The Department of Defense is providing $7 million to better understand how much and which components of Applied Behavior Analysis (ABA) are the most effective for young children with a diagnosis of autism spectrum disorder (ASD).
As of 2017, almost 17,000 children of military personnel were receiving ABA through Tricare. ABA is often recommended at a very high intensity level, often more than 20 hours a week of individual intervention. This is often quite difficult for families to access.
Recent research suggests that ABA could be as effective when delivered at a lower intensity for some children when it is tailored to specific skills and includes effective ways of supporting parents.
"There is a great need to understand how to tailor ABA intervention approaches to individual children with ASD and their families," said Zachary Warren, Ph.D., executive director of the Vanderbilt Kennedy Center Treatment and Research Institute for Autism Spectrum Disorders (TRIAD).
"This study will provide us with compelling data about whether a lower intensity tailored intervention may be as powerful, and potentially more desirable, as typical high intensity intervention," he said.
The project is being coordinated through the University of Rochester School of Medicine and includes the May Institute, Cleveland Clinic and Nationwide Children's Hospital, in addition to Vanderbilt.
ABA has been shown to be effective at increasing adaptive behaviors and decreasing challenging behaviors. The DOD study will advance current knowledge on how to best implement behaviorally-based interventions for young children with ASD by examining the impact of interventions on both children and families.
Military families have unique stressors and lifestyle needs that may include planned relocation and the need to transfer services to new providers. To ensure early identification and referral for intervention in early childhood, children of military dependents are screened for ASD in the context of routine health care.
"Often we study interventions in highly controlled intervention environments, but fail to study whether these approaches translate into the real world," Warren said. "In this work we're taking the work far beyond university walls to ensure that this intervention works well for military families, who often experience unique stressors and challenges."
Children newly diagnosed with an autism spectrum disorder, ages 1½ to 5 years and referred for ABA through Tricare in North Carolina, Ohio, and Tennessee may be eligible to participate in this landmark study.