Barriers to Receiving Applied Behavior Analysis Services in Children With Autism Spectrum Disorder

Introduction Applied behavior analysis (ABA) is commonly used to treat children with autism spectrum disorder (ASD). The objective of this study is to evaluate barriers to ABA treatment in ASD. Methods A voluntary 51-question survey, including demographics, socioeconomic status, parental assertiveness/self-advocacy, and parent perceptions, was provided to caregivers of children aged one to eight years old diagnosed with ASD. The survey consisted of a series of yes/no, five-point Likert scale, multiple-choice, and text field questions. Results A total of 540 surveys were completed. The median time since ASD diagnosis was three to five years ago. Respondents were identified as receiving ABA (r-ABA) vs. not receiving ABA (n-ABA). Respondents were from Florida (60%; r-ABA = 61.7%; n-ABA = 57.0%), Pennsylvania (18%; r-ABA = 21.3%; n-ABA = 12.8%), Delaware (17%; r-ABA = 11.7%; n-ABA = 26.8%), and New Jersey (5%; r-ABA = 5.3%; n-ABA = 3.4%) (p < 0.001). Caregiver belief in ABA treatment, empowerment, and comfort level were greater for r-ABA (4.20 ± 0.72; 3.19 ± 0.93; 4.35 ± 0.72) compared to n-ABA (4.06 ± 0.83; 2.90 ± 1.00; 4.03 ± 0.91), respectively (mean ± SD). Conclusion Barriers to accessing ABA services are a multifactorial issue. Location, income, education of the caregiver, time since ASD diagnosis for the child, as well as caregiver empowerment, belief in treatment, and level of comfort in accessing services most likely contribute to children with ASD not receiving ABA. Empowering parents on their impact on their child's treatment may improve ABA use.