Five-Year Program Evaluation of a Government Funded Applied Behaviour Analysis Program

Background:  Since September 2011, the Durham Region, in Ontario, Canada has been providing customized Applied Behavioural Analysis (ABA) services and supports to children and youth with Autism Spectrum Disorder (ASD) and their families. This program is available for children and youth with ASD up to their 18^th birthday. This government funded ABA program is designed to be short-term and intensive (i.e. between 2 to 4 hours per week and 2 to 6 months). The clinicians, in consultation with the parents, develop goals for each child upon entry and create a unique service plan to help the child achieve these goals (using goal achievement scaling).

Objectives:  The objective is to describe the program evaluation results of Durham’s ABA-based services examining who has received the services according to age, sex, area of concern (i.e. behaviour management/emotional regulation, communication, social/interpersonal, or daily living skills.), and the outcome of service plan (goals achieved).

Methods: De-identified data on ABA clients housed in a health information management system were extracted for services delivered between September 1, 2011, and March 31, 2016. The data was cleaned, sorted, and relevant variables were selected for coding and analysis.

Results:

The ABA program administered 1373 service plans in 5 years to 1044 individual children (once a round of service is complete, parents can place their child back on the waitlist to receive another round of service); 82% were male, 18% were female, and the average age was 8 years old. The largest number of service users were between the ages of 6-10 (42.5%) followed by 0-5 year olds (31.9%). The most common area of concern for service users was communication skills (37.5%), followed by behaviour skills (28.8%), social skills and activities of daily living (27.2% and 6.5% respectively). Children aged 6-10 and 11-14 were most likely to receive services for behaviour (38.8% and 40.7% respectively), and communication was the most common area of concern for children aged 0-5 (70.3%), whereas youth aged 15-17 were most likely to receive services for social skills (45.5%). 82% of the clients achieved their goals. By area of concern, those who received services for communication were the most likely to achieve their goals (87.5%). Those age 0-5 were the most likely to achieve their goals (88.6%) and those aged 15-18 were the most likely to not achieve their goals (23.6%). The percent of males and females who achieved their goals was similar across the age groups, ranging from 77-90%, except for females in the 15-18 age range, where only 55.6% achieved their goals. Among those who did not achieve their goals, the majority (20.0%) cancelled their sessions and had difficulty fulfilling their plan (19.0%).

Conclusions:  In its first 5 years, the Durham ABA-based services and supports for children and youth with ASD has demonstrated to be effective at facilitating the achievement of the goals established by the families. It is critical to understand why children and their families have difficulty with their service plans in order to best support these families.