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Comparison of Home Base and School Base Applied Behavior Analysis Programs

Introduction

Autism has for the last number of years been explained as a growing epidemic in the society. Researchers at the center for disease control and prevention have estimated that in a population of 166 children, one of them is autistic at birth. Medically, autism has three main components that are noticeable either by the parents or the medical professionals. These include major delays in the development of the social abilities, communication behavior and slowness in the development of linguistic skills.Ingvarsson&Hollobaugh (2011) explains that previous research on inter-verbal training techniques have evaluated the transfer of procedures of stimulus [login to view URL], according to the recent research work, the application of applied behavior analysis by parents and the ABA experts have been seen to be efficient and effective in improving such complications.

Applied behavior analysis, generally abbreviated as ABA, refers to the science of human behavior. The word applied has been used by many researchers and academicians to mean practice rather than research or philosophy. On the other hand, behavior analysis may be understood as a learning theory. That is, it is the understanding of what leads or what does not lead to a specified kind or type of behavior. Behavior analysis refers to the scientific study of behaviors. Applied behavior analysis refers to the application of the principles of learning and motivation from behavior analysis, and the procedures and technology that is derived from those particular principles, to the solution of problems that are of social significance. Some of the known socially significant behaviors include reading, social skills, academics, communication and the adaptive living skills. According to Green, Taylor, Luce, &Krantz (2005), the main goal of ABA is to enable an autistic child to best function in an independent and successful manner in the environment.

Interventional proposals that are based on the ABA programs are in most works mentioned as proposals with results which have been scientifically proven (Sulzer-Azaroff et al., 2008; Klintwall et al., 2012). Applied behavior analysis is done following two main ways. It is either home base or school based. A question that has become common among researchers and academicians in the field of applied behavior analysis is how these two ways of application compares to each other. Which is more effective than the other? These questions are the subject of this research work. Although there are many different types of applied behavior analysis, the paper will mainly focus on the two described above. The paper begins with a discussion and analysis of the works of research on the effectiveness ABA programs and will then proceed to compare them based on different criteria.

Effectiveness of Applied Behavior Analysis Programs

Educational and therapeutic proposals that are directed towards children with autistic conditions have been an object of discussion and debate frequently discussed in ideology, politics and frequently disregarding the scientific meaning on their efficiency and social validation (Callahan et al., 2010; Vismara et al., 2010).For more than thirty years, numerous empirical studies have been conducted and published on many peer reviewed journals that show the efficacy and the efficiency of applied behavioral analysis in the treatment and management of autism in children (Healy, O’ Connor, Leader, Kenny, 2013).Parents establish intensive in-home ABA programs in order to meet the unique needs of their children that may include motor, linguistic, emotional, social as well as other academic skills. The purpose and the aim of the ABA programs range from motor imitation (Paul, Campbell, Gilbert, Tsiouri, 2013) to adaptation abilities (Peters-Scheffer, Didden, Mulders andKorzilius, 2010), toilet training, motor, social and linguistic abilities (Eldevik et al., 2012; Grindle et al.,2012; Gutman, Greenfield and Rao, 2012; Reed and Osborne, 2012). Applied behavioral analysis is a science based approach to education. As LeBlanc and Gillis (2012) explains there are three critical features in any kind of behavioral treatment for autistic children whether conducted in the pediatric care units, schools or even in hospitals. First, all the procedures involved are directly derived from the behavioral theory and research. Secondly, there exists a high level emphasis on the frequently and timed measurement of the observable indicators of progress for the children. Finally, all the aspects and qualities of the child’s functioning are considered as the outcomes or the product of the interaction that exists between the children and the influential factors in their environment. In home-based applied behavioral analysis, the main influential factor are the parents.

