Centre for Reviews and Dissemination
Synthesising Comprehensive Applied Behavior Analysis interventions - Research for children with autism spectrum Disorders (SCABARD)
What is SCABARD?
Synthesising Comprehensive Applied Behavior Analysis interventions - Research for children with autism spectrum Disorders (SCABARD) is an international collaborative systematic review/meta-analysis and a cost effectiveness analysis.
This means we will collect and reanalyze data that has previously been collected in existing studies. SCABARD is not a research trial of applied behaviour analysis or any other type of intervention.
Background
Autism Spectrum Disorder is a complex life-long condition that impacts on development in different areas including intellectual, communication, social, emotional, and adaptive skills for daily living. ASD affects approximately 3 in 200 children born in the UK. People with autism often experience difficulties in life and can also experience poor mental health. The high prevalence, serious long-term outcomes, and the costs of providing high-quality health, educational and community services for the people with autism and their families makes it a considerable concern. Some studies involving young children with autism have suggested that treatments based on applied behaviour analysis (ABA) can help. These intense, comprehensive approaches when used early in the child’s development target a broad range of skills and behaviours. However, it remains unclear to what extent these interventions are effective in the short and long-term.
Aims
SCABARD aims to investigate the research evidence produced to date to see if intensive ABA-based therapy helps children with autism spectrum disorder learn and adapt, and improves longer term outcomes. We will then look to see if it might benefit some children more than others and who those children might be. We will also examine the costs involved in implementing such an intervention in the UK. If there is not enough information available now to answer any of these questions, we will identify what data are needed to answer them in the future and whether it would be valuable to commission new research to collect this information.
What will the research involve?
SCABARD will consist of two related investigations:
Firstly, we will identify all known studies that have tested the effectiveness of intensive ABA-based interventions for young children with autism. The results of these studies will be combined to find out how effective ABA-based interventions are. This might include effects on children’s cognitive, adaptive or social abilities, communication/language skills, symptom severity, quality of life, educational attainment, or daily functioning and decision making capacity.
We will not be recruiting children to a new primary study, but collecting and re-analysisng data from studies that have already been completed. Unlike previous reviews we will work in collaboration with the trial investigators responsible for each of the original studies to assemble anonymised data from individual children. This will allow us to conduct an individual participant data meta-analysis (IPD-MA) and explore whether intensive ABA-based interventions work better for particular groups of children or in certain environments.
Secondly, we will look at the costs and benefits of implementing intensive ABA-based interventions for young children with autism in the short term, midterm and long term. The work will be carried out from a public sector point of view and will be informed by the results of the IPD-MA. This work will also evaluate the consequences of implementing intensive ABA-based interventions on different government budgets such as the NHS or local authority, as well as the value of conducting further research in this area.
Who is involved in SCABARD?
SCABARD is a multi-disciplinary partnership between York, Newcastle and Bristol Universities, with advice and guidance from an international group of experts. The analysis will be undertaken at the University of York by an independent research team. The multidisciplinary research team brings together expertise in ABA-based interventions, systematic reviews, meta-analysis, decision modelling, and health technology assessment with relevant clinical expertise. The project is advised by the SCABARD Advisory Group, which includes representation from the National Autistic Society, research study investigators, parents of children with autistic spectrum disorder, adults with autism spectrum disorder, individual participant data (IPD) research specialists, health economists, psychiatrists, clinical and educational psychologists.
The project will be carried out on behalf of the SCABARD Group. All study investigators who share anonymized data will also become participating members of the group.
Funding organisation
SCABARD is funded by NIHR Health Technology Assessment (HTA) Programme. The HTA Programme funds research about the clinical and cost effectiveness and broader impact of healthcare treatments and tests for those who plan, provide or receive care in the NHS. HTA research is undertaken where some evidence already exists to show that a technology can be effective and this needs to be compared to the current standard NHS intervention to see what works best.
FAQs
Can my child take part in this study?
As this is an analysis of existing research data, we will not be recruiting children to ABA-based or any other form of treatment. However, if the analysis discovers important areas of uncertainty, we may make recommendations about the kind(s) of study that should be conducted in the future.
What kinds of studies will be included in the IPD-MA?
Studies will be included if they compare intensive ABA-based behavioural interventions in children with autism spectrum disorder against any other intervention.
Relevant studies will be included regardless of where or when they were conducted, or in what language they were originally published.
Relevant studies will be included regardless of which outcomes they measured.
What will SCABARD conclude?
It is not possible to predict what the outcome of the research will be until all the data have been collected and analysed.
Where can I find information on the progress of SCABARD?
This webpage will be updated with further information as project meets major milestones.
When will SCABARD be completed?
The research project began on 1st July 2017 and is due to be completed in December 2018. At this point, a report will be submitted to the funding organisation, who will submit it to independent peer-review prior to publication.
The SCABARD group will also publish the results of the research in a peer-reviewed academic journal and as a plain English summary for a wider audience.
Publications
ABA Infographic (PDF 
, 2,397kb) - download this easy to read one page summary of findings and recommendations
This video explains the results of the research in more detail