Skip to main content
SpringerLink
Log in

An Evaluation of the Impact of Supervision Intensity, Supervisor Qualifications, and Caseload on Outcomes in the Treatment of Autism Spectrum Disorder

  • Research Article
  • Published:
Behavior Analysis in Practice Aims and scope Submit manuscript

Abstract

Ample research has shown the benefits of intensive applied behavior analysis (ABA) treatment for autism spectrum disorder (ASD); research that investigates the role of treatment supervision, however, is limited. The present study examined the relationship between mastery of learning objectives and supervision hours, supervisor credentials, years of experience, and caseload in a large sample of children with ASD (N = 638). These data were retrieved from a large archival database of children with ASD receiving community-based ABA services. When analyzed together via a multiple linear regression, supervision hours and treatment hours accounted for only slightly more of the observed variance (r 2 = 0.34) than treatment hours alone (r 2 = 0.32), indicating that increased supervision hours do not dramatically increase the number of mastered learning objectives. In additional regression analyses, supervisor credentials were found to have a significant impact on the number of mastered learning objectives, wherein those receiving supervision from a Board Certified Behavior Analyst (BCBA) mastered significantly more learning objectives. Likewise, the years of experience as a clinical supervisor showed a small but significant impact on the mastery of learning objectives. A supervisor’s caseload, however, was not a significant predictor of the number of learning objectives mastered. These findings provide guidance for best practice recommendations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Association.

    Book  Google Scholar 

  • Behavior Analyst Certification Board, Inc. (2012). Guidelines: health plan coverage of applied behavior analysis treatment for autism spectrum disorder. Tallahassee: BACB.

    Google Scholar 

  • Behavior Analyst Certification Board, Inc. (2014). Applied behavior analysis treatment of autism spectrum disorder: practice guidelines for healthcare funders and managers (2nd ed.). Retrieved from http://bacb.com/wp-content/uploads/2015/07/ABA_Guidelines_for_ASD.pdf.

  • Ben-Itzchak, E., & Zachor, D. A. (2007). The effects of intellectual functioning and autism severity on outcome of early behavioral intervention for children with autism. Research in Developmental Disabilities, 28(3), 287–303.

    Article  PubMed  Google Scholar 

  • Ben-Itzchak, E., & Zachor, D. A. (2011). Who benefits from early intervention in autism spectrum disorders? Research in Autism Spectrum Disorders, 5(1), 345–350.

    Article  Google Scholar 

  • Bibby, P., Eikeseth, S., Martin, N. T., Mudford, O. C., & Reeves, D. (2002). Progress and outcomes for children with autism receiving parent-managed intensive interventions. Research in Developmental Disabilities, 23(1), 81–104.

    Article  PubMed  Google Scholar 

  • Dixon, D. R., Tarbox, J., Najdowski, A. C., Wilke, A. E., & Granpeesheh, D. (2011). A comprehensive evaluation of language for early behavioral intervention programs: the reliability of the SKILLS Language Index. Research in Autism Spectrum Disorders, 5(1), 506–511.

    Article  Google Scholar 

  • Eikeseth, S. (2010). Examination of qualifications required of an EIBI professional. European Journal of Behavior Analysis, 11(2), 239–246.

    Article  Google Scholar 

  • Eikeseth, S., Hayward, D., Gale, C., Gitlesen, J. P., & Eldevik, S. (2009). Intensity of supervision and outcome for preschool aged children receiving early and intensive behavioral interventions: a preliminary study. Research in Autism Spectrum Disorders, 3(1), 67–73.

    Article  Google Scholar 

  • Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2002). Intensive behavioral treatment at school for 4- to 7-year-old children with autism: a 1-year comparison controlled study. Behavior Modification, 26(1), 49–68.

    Article  PubMed  Google Scholar 

  • Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2007). Outcome for children with autism who began intensive behavioral treatment between ages 4 and 7: a comparison controlled study. Behavior Modification, 31(3), 264–278.

    Article  PubMed  Google Scholar 

  • Eldevik, S., Eikeseth, S., Jahr, E., & Smith, T. (2006). Effects of low-intensity behavioral treatment for children with autism and mental retardation. Journal of Autism and Developmental Disorders, 36(2), 211–224.

    Article  PubMed  Google Scholar 

  • Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2009). Meta-analysis of early intensive behavioral intervention for children with autism. Journal of Clinical Child and Adolescent Psychology, 38(3), 439–450.