Researchers have shown that home based applied behavioral analysis programs in the homes are very effective. A research that was conducted by Grindle, Kovshoff, Hastings and Remington (2009), the parents and the guardians who had been involved in the treatment and the application of the ABA principles are positive on the advantages and the benefits that the application has on their children. Dawson et al (2011) also conducted another research aimed at assessing the effectiveness of home based ABA treatment. In his research in which he reviewed and summarized a total of 27 studies that were published since January 2010, behavioral interventions, especially once conducted by the parents and the relatives of the children at the homes, were found to be very effective for the children. They are effective for the treatment and improvement of language, cognitive abilities, adaptive behavior and the social skills. It was also seen to be very effective in reducing anxiety and aggression. However, though these studies show primarily high degrees of efficiency for applied behavioral programs to children with autism disorder, Matson, Matson and Livet (2007) notes that most of the studies have been particularly marked by fragmented development, using a wide range of interventions and definitions of constructs. In the research that brought 79 treatment studies, the authors noted that large scale group studies and comparisons on the different approaches to applied behavioral analysis have been almost non-existent.

The recent estimates on the prevalence of autistic disorders among the children are much higher than the estimates made more than thirty years ago. Diggle, McConachie and Randle (2008) explains that one in every four hundred children are affected with the disorder. In light to these, researchers have formed a base of research on the main and the proposed treatment mechanisms. A research by the Blue Cross and Blue Shield Associations (2009) reviewed research articles that had been published between the year 1987 and July 2008. The review majored on considering the use and application of and the effectiveness of EIBI that is based on the applied behavioral analysis. The review excluded and pushed away the experimental studies that are based on single cases arguing that such research designs lacked the aspect of being generalizable across individuals and are thus less valuable in the evaluation of the applied behavior analysis methods due to their methodological constraints. The review, which reviewed 16 articles of studies, concluded that the many weaknesses in the design of research studies, the differences in the methods of treatment and the outcomes and the inconsistent results and findings of different research works mean that the impact of applied behavioral analysis could not be obtained in an effective manner. However, the research showed that most home based applied behavioral analysis techniques were effective in improving most of the behavioral aspects of children affected by autism.

Though there seems to be a variety of research works that have shown mixed findings from early intensive behavioral intervention, it is clear that ABA has remained to be an effective method for most of the children. A research conducted by Perry et al. (2011) brought together a total of 332 autistic children of age between 2 years and 7 years. The results of the study showed clearly that ABA programs have significant and major advantages to the children. Children who were most successful in the program were younger in age and received longer hours of training.

Home based applied behavioral analysis has received attention from many different researchers and academicians. Ospina et al (2008) conducted a research in which they evaluated a total of 101 controlled studies across a wide range of interventions that ranged from behavioral interventions to developmental interventions. The ABA interventions that took the concern of the researcher are those that dealt on direct trial training and the Lovaas therapy. Their analysis and evaluation demonstrated that there exists some level of support for the discrete trial training in regards to the motor as well as the functional skills of the patients but not on the communication skills as demonstrated by the patients. Moreover, the analysis showed that the home based applied behavioral analysis appeared to show more benefits than the special education programs that are provided in the schools. The main domains in which such results were obtained included the adaptive behavior, communication and interaction, the comprehensive language development, daily skills of life, expressive language, socialization and the overall intellectual functioning. It is however important to note that even with the major improvements to the developments and the abilities of the autistic children, very few cases have been reported where patients have fully recovered from the disease. A research conducted by Reed, Osborne, &Corness (2007) showed major improvements on the abilities and the rate of development for the children with autistic conditions but noted that there is no evidence for recovery from the autistic conditions. The research also showed clearly that the increase in the number of treatment or practice hours per week lead to increase in the development of the children. Most of the research works shows a direct correlation between the number of hours of training per week and the progress of the patients. 30 and above hours per week have been seen as the most appropriate rate of training. However, research conducted by VismaraColombi and Rogers (2009) also showed that one hour of training per week also produced significant results.

Particularly, treatment programs that take place in the homes of the autistic children show huge improvements but has been regarded as being sources to other cases of stress and health concerns. Johnson et al. (2007) noted that interventions that are applied by parents and which are based on applied behavioral analysis have depicted encouraging results for when evaluated through the application of primary single subject design strategies. However, there has been major and significant challenges for both the parents and the guardians. For instance, a research conducted by Hastings et al.2006) showed that mother of children with autism and those requiring applied behavioral analysis have been seen to be at a higher risk of parenting stress that the other mothers. Johnson et. al (2007) notes that there is need for the standardization of the interventions to allow for replication in the media sources and in research works with large sample sizes. In their research, Schwichtenberg&Poehlmann (2007) noted that while there are very many research articles that have been conducted aiming to show the impacts of the applied behavioral interventions on children, very few of them show the impacts of these strategies on the families. In this research, most mothers or guardians to children who are autistic and who have been admitted to receive applied behavioral treatments showed high levels of stress due to the requirements of the treatment programs and the conditions of their children.

