Concordance between patient-centered and adaptive behavior outcome measures after applied behavior analysis for autism
Abstract Background Applied behavior analysis (ABA) is an evidence-based approach to autism spectrum disorder that has been shown in clinical trials to improve child functional status. There is substantial focus in ABA on setting and tracking individualized goals that are patient-centered, but limit...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-022-03383-2 |
| _version_ | 1818207533325615104 |
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| author | Kristen R. Choi Amin D. Lotfizadah Bhumi Bhakta Paula Pompa-Craven Karen J. Coleman |
| author_facet | Kristen R. Choi Amin D. Lotfizadah Bhumi Bhakta Paula Pompa-Craven Karen J. Coleman |
| author_sort | Kristen R. Choi |
| collection | DOAJ |
| description | Abstract Background Applied behavior analysis (ABA) is an evidence-based approach to autism spectrum disorder that has been shown in clinical trials to improve child functional status. There is substantial focus in ABA on setting and tracking individualized goals that are patient-centered, but limited research on how to measure progress on such patient-centered outcomes. Purpose The purpose of this investigation was to assess concordance between patient-centered and standard outcome measures of treatment progress in a real-world clinical sample of children receiving ABA for autism spectrum disorder. Methods This observational study used a clinical sample of children ages 3 to 16 years (N = 154) who received 24 months of ABA from an integrated health system. Concordance between three outcome measures after ABA was assessed using a correlation matrix: (1) patient-centered measures of progress on individualized treatment goals, (2) caregiver-centered measure of progress on treatment participation goals, and (3) the Vineland Adaptive Behavior Scales adaptive behavior composite. Results There was limited concordance among measures at both 12 and 24 months of ABA. None of the patient-centered measures showed significant positive correlation with adaptive behavior composite difference scores at either 12 or 24 months, nor did the caregiver measure. The percentage of children achieving clinically meaningful gain on patient-centered goal measures increased between 12 and 24 months of ABA, while the percentage of children achieving clinically meaningful gains in adaptive behavior declined during the same time period. Conclusions In a health system implementation of ABA, there was limited concordance between patient-centered and standard measures of clinically meaningful treatment progress for children with ASD. Clinicians should have ongoing dialogue with patients and parents/caregivers to ensure that interventions for ASD are resulting in progress towards outcomes that are meaningful to patients and families. |
| first_indexed | 2024-12-12T04:30:26Z |
| format | Article |
| id | doaj.art-71c50a0bc86b4d7697f20b8326691e3e |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-12T04:30:26Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-71c50a0bc86b4d7697f20b8326691e3e2022-12-22T00:38:06ZengBMCBMC Pediatrics1471-24312022-05-0122111010.1186/s12887-022-03383-2Concordance between patient-centered and adaptive behavior outcome measures after applied behavior analysis for autismKristen R. Choi0Amin D. Lotfizadah1Bhumi Bhakta2Paula Pompa-Craven3Karen J. Coleman4UCLA School of NursingEasterseals Southern CaliforniaDepartment of Research & Evaluation, Kaiser Permanente Southern CaliforniaEasterseals Southern CaliforniaDepartment of Research & Evaluation, Kaiser Permanente Southern CaliforniaAbstract Background Applied behavior analysis (ABA) is an evidence-based approach to autism spectrum disorder that has been shown in clinical trials to improve child functional status. There is substantial focus in ABA on setting and tracking individualized goals that are patient-centered, but limited research on how to measure progress on such patient-centered outcomes. Purpose The purpose of this investigation was to assess concordance between patient-centered and standard outcome measures of treatment progress in a real-world clinical sample of children receiving ABA for autism spectrum disorder. Methods This observational study used a clinical sample of children ages 3 to 16 years (N = 154) who received 24 months of ABA from an integrated health system. Concordance between three outcome measures after ABA was assessed using a correlation matrix: (1) patient-centered measures of progress on individualized treatment goals, (2) caregiver-centered measure of progress on treatment participation goals, and (3) the Vineland Adaptive Behavior Scales adaptive behavior composite. Results There was limited concordance among measures at both 12 and 24 months of ABA. None of the patient-centered measures showed significant positive correlation with adaptive behavior composite difference scores at either 12 or 24 months, nor did the caregiver measure. The percentage of children achieving clinically meaningful gain on patient-centered goal measures increased between 12 and 24 months of ABA, while the percentage of children achieving clinically meaningful gains in adaptive behavior declined during the same time period. Conclusions In a health system implementation of ABA, there was limited concordance between patient-centered and standard measures of clinically meaningful treatment progress for children with ASD. Clinicians should have ongoing dialogue with patients and parents/caregivers to ensure that interventions for ASD are resulting in progress towards outcomes that are meaningful to patients and families.https://doi.org/10.1186/s12887-022-03383-2Autism spectrum disorderApplied behavior analysisPatient-centered outcomesConcordanceMeasurement |
| spellingShingle | Kristen R. Choi Amin D. Lotfizadah Bhumi Bhakta Paula Pompa-Craven Karen J. Coleman Concordance between patient-centered and adaptive behavior outcome measures after applied behavior analysis for autism BMC Pediatrics Autism spectrum disorder Applied behavior analysis Patient-centered outcomes Concordance Measurement |
| title | Concordance between patient-centered and adaptive behavior outcome measures after applied behavior analysis for autism |
| title_full | Concordance between patient-centered and adaptive behavior outcome measures after applied behavior analysis for autism |
| title_fullStr | Concordance between patient-centered and adaptive behavior outcome measures after applied behavior analysis for autism |
| title_full_unstemmed | Concordance between patient-centered and adaptive behavior outcome measures after applied behavior analysis for autism |
| title_short | Concordance between patient-centered and adaptive behavior outcome measures after applied behavior analysis for autism |
| title_sort | concordance between patient centered and adaptive behavior outcome measures after applied behavior analysis for autism |
| topic | Autism spectrum disorder Applied behavior analysis Patient-centered outcomes Concordance Measurement |
| url | https://doi.org/10.1186/s12887-022-03383-2 |
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