JMIR Publications

ABSTRACT

Background:

Autism spectrum disorder (ASD) can have traits that impact multiple domains of functioning and quality of life, which can persevere throughout life. To mitigate the impact of ASD on the long-term trajectory of an individual’s life, it is imperative to seek early and adequate treatment via scientifically validated approaches, of which Applied behavior analysis (ABA) is the gold-standard. ABA treatment must be delivered via a behavior technician with oversight from a board-certified behavior Analyst. However, shortages in certified ABA therapists create treatment access barriers for individuals on the autism spectrum. Increased ASD prevalence demands innovations for treatment delivery. Parent-led treatment models for neurodevelopmental conditions are effective, yet underutilized and may fill this care gap.

Objective:

This study reports findings from a retrospective chart review of clinical outcomes for children that received parent-led ABA treatment and intends to examine the sustained impact that modifications to ABA delivery have had on a subset of patients of Montera, Inc. dba Forta (“Forta”) as measured by progress towards skill acquisition within multiple focus areas (FAs).

Methods:

Parents received 40+ hours of training in ABA prior to initiating treatment, and patients were prescribed focused (<25 hrs/week) or comprehensive (>25-40 hrs/week) treatment plans. Retrospective data were evaluated over 90+ days for 30 patients. The clinical outcomes of patients were additionally assessed by age (2-5; 6-12; 13-22 years) and utilization of prescribed treatment. Treatment encompassed skill acquisition goals and successful attempts were logged within an in-house built software application to facilitate data collection consistency.

Results:

Improved goal achievement success between weeks 1-20 was observed for older age, all utilization, and both treatment plan type cohorts. Success rates increased over time for most FAs, with the exception of executive functioning in the youngest cohort and comprehensive plan cohort. Goal achievement experienced peaks and declines from week to week, as expected for ABA treatment, however, overall trends indicate increased skill acquisition success rates. Of 40 unique combinations of analysis cohorts and FAs, 20 showed statistically significant positive linear relationships (p<0.05). Statistically significant positive linear relationships were observed in the high utilization cohort (communication, social skills; p<0.05); in the fair and full utilization cohorts (overall success and success in emotional regulation); and in the comprehensive treatment cohort (communication, emotional regulation).

Conclusions:

Parent-led ABA can lead to goal achievement and improved clinical outcomes and may be a viable solution to overcome treatment access barriers that delay initiation or continuation of care. Clinical Trial: n/a