As discussed in the discussion above, applied Behavioral analysis can either be conducted in the homes or in the schools. These two different strategies to applied behavioral analysis have been seen as being different in the results and their impacts on the patients as well as their parents. A research by Spreckley& Boyd (2009) metaanalyzed and reported on the applied behavioral interventions for the pre-school with ASD. The research, which initially had a total of 13 peer reviewed articles, had six of these articles meeting the minimum requirements for analysis. The results of the analysis suggested minimal or no significant improvement on the outcomes for the applied behavioral analysis programs as compared with the standard care on cognitive outcomes, expressive language, receptive language or adaptive behavior. Low to moderate heterogeneity was seen across the outcomes of the research prompting uncertainty about the suitability of the applied behavioral analysis techniques.

On the matter of school based applied, opposing results on their effectiveness and efficiency on the patients have been reported. Eikeseth (2009) conducted a research on comprehensive psycho-educational research that included 20 studies on ABA-based interventions. The researchers and the reviewers concluded that the intensive ABA treatments that are carried out by trained therapists are effective and applicable and enhancing the global functioning in pre-school children with autism. Howlin et al (2009) also conducted a research in which 11 controlled group EIBI studies were considered. In the review, the IQ scores and levels were observed significantly higher for the children after the EIBI group as compared to the children in the controlled group. The researchers concluded in their research that EIBI is highly effective and efficient for some group of children but there exists a wide individual variation in response and some of the children failed to demonstrate or show any progress in development at all. Howlin et al (2009) also explained that the age of the children and the length of the intervention did not appear in any way to be related to the outcomes of the intervention, with varying results for the initial language level as the predictor of the study. The initial IQ strongly predicted huge improvements after the ABA-based IEBI treatment.

In the school environment, ABA has shown major improvements especially at older age. Numerous researchers have demonstrated and shown in a clear manner that though it is slow in showing and demonstrating improvements, it is effective in ensuring change and improvements in the different areas of growth. Reichow and Wolery (2009) conducted a review and a meta-analysis of 13 controlled group studies on the ABA interventions that is based on the Lovaas model. The study was aimed at understanding and assessing the changes in IQ within the children that underwent the EIBI. The meta-analysis of 12 studies taking regard in the changes on the IQ suggested a moderate size of improvement at the follow-up studies. The researchers however explained that the findings were attributed to the reference to the comparison group and as such could not be traced solely on the EBI treatment. Both the descriptive as well as the summative analysis however demonstrated that ABA can be an effective and appropriate treatment method for some children with cases of autism. The researchers also noted that the treatment did work for some but not all the children who underwent the treatment.

ABA based programs mainly demand a detailed assessment of the environmental factors and their influence on the progress of the condition of the children. This information is particularly important and significant for the follow up activities of the children (Sulzer-Azaroff et al., 2008). Another review that is of major importance to this study is the review that was conducted by Rogers and Vismara (2008). These reviewers considered seven ABA based interventions that mainly focused on early interventions for young children with autism. Four out of the considered intervention plans implemented the application of Lovaas treatment which the authors explained met the criteria for a well-established psychological intervention for the improvement of the intellectual abilities of the children. Specifically, the researchers considered the IQ score of the children before and after the treatment sessions. According to the reviewers, the research showed low consistency in the data for behavioral improvements, improvements in the adaptive skills and improvements in the linguistic skills. On overall, the reviewers found out that the researches showed that focused and well managed early intervention programs of different kinds are of significant benefits to the young children affected with autism. However, the works of research precluded the determination of which approach among the many ABA-based treatments is best among the many different approaches.

