effectiveness in significantly reducing (and maintaining reduction of) problem behaviors in at least one-half, if not more, of all applied behavioral analysis studies of problem behaviors in children with autistic spectrum and related disorders;
doubled effectiveness when functional behavioral assessments were used to determine what reliably predicted and maintained the behavior before undertaking the intervention, that is, what function that behavior served for the child;
ability to be effectively carried out in community settings by the children’s usual caregivers, although effective treatment data for the most difficult cases generally involved specialized personnel in less typical settings;
minimal effectiveness (fewer than one-fourth of the cases) in reducing behavior problems that prior functional behavioral analysis indicated were maintained by sensory input; and
increased problem behavior for a small percentage of outcomes studied (6–8%).
These conclusions are particularly important because such interventions must be considered, under IDEA, if a child’s behavior impedes his or her learning or the learning of others.
IDEA contains what has been termed a “rebuttable presumption” (Turnbull et al., 1999) in favor of using positive behavioral interventions and supports in cases of “impeding behavior.” This presumption (having legal weight) can be refuted by evidence to the contrary, but positive behavioral interventions and supports is the only intervention strategy specifically required for consideration by IDEA; other strategies may be considered. If positive behavioral interventions and supports is seen as a rebuttable assumption, it means that an IEP team can consider other intervention strategies only in comparison with positive behavioral interventions and supports and must have adequate cause for adopting a different strategy. Evidence for the efficacy of positive behavioral interventions and supports (presented above), although encouraging, also indicates that current positive behavioral interventions and supports strategies, as presently implemented, may be ineffective or only minimally effective for up to one-third of all problem behaviors and for up to three-quarters of those problem behaviors maintained by sensory input. In these cases, different or additional strategies may be required, after first considering positive behavioral interventions and supports.