    Article  PubMed  Google Scholar 

  • Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2010). Using participant data to extend the evidence base for intensive behavioral intervention for children with autism. American Journal on Intellectual and Developmental Disabilities, 115(5), 381–405.

    Article  PubMed  Google Scholar 

  • Eldevik, S., Hastings, R. P., Jahr, E., & Hughes, J. C. (2012). Outcomes of behavioral intervention for children with autism in mainstream pre-school settings. Journal of Autism and Developmental Disorders, 42(2), 210–220.

    Article  PubMed  Google Scholar 

  • Fava, L., & Strauss, K. (2014). Response to early intensive behavioral intervention for autism—an umbrella approach to issues critical to treatment individualization. International Journal of Developmental Neuroscience, 39, 49–58.

    Article  PubMed  Google Scholar 

  • Flanagan, H. E., Perry, A., & Freeman, N. L. (2012). Effectiveness of large-scale community-based intensive behavioral intervention: a waitlist comparison study exploring outcomes and predictors. Research in Autism Spectrum Disorders, 6(2), 673–682.

    Article  Google Scholar 

  • Gibson, J. A., Grey, I. M., & Hastings, R. P. (2009). Supervisor support as a predictor of burnout and therapeutic self-efficacy in therapists working in ABA schools. Journal of Autism and Developmental Disorders, 39(7), 1024–1030.

    Article  PubMed  Google Scholar 

  • Granpeesheh, D., Dixon, D. R., Tarbox, J., Kaplan, A. M., & Wilke, A. E. (2009). The effects of age and treatment intensity on behavioral intervention outcomes for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3(4), 1014–1022.

    Article  Google Scholar 

  • Granpeesheh, D., Tarbox, J., Najdowski, A. C., & Kornack, J. (Eds.). (2014). Evidence-based treatment for children with autism: the CARD model. Waltham: Elsevier.

    Google Scholar 

  • Harris, S. L., & Handleman, J. S. (2000). Age and IQ at intake as predictors of placement for young children with autism: a four- to six-year follow-up. Journal of Autism and Developmental Disorders, 30(2), 137–142.

    Article  PubMed  Google Scholar 

  • Hayward, D., Eikeseth, S., Gale, C., & Morgan, S. (2009). Assessing progress during treatment for young children with autism receiving intensive behavioral interventions. Autism, 13(6), 613–633.

    Article  PubMed  Google Scholar 

  • Howlin, P., Magiati, I., & Charman, T. (2009). Systematic review of early intensive behavioral interventions for children with autism. American Journal on Intellectual and Developmental Disabilities, 114(1), 23–41.

    Article  PubMed  Google Scholar 

  • Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3–9.

    Article  PubMed  Google Scholar 

  • Love, J. R., Carr, J. E., Almason, S. M., & Petursdottir, A. I. (2009). Early and intensive behavioral intervention for autism: a survey of clinical practices. Research in Autism Spectrum Disorders, 3(2), 421–428.

    Article  Google Scholar 

  • Luiselli, J. K., O’malley Cannon, B., Ellis, J. T., & Sisson, R. W. (2000). Home-based behavioral intervention for young children with autism/pervasive developmental disorder: a preliminary evaluation of outcome in relation to child age and intensity of service delivery. Autism, 4(4), 426–438.

    Article  Google Scholar 

  • Magiati, I., Charman, T., & Howlin, P. (2007). A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist nursery provision for children with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 48(8), 803–812.

    Article  PubMed  Google Scholar 

  • Magiati, I., Moss, J., Charman, T., & Howlin, P. (2011). Patterns of change in children with autism spectrum disorders who received community based comprehensive interventions in their pre-school years: a seven year follow-up study. Research in Autism Spectrum Disorders, 5(3), 1016–1027.

    Article  Google Scholar 

  • Makrygianni, M. K., & Reed, P. (2010). A meta-analytic review of the effectiveness of behavioural early intervention programs for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 4(4), 577–593.

    Article  Google Scholar 

  • Matson, J. L., & Goldin, R. L. (2014). Early intensive behavioral interventions: selecting behaviors for treatment and assessing treatment effectiveness. Research in Autism Spectrum Disorders, 8(2), 138–142.