Case-Smith and Arbesman (2008) also conducted review some of the interventions that are relevant to occupational therapy. According to the authors, the behavioral interventions are a successful means of training children in basic academic and the skills of life. However, the authors also explained that the generalization of skills to the natural environment was largely unproven. The researchers also made numerous compliments regarding the lack of studies for the promotion of effective transition to work under independent environments of living. Case-Smith and Arbesman (2008) also pointed out that the time and the resources that are required to implement a 30- to 40-hour per week intervention as well as the lack of definition to most of the candidates that are appropriate for the interventions.

Seida et al (2009) also conducted what they called an umbrella review for a systematic reviews of both behavioral as well as psychological interventions for children with ASD. There researchers and the reviewers noted that there was high favor and application of behavioral programs than there are for other types of analysis and treatment programs. Seida et al (2009) however noted the lack of research attention to the factors in the choice of the treatment including factors such as the cost, the convenience and the burdens to families and the relatives. Another review by Ostryn et al (2008) also produced similar results. In this research review, a total of 15 studies were considered. The research review showed that while PECS is widely implemented in conjunction with ABA, it lacks a strong empirical base for consideration. The reviewers critiqued the literature provided by the researchers based on their lack of reporting of the statistical significance and the precision of the results, the lack of scope and definition of the key and primary outcomes and the lack of data during maintenance. The reviewers recommended that based on the available literature and findings from the many works of research that have been done by many researchers, PECS would best be recommended as an initial intervention to teaching programs and should be applied as a long term intervention plan. Sulzer-Azaroff et al (2009) also reviewed numerous types of Picture Exchange Communication System as used in conjunction with ABA and obtained the results closely to those obtained by Ostryn et al (2008).

As discussed above, researchers in the field of autism have not conducted enough research on inter-verbal training procedures for children with autism. According to Kodak, Fuchtman and Paden (2012), the development of an inter-verbal report has been overlooked in the early intervention programs in children with autistic conditions. Cohen et al (2006) also conducted a research on the effectiveness of the early intensive behavioral treatment. The researcher replicated the application of the Lovaas model. They compared a total of 21 children who received a 35-40 hours of ABA per week to a control group of 21 and IQ matched children from public school special education classes. According to the results of the study, the children who were treated with ABA obtained a higher IQ and adaptive behavior scores than the control group. After the treatment, six out of the 21 children placed under ABA were fully included into the regular classes at the public schools without any assistance whole 11 of the remaining 15 children were included with support. This was in comparison to the one child out of the 21 comparison children for the regular education.

However, due to the many statements with regard to who benefits from early intervention proThe ABA principles have been applied by many researchers in their research works, often in combination with other techniques and strategies. In 2011, Dawson et al conducted a randomized controlled trial of the early start Denver model, one of the developmental behavioral intervention that is highly based on the ABA model. In their research, 48 children who were autistic and between the age of 18 and 30 months were assigned to either the early start Denver model by trained and graduated therapists or referred to community care providers. After the period of treatment was over, the children who underwent treatment through the early start Denver model showed significant and faster developments in their IQ, adaptive behaviors and the diagnosis of autism.

Maglione et al. (2012) also conducted a research on the nonmedical interventions for children with autistic conditions, focusing mainly on applied behavioral analysis and treatment. The researchers begun by developing and consensus guidelines on the nonmedical interventions that mainly addressed cognitive functions and the core deficits in children with autistic conditions. These guidelines were developed by the technical expert panel based on systematic and an integrated analysis and discussion of results and findings from other respondents and researchers. According to the results and findings of the research, the panel agreed that children with conditions of autism should be provided with at least 25 hours a week of comprehensive ABA intervention to address skills in social communication, language, playing and social interaction and the development of maladaptive behaviors and skills. The results of the research also showed that applied behavioral analysis have shown efficacy and effectiveness during application.

Another research that was aimed at assessing the effectiveness of the applied behavior analysis techniques is the research that was conducted by Landa and kalb (2012). In their research, a total of 48 patients with autistic conditions received interventions based on the applied behavior analysis over a period of six months. This was at the beginning of the age of two years. The researchers assessed the cognitive ability, the communication ability and the severity and appearance of the autism signs and symptoms. These factors were assessed through the use of standardized measures. After the research, the researchers reported significant improvements and achievements the IQ and communication domains of the participants as well as a reduction in the severity of the autism signs and symptoms.

