A national UK census of Applied Behavior Analysis school provision for children with autism

Research in Autism Spectrum Disorders 6 (2012) 798–805

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A national UK census of Applied Behavior Analysis school provision for children with autism G.M. Griffith *, R. Fletcher, R.P. Hastings School of Psychology, Bangor University, Brigantia Building, Penrhalt Road, Bangor, LL57 2AS, UK

A R T I C L E I N F O

A B S T R A C T

Article history: Received 25 October 2011 Received in revised form 27 October 2011 Accepted 28 October 2011

Over more than a decade, specialist Applied Behavior Analysis (ABA) schools or classes for children with autism have developed in the UK and Ireland. However, very little is known internationally about how ABA is defined in practice in school settings, the characteristics of children supported in ABA school settings, and the staffing structures used. To answer these questions, the focus of the present research was a nationwide census of ABA schools throughout the UK. As far as it was possible to ascertain, we achieved a 100% return rate. There were 14 ABA schools and classes throughout the UK, supporting 258 children with autism, and employing 382 staff that supported ABA teaching. The mean ratio for ABA staff to children was 1.4 staff members: 1 child (range 0.7:1–2:1). The majority of all staff members were graduates or had a higher academic qualification (67.7%). This census methodology, if repeated, may help to identify future trends and can provide a baseline for developments in ABA schools/classes in the UK. ß 2011 Elsevier Ltd. All rights reserved.

Keywords: Applied Behavior Analysis Census survey United kingdom Autism Schools

1. Introduction In the international research literature on autism, there is considerable debate about whether various interventions reach criteria that means they can be described as ‘‘evidence-based’’ (e.g., Eldevik et al., 2010; National Autism Center, 2009; Ospina, Krebs Seida, Clark, Karkhaneh, & Hartling, 2008; Rogers & Vismara, 2008). Meanwhile, perhaps a bigger problem is the availability of any intervention at all for children with autism and their families (Green, 2007). Where families do engage with and have access to interventions, research data suggest that a mixture of methods is used. For example, Green et al. (2006) conducted an Internet survey of 552 parents of children with autism spectrum disorder (ASD) examining which interventions they used. The majority of parents used ‘standard therapies’ which included speech therapy and music therapy (69.9%), and ‘other skills based’ which included social stories and visual schedules (61.4%). Skills training based on ABA principles was the third most common intervention used by parents (56.3%). Several recent systematic reviews with meta-analysis of outcome data have concluded that ABA-based intervention for children with autism can be effective for increasing children’s cognitive, adaptive, and language skills (Eldevik et al., 2009, 2010; Makrygianni & Reed, 2010; Peters-Scheffer, Didden, Korzilius, & Sturmey, 2011; Reichow & Wolery, 2009; Virue´sOrtega, 2010). However, even with a focus on fairly intensive and comprehensive ABA-based intervention, in most evaluation research children and families have received a variety of other intervention supports. For example, Remington et al. (2007) reported that approximately one quarter of children in their ABA intervention group received speech therapy throughout the two years, and approximately one half were on dietary interventions. Therefore, it is clearly important to

* Corresponding author. Tel.: +44 1248 388067. E-mail address: g.m.griffi[email protected] (G.M. Griffith). 1750-9467/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.rasd.2011.10.014

