Behavior Analysts' Use of Treatments for Individuals with Autism: Trends within the Field

Marshall’s team emailed a short survey to every BCBA and BCaBA in 2023. They asked, "Which treatments do you use for autism?" They compared the answers to the same survey from 2016. They counted how many people picked ABA, sensory integration, DIR/Floortime, and other choices.

Use of pure ABA dropped. Use of unproven treatments like sensory integration and DIR also dropped. Yet many certificants still pick treatments because a co-worker or parent talked them into it, not because studies support it.

McComas et al. (2025) extends these numbers. They argue that ableist views—like thinking autistic kids need to "look normal"—push clinicians toward non-ABA options. The survey data give the trend; the ableism paper gives a reason.

Neely et al. (2021) reviewed telehealth ABA up to 2021. They found solid evidence for teaching skills online but weak evidence for stopping problem behavior remotely. Marshall’s survey shows clinicians are slowly moving away from unproven treatments, yet telehealth still tempts people to add extras like sensory play over Zoom. The two papers together warn: remote delivery does not make a treatment evidence-based.

Sherman et al. (2021) and Denegri et al. (2025) both show that brief Behavioral Skills Training (BST) quickly brings staff skills to mastery. Marshall shows that simply knowing the science is not enough; persuasion by others still wins. The training studies supply a fix: give staff live practice and feedback, not just reading lists.

Your caseload probably includes a child getting brushing, weighted vests, or DIR hours. This study says you are not alone, but the field is drifting. Use the data to start a team meeting: "Here’s what the evidence says. Here’s what we actually bill for." Replace one unproven block each month with a BST-guided ABA procedure. Track it on a simple Excel sheet. In thirty days you will have both ethical and insurance-friendly treatment.