Fein et al. (2013) also conducted a research aimed at analyzing the cases of 34 individuals with a clear and a well-documented history of autism. The researcher however required that the research participants to not have met the criteria for autism as provided by the medical requirements. The results of the study substantiated the possibility for optimal outcome from the autism spectrum disorders and demonstrated an overall level of functioning within the normal limits of the participants of the study. The researchers also explained that the parents who advocated for the application of the best interventions to their children may better maximize the chances for the optimal outcomes for their children.

One of the main language skill that is frequently targeted is manding. According to Christina et al. (2012), manding is the process of teaching an individual to request access to reinforcement. He also explains that manding has been frequently linked to motivating operations because it motivates the individuals to communicate in future. The impacts of motivating factors has been demonstrated by researchers on academic behaviors (Rispoliet al., 2011) and treatment of problem behaviors (Lang et al., 2010).

As the results from the many findings have shown, applied behavioral analysis is by far one of the best and the most effective means of treating and managing autism. The results have clearly demonstrated that ABA can have significant advantages and benefits if well managed and especially in the homes and schools. However, it also does not lack some bottlenecks. Simpson et al. (2013) explains that one of the limitations is that it is very expensive to conduct at homes in an effective manner. The next section discusses the differences and the comparisons between the home based applied behavioral analysis programs and school based applied behavioral analysis programs.

Comparing Home Based and School based Applied behavioral Analysis

ASD children have the same label of diagnosis, but different individual needs (Wilkinson, 2010). Due to differences among ASD children, there is need for individualized technique to deal with major deficiencies of the disorder including social, sensory and academic difficulties and communication problems. The technique must also toe with the individual needs of every child and preferences of family members. Presently, there are home based behavior management programs, developmental therapies and school based educational interventions useful for helping autistic children. Both home based and school based ABA interventions are similar because they rely on interactions between the child’s age, level of development, strength of the treatment, characteristics of individual children and competencies of the interventionist (Wilkinson, 2010). They have also been used to help some children attend school and achieve same intellectual functioning like other normal children (Matson, Matson & Rivet, 2007).

Applied behavior analysis is applicable in both school and home environments. According to Sharon (2015), ABA model is characterized by overlaps between school and home settings. Both school based and home based ABA programs have been proved to result in increased language skills, improvement in intellectual scores and improved performance in academics by children with ASD (Krieger, 2014). Most of parents agree that there is inadequate support from social and education services, hence propose the need to depend on family and friend support to ensure home based ABA programs succeed (Dillenburger et al, 2010).

Both ABA programs are similar because they need consistent application. Consistent application is achieved through written programs for all skills taught, training parents and guardians on ABA implementation by behavior analysis and manipulation the behavior that requires treatment (Group Health Cooperative, 2015). To raise the probability of generalizing both treatment efforts, it is imperative that parents and therapists receive training to implement home based and school based ABA programs among all people, settings and circumstances. In school, teachers repeat their trials for children to master necessary skills. They also reinforce alternative behaviors to self-injury and aggression in positive ways. Both programs are also unique for every child and they vary as children develop (Spreckley, 2009). According to Granpeesheh, Tarbox and Dixon (2009), ABA interventions require accurate keeping of records to assess the progress of children and make necessary adjustments.

Group Health Cooperative (2015) states that home based and school based ABA programs are based on modification of behavior. Behavior modification entails providing education on appropriate behaviors by using small steps and trainings to perform tasks. The teaching is a one to one interaction with the children. For instance, early intensive behavioral intervention (EIBI) is a home based ABA program, which takes 40 hours in every week (Reichow, 2011; Howlin, Magiati&Charman, 2009). The methods of implementing ABA operate on the premise that ASD children face difficulties of listening like other normal children, inability to learn though imitation and learning difficulties. Both home based and school based programs are motivated to ensuring that children succeed. Behavioral principles that guide both ABA programs include motivation through learning, reinforcement, stimulus control, extinction and generalization (Group Health Cooperative, 2015). The underlying principle of learning is that the impacts of a given behavior may strengthen it or weaken it. Desirable outcomes reinforce behavior whereas aversive outcomes results in weakened behavior.

