Evaluation of Multiple Iterations of Government Funded Applied Behaviour Analysis Services for Children and Youth with ASD

Background:  The Durham Region Applied Behaviour Analysis (ABA) based-services and supports is a government funded program for children and youth with Autism Spectrum Disorder (ASD). When parents enrol their children in the program and provide written confirmation of ASD diagnosis they are placed on a waitlist; when children are discharged from the program parents are given the option to put their child back on the waitlist. Goals for the service are discussed with parents and accordingly individual service plans are developed. As a result, this program has seen children receive 1, 2 or even 3 rounds of ABA based-services since 2011.

Objectives: As part of an overall program evaluation we sought to understand the needs of the children who have received more than one round of service, and the outcomes of the service (i.e. goals achieved).

Methods:  Data from de-identified ABA clients was extracted from the treatment centre’s health information management system for services delivered from September 1, 2011 to March 31, 2016. The data for each round of service was cleaned, sorted and analyzed according to age, sex, area of concern (i.e. communication, behaviour, social and activities of daily living) and outcome of program. The outcome of the program is determined by assessing the service plan and implementing a goal achievement scale to determine if children achieved or did not achieve their goals in the allotted time.

Results:  The ABA program saw 1044 individual children and youth over 5 years, of which 71.0% received one round of service, 26.0% received two rounds, and 3.1% received three rounds equalling over 1300 delivered service plans. The average age of children and youth with: one round of service was 8.5 years, with two rounds was 7.7 years, and with three rounds was 6.4 years. There were 266 children and youth who received two rounds of service, and 77.8% achieved their goals. Approximately half (51.1%, n=135) of these children received services for the same area of concern in both rounds (mostly for communication) and 79.2% whose 2^nd service was in the same area of concern achieved their goals; the other half (48.9%, n=129) changed their area of concern for their second round of service and 71.3% achieved their goals. Within individuals with two rounds of service, 64% of females switched their area of concern while 46% of males did. There were 32 children and youth who received three rounds of service, and 66.7% achieved their goals. 53.1% of these children received three rounds of service for the same area of concern (majority were for communication) for all three rounds and 46.8% of children or youth changed their area of concerns and 73.3% achieved all of their goals.

Conclusions: It is unclear why children and youth are staying within the same area of concern in each round of service given the high rate of goal achievement. Future research should examine why families return to the area of concern (e.g. was there a regression or is it a new goal in that area of concern).