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understand the broader intervention context in which even focused models like Early Intensive Behavioral Intervention (EIBI) are being used in practice. One of the first reports about how ABA home-based programs are delivered in practice was carried out in the UK (Mudford, Martin, Eikeseth, & Bibby, 2001), where it was found that home EIBI programs were delivered for a mean of 32 h per week and all received less frequent supervision than recommended by Lovaas (1987). Additionally, just 21% of children received consultancy from individuals qualified to the standards as recommended by Lovaas (1987). More recently, Love, Carr, Almason, and Peturdottir (2009) conducted an Internet survey of 211 EIBI supervisors who worked in a range of home, school, and clinic-based EIBI programs. Variations in EIBI practices among supervisors included differences in approaches to EIBI (verbal behavior vs. discrete trial training), amount of EIBI training given to parents (none vs. equal training to ABA tutors), and hours of behavioral treatment given per week (30–40 h vs. 1–10 h). A small number of group design studies have provided evidence that comprehensive ABA-based interventions delivered in elementary and pre-school settings can achieve outcomes similar to those found in evaluations of home-based EIBI (e.g., Eikeseth, Smith, Jahr, & Eldevik, 2007; Eldevik, Hastings, Jahr, & Hughes, 2011). For a decade or more, school-based organizations in the UK and Ireland have been delivering comprehensive educational models for children with autism using ABA principles. A developing literature has also suggested positive results from these school-based models (e.g., Grindle et al., 2009; McGarrell, Healy, Leader, O’Connor, & Kenny, 2009; Waddington & Reed, 2009). However, we could find no study describing the characteristics specifically of ABA school-based services internationally and certainly no such study for the UK. The purpose of the present research was to conduct a nationwide census of ABA schools/classes throughout the UK. To our knowledge, this is the first time data have been collected on any aspect of ABA schools from a national perspective. Improving on methodologies of earlier surveys of home-based programs, parents’ reports on interventions, and practitioner surveys, we adopted a census methodology. The aim of the census was to obtain a complete count of the entire population of ABA schools/classes in the UK. Information was obtained about the following domains: (1) the structure of schools, (2) demographic information about children attending ABA schools, and (3) ABA and non-ABA staff working in schools. 2. Methods 2.1. Census procedure ABA schools throughout the UK were first identified via a practice and research-based ABA Schools Forum that has been in place since 2002. The ABA Schools Forum met regularly and was attended by representatives of ABA schools/classes across the UK. The membership of this Forum included 13 schools/school-based services (e.g., ABA classes in a larger school) in early 2010. To ensure that all ABA schools/classes in the UK were identified, the 13 members were contacted via email with a list of all known ABA schools/classes in the UK, and asked if they knew of any other existing ABA schools/classes. The researchers also conducted an extensive Internet search to identify any other ABA schools/classes in the UK. One additional school/class, in operation at the time of the census, was identified via these means and was contacted via telephone and asked if they were interested in their school participating in the census. As a result, all 14 representatives of ABA schools/classes agreed to participate in the census. The inclusion criteria were that schools/classes had to self-identify as ABA schools/classes and be formally recognized as providing ABA-based education by placing education authorities. The census was developed and piloted, and was mailed to each ABA school/class, along with a consent form and a covering letter explaining the census and its aims. The contact details of researchers were included in the information packs in case schools needed clarification on any aspect of the census, and were given the option of having researchers visit the school to assist in completing the census. No school contacted the researchers for either of these reasons. Schools were also given the option of completing the census electronically, but all completed paper copies. The date of the census was 1 March 2010, and schools were requested to complete the census by including information on all children and staff members employed at the school on this date. ABA schools and classes were asked to return the census by the end of March 2010. Any ABA schools/classes who did not respond by this date were prompted via telephone and/or email by the researchers. The last completed census was returned in November 2010. A total of 14 ABA schools/classes completed the census; a 100% return rate. We believe that this represents the full extent of ABA schools/classes for children with autism in operation in the UK on 1 March 2010. 2.2. Census survey instrument The UK ABA Schools Census was developed by the authors in collaboration with representatives from three ABA schools in the UK, who advised the research team on behalf of the ABA Schools Forum (a complete copy of the census document is available on request from the corresponding author). The census was divided into three sections: (1) school structure, (2) child information, and (3) staff information. Extensive guidance notes were provided for each section, giving detailed examples and explanations of terminology. For example in the child information section, challenging behaviors and their severity were given operational definitions, and were based upon the definitions given in the Challenging Behavior Interview (Oliver et al., 2003). A draft version of the census was piloted with three representatives from different ABA schools, who were asked to complete all sections of the census for at least five children and five staff members. They were asked to feedback on ease of use, clarity, and the comprehensiveness of the census. Their feedback was collated and minor improvements were made to the final version of the census. Details of each of the three sections of the census are given below.