School based ABA programs provide opportunities for autistic children to attend school with other normal children within the neighborhoods (Weiss, 2016). Attending school and interacting with other children in contexts such as sports and block provides room for integration. Hardman and Drew and Egan (2008) found that students with disabilities struggling academically frequently benefit from classes focused on day-by-day life-skills and education which includes career exploration and community integration. There are also numerous inclusive opportunities for children to participate, which may help improve behavior of autistic children.

The inclusive experiences can be toed with specific preferences and needs of the children, since every child has unique needs (Wilkinson, 2010; Spreckley, 2009). As notef by Mastropieri and Scruggs (2010), apart from fostering equality, full inclusion of children in schools often diminishes certain stigmas linked to special education. Children who enjoy art and music are exposed to them while those who need individualized pre-academic instructions receive them; gaining exclusive experiences (Weiss, 2016). Such opportunities are not available in home based ABA programs.

More extensive resources available and easily accessible in schools make school based ABA programs attractive (Weiss, 2016). Having a variety of educators with key competencies in schools may expose autistic children to different experiences, helping them improve in academic performance and language skills. Teachers offering school based ABA programs enable children to feel certain enough to articulate themselves without fear of rejection. They devise methods to help the children discover who they are and who they are capable of becoming within a secure, cheering mood. They can see every child as only one of its kind (Wilkinson, 2010) who deserves the chance to express his or her true self in an accommodating environment. They allow the child to be their teacher, allowing nonstop growth and development. All of this can be done by basically making a bond with a child. (Parish, 2008, p. 32).

Peer training programs in schools are helpful as they enable some children to be well equipped and interact with those with ASD, providing motivation and mentorship. Full inclusion is undoubtedly the most natural form of education, and it allows students with disabilities to have peer role models (Hardman, Drew & Egan, 2008). On the other hand, home based ABA programs may lack extensive resources, making it unattractive. Lack of variety of expertise for rendering different abilities to autistic children may not lead to improved cognitive skills and academic excellence. Children may also lack other peers to identify with in home environments, leading to depression, aggression, de-motivation and mentorship.

Some school based ABA programs may have inefficient staff members who lack key competencies in relations to effective methods of ASD treatment (Weiss, 2016). The deficit in skill specialization may result in problems with comprehending various learning and behavioral challenges that ASD children face. For staff members who are not familiar with ADA science in school settings, there may be insufficient expertise to deal with learning and behavioral challenges of autistic children. In such cases, home based ABA program may be useful if parents have appropriate interventionists. According to Laugesen, Frankel, Mogil, and Dillon (2008), enhancing peer entry and exit competencies, conversation skills, dealing with bullying, teasing and arguments, developing friendship skills in home based ABA programs help deal with deficiencies in ASD expertise that may arise in school based ABA programs. Mahoney and Wiggers (2007) stress that parents have major roles to play in the lives of their children, a good option for home based ABA programs. The research as conducted by Farrell, Trigonaki, & Webster (2005) also showed similar results. According to the author, the collaboration of both school-based as well as home-based ABA proved to result in higher improvements and progress than the individual plans employed alone. Luiselli& Hurley (2005) also found out that the much needed training in language and social communication among the preschool students can be achieved effectively through the application of ABA programs in schools.

Ospina et al. (2008) conducted a meta-analysis investigation of behavioral and developmental interventions involving children with autism spectrum disorders. Meta-analyses of the 3 controlled clinical trials indicated that Lovaas (home based treatment) was superior to special education (school based program) on the following parameters; communication and interaction, adaptive behavior, on a daily basis living skills, complete language, communicative language, socialization and overall intellectual functioning. High-intensity Lovaas was superior to low-intensity Lovaas on the parameters such as intellectual functioning in two exposition cohort studies. Combining the results from the two randomized controlled trials encouraged developmental methods based on initiative interaction compared to contingency interaction for time spent in stereotyped behaviors and distal social behavior. However, the consequence sizes were not clinically significant. No statistically noteworthy differences were found for: a) Lovaas against special education for non-verbal intellectual functioning; b) Lovaas against developmental individual-difference relationship-based intervention for communication skills; c) computer assisted instruction against no treatment for facial expression recognition; and d) Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) versus normal care for replication skills and eye-hand incorporation. Ospina et al (2008) concluded that while the investigation reviewed suggests that Lovaas might improve some major symptoms of ASD compared to special education programs, these findings are based on combination of a few, methodologically feeble studies with few participants and comparatively short-term follow-ups. Since there is no definitive behavioral or developmental intervention to improve all symptoms for all persons with ASD, it is recommended that clinical supervision be guided by personage needs and accessibility of resources. Contrary to the results by above listed authors, there have been major disparities according to the results of the research conducted by Fernandes and Amato (2013) that there does not exist enough evidence of the preponderance of the ABA programs over the alternatives.

