Catalight Practice Guidelines Reflect a Contemporary Research View of the Dosage Effect and Outcome Measures in Autism Care New Clinician Resource Calls for Lower Treatment Hours and More Parent-mediated Care

Catalight, one of the largest behavioral health networks in the United States working to support individuals with autism and intellectual and developmental disabilities (I/DD), recently unveiled a set of guidelines for behavioral analysts, psychologists and clinicians working with community-based applied behavioral interventions.  

The Catalight Practice Guidelines challenge the common belief of a ‘dosage effect’ by stating that high hours of applied behavior analysis (ABA) are not needed for good outcomes in the treatment of children with autism or I/DD.  

With the goal of doing a thorough review of the latest studies, Catalight Research Institute leaders, along with a review committee, spent a year and a half researching and compiling the new guidelines. Reviewers included psychologists, board-certified behavioral analysts, adult autism self-advocates, parents of children with autism and a marriage and family therapist.  

“Most behavioral interventions like ABA are delivered by trained paraprofessionals under the supervision of a certified or licensed clinician. We looked at numerous group studies, meta-analyses and other research studies to assess the impact of high-hour ABA and related behavioral interventions for young children. We did not find a strong dosage effect and we did not find good support for high-hour comprehensive ABA. More isn’t always better,” Catalight’s Chief Clinical Officer Doreen Samelson, Ed.D., MSCP, said. “What we did find was support for behavioral interventions being effective in lower hours – much lower hours than people think – which is good news for families currently in care, those on a waitlist and the industry. While dosage decisions should be made based on the individual needs of the child and their family, the guidelines basically say that there’s a lack of strong research support for more than 15 hours a week of behavioral interventions such as ABA.” 

The new Catalight guidelines also show that research supports parent-mediated interventions such as parent-mediated ABA – where parents are taught to use behavioral interventions in routine parenting by teaching their child new skills and decreasing disruptive behaviors. The strength of parent-mediated care, as demonstrated by the research, is comparable to practitioner-mediated interventions, according to the guidelines. General guidelines are given about what practitioners should consider when working with parents in order to empower them in their everyday lives. 

Noticing that some current practice standards lacked outcome measures, the Catalight team provided outcome guidelines that help gauge wellbeing for the individual, parental stress and general quality of life for the entire family. Several of the outcome measures included in the guidelines can be downloaded for use by clinicians providing autism care at no cost.

Catalight believes that there are options outside of ABA and multiple options within ABA for the treatment of autism and I/DD. A personalized care path should be a collaboration between the client, their parents and the care team.

 “We hope these new guidelines serve as a resource to help clinicians as they seek to deliver person and family-centered care,” said Dr. Samelson.  

Dr. Samelson added that the Catalight Practice Guidelines will be kept current as new research becomes available.