Establishing Quality Standards for Applied Behavior Analytic Skill Acquisition Interventions

National annual costs associated with autism spectrum disorder (ASD) total $268 billion with an average of $60,000 per individual for behavioral intervention based on applied behavior analysis (ABA). Despite increased provision of and access to ABA services, no standards exist to evaluate the quality of ABA interventions which could contribute to differential effectiveness of treatment. Treatment integrity (i.e., the extent to which prescribed components of an intervention are implemented correctly) could determine quality; some research has identified that interventions become ineffective if implemented inconsistently. However, it may be unrealistic to expect perfect treatment integrity in clinical practice when resources for training and supervising staff may be limited. Therefore, the purpose of the present study is to establish an empirically-derived level of treatment integrity as a quality assurance standard for ABA skill acquisition interventions; that is, we will identify the minimum percent of integrity that does not produce detriments to the efficacy of instruction. The present study uses a translational research model whereby results from highly-controlled laboratory studies with undergraduate students will be applied to a clinically-relevant population of children with ASD receiving ABA services. First, we will systematically manipulate treatment integrity between 75% and 100% to determine the level at which the efficacy of intervention is maintained with a non-clinical population. Then, we will apply a restricted range of impaired treatment integrity conditions with children with ASD to identify the minimum level of integrity for skill acquisition interventions to retain efficacy. The results of this series of studies will provide the field of behavior analysis with a standard to determine what constitutes quality service and direct resources to training and supervising staff to maintain the effectiveness of skill acquisition interventions for individuals with ASD.