Dillenburger, Keenan, Doherty, Byrne and Gallagher (2012) conducted a study to investigate experiences of professionals and parents with autistic children using both home based and school based ABA programs. The study was based on experiences of 95 parents and 67 professionals. The findings of the study indicated that there was increased satisfaction in monitoring procedures used, provision of education and the degree of staff training among parents with children who received school based ABA programs.

The study used parents, because they are imperative in measuring social validity and they may also have views which fail to toe with those of the professionals, making it a success (Dillenburger et al, 2010). For instance, parents under tremendous stress make excessive sacrifices that have impacts on other siblings. The study demonstrated that there are differences between home based and school based ABA programs, giving rise to some ethical and practical concerns about children whose parents could not afford school based ABA programs. However, this approach is limited by the fact that effective quantitative evidence may not toe with parental perceptions and experiences, which may be subjective. Another significant problem with Dillenburger et al’s study is that parents with wide range of knowledge about ABA applications and more interested in receiving new information. This situation was supposed to be the case for professionals and not parents. The study was quantitative in nature, but it failed to explicitly state a priori hypothesis to act as a basis for the research. Dillenburger et al (2012) explored professional and parental involvement and experiences, using ABA school and home based programs, with the sample not chosen by the researcher. Having a wide range participants without invitation by the researcher means that the research relied only on informed consent, giving room for sample bias.

While determining the relationship between learning rate and treatment outcomes for children with autism receiving home based ABA intervention, Weiss and Delmolino (2006) made some follow up evaluation of changes in adaptive performance and progress of autistic symptoms. The researchers compared the learning rate to functional skills and autistic symptoms, for 4 hours on weekly basis. For the first two years, the treatment entailed delivering home based ABA treatment model where students were given instructions for 40 hours. The last two years involved using home based and school based ABA instructions for 20 hours on weekly basis. The results of the study indicated improvement in post-intervention scores (Weiss &Delmolino). 9 of the participants did not indicate any signs of autism, 9 had average autistic conditions and 2 indicated autistic conditions. It also found that there is a correlation between initial learning rate and learning rate at the end of 4 years among the children (participants).

The study however failed to establish a positive relationship between childhood autism rating scale and skill acquisition speed, showing that children who had lower and higher learning rates showed relative improvements on their scores after 4 years. The study is limited because of a biased sample (1 girl and 19 boys), smaller sample size and lack of data indicating the number of hours the participants received instructions. The study did not have a control group of children who could receive different treatments. This condition makes the study a primary clinical description that shows the impacts of intervening in children behavior (Weiss and Delmolino, 2006). The scholars failed to collect data on family environment (the characteristics of parents and children). The sample used therefore shows only self-chosen group of families. There is a significant role of parental involvement in the children outcomes, and data on parental characteristics would have had some influences on the above results. The study did not also used intelligent quotient (IQ) values of the children. Failing to test IQ values is a serious omission since the appropriate standard measure of IQ would have been included to strengthen the results reported. The IQ would have also been useful in demonstrating prognostic value. Learning rate is also likely to be confounded with other factors such as responses to rewards. The study did not consider such factors which would have been important in improving on the results. The study fails to provide information on the level to which learning rates are useful in predicting the outcomes (Weiss and Delmolino, 2006). Due to the limitations highlighted, it is necessary to conduct a study that addresses prediction by tracking various learning rates among the children suffering from autism.

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