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2.2.1. School structure information The aim of the school structure section was to describe the overall nature/focus of each school/class. Items included how classes were organized, what age range of children the school was registered for (i.e., admissions age range), and how many classes were in the school. There were also items about the primary behavior analytic ‘‘model’’ used by the schools, and whether ABA provision varied by UK educational Key Stage.1 Items were either open-ended (e.g. ‘How would you describe the primary behavior analytic model used in the school?’) or participants were asked to select the item(s) that best described their school structure (e.g. for the item ‘How are classes organized at the child level?’ the options were ‘single age/year group’ ‘by Key Stage’ ‘ability’ ‘severity of challenging behavior,’ and ‘other (please describe’). 2.2.2. Child information Schools were asked to complete a standard set of questions about each child in their school. All data collected on children were anonymous. Items included child age, gender, diagnosis, family socio-economic information, ethnicity, most recent P scale educational assessment scores,2 and severity of the child’s challenging behaviors. Again, items were either open-ended (e.g., ‘What are the child’s diagnoses as specified on the statement of Special Educational Needs?’)3 or respondents were asked to select answers or tick boxes to answer items. 2.2.3. Staff information Following consultation from the school representatives about typical staff structures within ABA schools/classes in the UK, the staff information section focused on four categories of staff. Schools were asked to place all their staff members who worked directly with children (so not including receptionists, cleaners, etc.) into one of those four categories, and give information about each staff member. All data collected on members of staff were anonymous. Detailed definitions of each staff category were given and, in brief, the categories were: (a) ABA consultants: senior staff members who are responsible for overall ABA program writing, (b) supervisors/lead ABA tutors: staff members who are in an ABA supervisory role within a classroom, but who also may work as ABA tutors (therapists) as part of their role, (c) ABA tutors/trainee ABA tutors (therapists): staff members who provide 1:1 ABA therapy for children, but who do not have an overall supervisory role, and (d) non ABA staff: professionals and teachers whose primary role is not ABA based, such as specialist music teachers and speech and language therapists. Typical questions for each category of staff then included what ABA-related professional qualifications each staff member had, their general level of education, years of experience working in ABA settings, and how long staff members had been employed by their current school. 3. Results 3.1. General description of ABA schools/classes in the UK Of the 14 participating settings, there were 10 ABA schools, two ABA classrooms within a special school setting, and two ABA classrooms within a mainstream setting or linked to a mainstream setting. Of the 10 ABA schools, the smallest school had one ABA class, while the largest school had 14 ABA classes (mean 5.25 classes per school). Schools were registered for children and young people from the age of 3 up to 19 years, with individual schools within this broad range. Six schools were registered to admit children and young people across the age range 3–16 years, and six were registered to admit children and young people across the whole 3–19 age range. One school was registered to admit children from 3 to 11 years of age only, and one was registered to admit young people from 11 to 16 years of age only. There was a mean of 18.4 children per school/class (range 2–76 children). Eight schools described their primary behavior analytic model as just ‘ABA’, three as ‘ABA and Verbal Behavior (VB)’, two as ‘VB only’, and one as ‘Comprehensive Application of Behavior Analysis to Schooling (CABAS1).’ Seven of the 14 schools/classes completed information about whether their provision varied by Key Stage, of those, five reported that ABA provision did not vary between Key Stage 1 (children 5–7 years of age) and Key Stage 3 (young people 11– 14 years of age), or the question was not applicable as they only served children in one Key Stage. Of the two schools that did differ in their approach to teaching over the Key Stages, one school recorded that they emphasized teaching daily living skills to young people in Key Stage 4 (aged 14–16 years old), and in another school, Key Stage 4 young people had an ‘‘outreach to a communication skills class’’. Classes in multi-classroom schools were organized according to one or a combination of categories, these included: the ability level or verbal ability of the child (9 of 14 schools/classes), Key Stage (7 of 14 schools/classes), child age (2 of 14 schools/classes), or levels of challenging behavior (2 of 14 schools/classes). In terms of how classes were arranged on a