    Article  Google Scholar 

  • Mudford, O. C., Martin, N. T., Eikeseth, S., & Bibby, P. (2001). Parent-managed behavioral treatment for preschool children with autism: some characteristics of UK programs. Research in Developmental Disabilities, 22(3), 173–182.

    Article  PubMed  Google Scholar 

  • Perry, A., Cummings, A., Geier, J. D., Freeman, N. L., Hughes, S., Managhan, T., et al. (2011). Predictors of outcome for children receiving intensive behavioral intervention in a large, community-based program. Research in Autism Spectrum Disorders, 5(1), 592–603.

    Article  Google Scholar 

  • Persicke, A., Bishop, M. R., Coffman, C. M., Najdowski, A. C., Tarbox, J., Chi, K., et al. (2014). Evaluation of the concurrent validity of a skills assessment for autism treatment. Research in Autism Spectrum Disorders, 8(3), 281–285.

    Article  Google Scholar 

  • Reichow, B. (2012). Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(4), 512–520.

    Article  PubMed  Google Scholar 

  • Reichow, B., Barton, E.E., Boyd, B.A., & Hume, K. (2012). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database Systematic Reviews, 10.

  • Reichow, B., & Wolery, M. (2009). Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA young autism project model. Journal of Autism and Developmental Disorders, 39(1), 23–41.

    Article  PubMed  Google Scholar 

  • Remington, B., Hastings, R. P., Kovshoff, H., degli Espinosa, F., Jahr, E., Brown, T., et al. (2007). Early intensive behavioral intervention: outcomes for children with autism and their parents after two years. American Journal on Mental Retardation, 112(6), 418–438.

    Article  PubMed  Google Scholar 

  • Ross, S. (2010). Introductory statistics (3rd ed.). Burlington: Academic.

    Google Scholar 

  • Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: four-year outcome and predictors. American Journal on Mental Retardation, 110(6), 417–438.

    Article  PubMed  Google Scholar 

  • Smith, T., Groen, A. D., & Wynn, J. W. (2000). Randomized trial of intensive early intervention for children with pervasive developmental disorder. American Journal on Mental Retardation, 105(4), 269–285.

    Article  PubMed  Google Scholar 

  • Smith, I. M., Koegel, R. L., Koegel, L. K., Openden, D. A., Fossum, K. L., & Bryson, S. E. (2010). Effectiveness of a novel community-based early intervention model for children with autistic spectrum disorder. American Journal on Intellectual and Developmental Disabilities, 115(6), 504–523.

    Article  PubMed  Google Scholar 

  • Virués-Ortega, J. (2010). Applied behavior analytic intervention for autism in early childhood: meta-analysis, meta-regression and dose–response meta-analysis of multiple outcomes. Clinical Psychology Review, 30(4), 387–399.

    Article  PubMed  Google Scholar 

  • Virués-Ortega, J., Rodríguez, V., & Yu, C. T. (2013). Prediction of treatment outcomes and longitudinal analysis in children with autism undergoing intensive behavioral intervention. International Journal of Clinical and Health Psychology, 13(2), 91–100.

    Article  Google Scholar 

Download references

Acknowledgments

We would like to thank Julie Kornack and James E. Carr, Ph.D. for their thoughtful comments on early drafts of this manuscript.

Author information

Authors and Affiliations

  1. Center for Autism and Related Disorders, 21600 Oxnard Street, Suite 1800, Woodland Hills, CA, 91367, USA

    Dennis R. Dixon, Doreen Granpeesheh, Marlena N. Novack & Alva Powell

  2. Schmid College of Science and Technology, Chapman University, One University Drive, Orange, CA, 92866, USA

    Erik Linstead, Ryan French, Elizabeth Stevens & Laura Stevens

Authors
  1. Dennis R. Dixon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erik Linstead
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Doreen Granpeesheh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marlena N. Novack
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ryan French
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elizabeth Stevens
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Laura Stevens
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alva Powell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dennis R. Dixon.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

For this type of retrospective analysis, formal consent was not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dixon, D.R., Linstead, E., Granpeesheh, D. et al. An Evaluation of the Impact of Supervision Intensity, Supervisor Qualifications, and Caseload on Outcomes in the Treatment of Autism Spectrum Disorder. Behav Analysis Practice 9, 339–348 (2016). https://doi.org/10.1007/s40617-016-0132-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40617-016-0132-1

Keywords

Search

Navigation