Autism & Developmental

Moderate Effects of Low-Intensity Behavioral Intervention.

Lotfizadeh et al. (2020) · Behavior modification 2020
★ The Verdict

Doubling ABA to about 11 hours weekly gives modest language and social gains after two years, but daily living skills stay flat.

✓ Read this if BCBAs writing treatment plans for preschoolers with autism in community clinics.
✗ Skip if Clinicians who only track daily living skills, not language or social targets.

01Research in Context

01

What this study did

The team tracked kids with autism for two years. One group got about 11 hours of ABA each week. The other group got about 6 hours plus other services.

They measured language, social skills, and daily living skills every few months. The study was run in regular community clinics, not university labs.

02

What they found

After two years, the 11-hour group spoke better and played with others more. The 6-hour group did not improve as much in these areas.

Both groups stayed the same on daily living skills like dressing and brushing teeth. More hours did not help those skills.

03

How this fits with other research

Fernell et al. (2011) saw the same pattern in Sweden. Their intensive group and light-ABA group both gained the same amount on daily skills.

Ostrovsky et al. (2022) also found that weekly hours did not predict adaptive gains. Kids improved no matter how many hours they got.

These studies seem to clash with Lotfizadeh et al. (2020), but they used different rulers. The Swedish and 2022 papers looked at broad Vineland scores. D et al. zoomed in on language and social tests. Hours may matter for talking and play, yet not for self-care.

04

Why it matters

You can tell families that bumping ABA from 6 to 11 hours weekly may help their child speak and interact more. Do not promise faster toilet training or dressing. Check language and social goals first when you debate adding hours.

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Review your client’s language and social goals—if progress is slow, propose a small hour increase and plot data for eight weeks.

02At a glance

Intervention
comprehensive aba program
Design
quasi experimental
Sample size
171
Population
autism spectrum disorder
Finding
positive
Magnitude
medium

03Original abstract

We compared clinical outcomes in a treatment group of 98 individuals who received between 8 and 15 weekly hours (M = 10.6; SD = 1.7) of applied behavior analysis (ABA) intervention with a comparison group of 73 individuals who received another provision, including some ABA, (between 1.4-8 weekly hours, M = 5.7; SD = 1.6). After 2 years, the treatment group made greater gains than the comparison group on language and social skills, and other areas assessed by the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP). We evaluated the outcome on adaptive skills for a smaller sample of participants using the Vineland Adaptive Behavior Scales II (VABS), but found no significant differences between the treatment (n = 17) and comparison groups (n = 11). Although the treatment group made important and clinically meaningful gains, the gains were moderate. These findings underline the importance of intervention intensity and provide further support for a dose-response relationship between ABA intervention hours and outcomes.

Behavior modification, 2020 · doi:10.1177/0145445518796204