1 A key stage is a stage in the UK educational system. Key stages are defined by chronological age groupings and state the expected educational knowledge at various chronological ages. 2 The P scales are a set of descriptions for recording the achievement of children with special educational needs (SEN) who are working towards the first (lowest) level of the National Curriculum in the UK. The P scales are split into eight different levels with P1 being the lowest and P8 the highest. Levels P1 to P3 describe early learning and conceptual development and are not specific to any academic subject. An example of a P1 level is ‘‘Children show emerging awareness of activities and experiences’’. Levels P3 to P8 are subject-specific and divided into three broad categories, Math, English, and Science, which are further divided into sub-categories. 3 A statement of SEN is a legal document which describes what a child’s educational needs are, the objectives to be achieved, the provision required to meet those objectives, and what school (or other placement) the child will attend.

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practical level, every school/class provided individual tables for children to work at, and eight schools also provided small group-work tables. The staff to child ratio was individually calculated for all 14 schools. Means were calculated first including ABA staff only (ABA consultants, supervisors, tutors/therapists, and trainee tutors/therapists), and again also including non-ABA staff members who worked directly with the children (e.g., curriculum mangers, speech therapists). The mean ratio for ABA staff to children was 1.4 staff members: 1 child (range 0.7:1–2:1), and the mean ratio for ABA and non-ABA staff was 1.6 staff members: 1 child (range 0.7:1–2.7:1). 3.2. Child information Two hundred and fifty eight children and young people (219 male, 39 female) were registered at ABA schools/classes throughout the UK on March 1st, 2010. Of these, 239 children attended the schools for full time school hours and 19 attended part time. The mean age of these children when they started at the ABA school was 7.1 years old (SD = 3.3 years, age range 3– 17 years old). The mean age of children on the census date was 10.8 years old (SD = 3.8 years, age range 3–18 years old). The school reported ASD as the primary diagnosis of 238 children (92.2%), and six children (2.3%) had a diagnosis of Asperger syndrome, six (2.3%) had intellectual disability/global developmental delay, two (0.7%) had ‘Pervasive Developmental Disorder’, one child had Fragile X syndrome (0.4%), and one had Down syndrome (0.4%) as their primary diagnosis. Data on diagnosis were missing for four children (1.5%). In addition to their primary diagnosis, 15 children (5.8%) were reported by their school to have a diagnosis of Attention Deficit/Hyperactivity Disorder, 12 (4.7%) had epilepsy, seven (2.7%) had dyslexia, and 46 children (17.8%) had additional ‘other’ diagnoses or conditions. The ‘other’ category included hearing and visual problems, and health difficulties such as allergies, and bowel conditions. Only 66 (26%) children were recorded as having an intellectual disability in their SEN Statement in addition to their ASD diagnosis. However, this is not consistent with data about child attainment (see Table 2), which show that the majority of children’s academic progress was recorded on P scales (typically used to record progress for children with intellectual disability within the UK school system). Table 1 shows the ethnicity of children, who came from a wide range of ethnic backgrounds. Postcodes (zip codes) of each child’s home address were used to calculate the Indices of Multiple Deprivation (IMD) ranks for their home neighborhood (Index of Multiple Deprivation, 2010). IMD ranks indicate the level of social deprivation in the neighborhood based on a variety of UK census data variables (such as rates of local employment, income levels, crime, and education). The ranks range from 1 (which indicates the most deprived area in England) to 32,482 (the least deprived area). Children residing in Wales were not included in this analysis, as Wales has a neighborhood deprivation ranking system separate to England (and only a very small number of children resided in Wales). A broad range of IMD ranks was evident in this sample ranging from 691 to 32,467 (mean rank = 17,025). Although there is a reasonable distribution of children’s home neighborhoods across broad levels of deprivation, Fig. 1 shows that 39.8% of children lived in the lowest two quartiles for England (more deprived areas) and 50.4% of children were in the highest two quartiles (less deprived areas), with 9.6% of child postcode data missing. Another indication of socio-economic disadvantage is the number of children who receive free school meals. To meet eligibility criteria for free school meals in England, parents/carers must be on income support (a state benefit) or have an annual income below £16,190. In the current sample, 32 (12.7%) children received free school meals at the time of the census. There was a wide range of UK National Curriculum attainment levels among children attending ABA schools/classes, ranging from P scales P2 (i) up to National Curriculum Level 4. Although the assessment criteria for P scales likely differed Table 1 Ethnicity of children. Ethnic origin

