functional analysis. Finally, treatment and experimental characteristics, but not participant characteristics, were statistically significant moderators of the behavioral treatment effectiveness.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.06.017