Study Finds More Treatment Hours for Autistic Children May Not Lead to Better Outcomes 

Press release |

For autistic children, receiving more hours of treatment may not lead to better outcomes, according to a new peer-reviewed study by researchers at the nonprofit Catalight Research Institute. The findings challenge long-standing guidelines that recommend 30 to 40 hours of applied behavior analysis (ABA) therapy per week for autistic children. ABA is a longstanding and commonly used treatment for autism. 

The study analyzed real-world clinical data from 725 autistic children receiving ABA across the United States over a one-year period. Researchers examined the relationship between treatment hours and measures of wellbeing, including communication, goal attainment and dangerous behavior. 

“For decades, families have been told that more hours mean better outcomes,” said Doreen Samelson, Ed.D., Catalight’s chief clinical officer and lead author of the study. “Our findings suggest a more nuanced reality – one where more hours are not a reliable predictor of meaningful, real-world progress.” 

Key Findings: 

  • Higher hours of ABA were not associated with improvements in adaptive behavior, such as communication, socialization or daily living skills. Children receiving more hours tended to start out with lower baseline adaptive abilities and showed slower improvement  
  • Dangerous behaviors decreased over time regardless of treatment hours – suggesting reductions were not driven by dosage 
  • Baseline communication skills were a stronger predictor of outcomes than the number of hours 

The authors emphasized the importance of distinguishing between short-term goal attainment and achieving broader outcomes that contribute to lasting wellbeing. While increased therapy hours appeared to support progress on highly specific goals, they did not lead to meaningful improvements in broader functioning.  

“These results reinforce the idea that autism care should be individualized, not driven by one-size-fits-all hour recommendations,” Dr. Samelson said. “For some children, increased hours may support short-term learning of specific skills. But more hours alone do not guarantee broader adaptive gains.”

The researchers note that ABA remains an effective intervention for many children, particularly for reducing dangerous behaviors and supporting skill acquisition. However, they argue that treatment decisions should prioritize individuals rather than defaulting to high hours of ABA. 

“Our findings align with a growing body of research suggesting that current practice guidelines may overemphasize high hours,” Dr. Samelson said. “Families and clinicians deserve guidance that reflects what actually works in real-world care settings.” 

The study, “Dosage in Applied Behavior Analysis: Effect on Adaptive Behavior, Goal Attainment, and Dangerous Behavior,” was published in the “Journal of Autism and Developmental Disorders.” It was co-authored by Dr. Samelson, Lindsey Sneed, Ph.D., BCBA, and Ben Pfingston, MS, all of the Catalight Research Institute.  
 
Contact:  

Media Contact:
Keith Ferguson
Director of Marketing and Communications
Catalight