ABA reduced carer burden but was no more effective than standard care in improving social outcomes in people with learning disabilities

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Applied behaviour analysis (ABA) is a way of helping people to change their behaviour by focusing on the observable relationship between behaviour to the environment. ABA has led to a range of specific procedures that have enabled analysts to develop tailored intervention programmes based on functional analysis, specifically designed for individuals in their environments. This person centred approach has been shown to reduce incidence and severity of challenging behaviour in people with learning disabilities.

The researchers in this study however were interested in looking at whether ABA interventions could also reduce the burden on carers and help to increase the participation of this group in their communities.

The researchers used a randomised controlled trial methodology for a 6-month period and followed this with a longer-term naturalistic follow-up of participants. They were interested in the impact of the behaviour on carers and on the daily activities of the participants. They measured this using the Carer Uplift and Burden Scale and Guernsey Community Participation and Leisure Assessment.

They found that community participation and carer burden improved at 6 and 24 months. The burden on family carers was shown to be significantly reduced compared with paid carers.

They conclude from this small study that applied behavioural analysis appeared to be no more effective than standard care in improving social outcomes in people with learning disabilities and challenging behaviour. However they recommend that this finding be tested through examination in a much larger trial.

Brief report: Impact of applied behaviour analysis (ABA) on carer burden and community participation in challenging behaviour: results from a randomised controlled trial, Hassiotis, A et al., in Journal of Intellectual Disability Research, 56: 285–290.

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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