Frequency (percentage)

White British White other Black – African Mixed race Black – Other Asian – Other Asian – Indian Asian – Pakistani Any other ethnic group Missing data

145 27 22 14 12 10 8 7 4 8

(56.2%) (10.2%) (8.5%) (5.6%) (5.4%) (3.9%) (3.1%) (2.7%) (1.6%) (3.1%)

Table 2 P scales and National Curriculum levels for children. P scale frequency (percentage)

P2(i)–P3(ii)

P4–P8

National Curriculum levels (NC1–NC4)

Missing data

Speaking Listening Numbers

23 (8.9%) 24 (9.3%) 31 (12.1%)

147 (57.2%) 145 (56.2%) 128 (49.8%)

30 (11.7%) 30 (11.6%) 41 (16%)

57 (22.2%) 59 (22.9%) 57 (22.2%)

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Fig. 1. The proportion of children who are in each quartile of IMD ranking, the 1st quartile represents the proportion of children in the lowest 25% of IMD ranks for England, the 4th quartile represents children in the highest 25% of IMD ranks.

between schools, the patterns of attainment levels are similar across the subjects of Speaking, Listening, and Numbers. The vast majority of child attainment scores were assessed as being within a P4–P8 range, indicative of most children having a degree of intellectual disability, however, almost a quarter of these child data were missing, thus the results presented should be interpreted with caution. Table 3 shows a broad range of severity of three topographies of challenging behavior among children. The majority of children either exhibited no problematic challenging behaviors (range 41–55% across topographies) or ‘slight’ severity (range 19.8–25.2% across topographies). Relatively few children were reported to engage in severe challenging behaviors (4.3–10.1% across topographies). These trends were similar across the three topographies of challenging behavior, although there were almost twice as many children reported to engage in severe levels of physical aggression than in severe self-injury or destruction of property. 3.3. Staff in ABA schools A total of 382 staff members worked directly with children in ABA schools/classes, 334 of whom directly contributed to ABA intervention. Table 4 demonstrates how many staff were assigned to each category of the ABA staff hierarchy (see earlier Table 3 Children’s severity of challenging behavior. Topography of challenging behavior frequency (percentage)

Does not occur/does occur but no problem

Slight

Moderate

Severe

Missing data

Physical aggression Self-injury Destruction of property

106 (41%) 142 (55%) 133 (51.6%)

61 (23.6%) 51 (19.8%) 65 (25.2%)

53 (20.5%) 43 (16.7%) 34 (13.2%)

26 (10.1%) 11 (4.3%) 14 (5.4%)

12 (4.7%) 11 (4.3%) 12 (4.7%)

Table 4 Summary of staff member employment status, ABA experience, and time employed at their school.

Total number of staff Employed full time Prior experience at an ABA school mean (range) Prior experience with home ABA programs Mean (range) Total years of ABA Experience prior to employment at the school/class Mean (range) How long has staff member worked at the school? Mean (range) a

Consultants

Supervisor/lead tutor

ABA tutors/trainees

Other staff members

40a 19 –

62 59 0.2 years (0–5 years) 1.4 years (0–6 years)

232b 210 0.2 years (0–8 years) 0.4 years (0–10 years)

48c 22 –

9.1 years (1–30 years)

1.6 years (0–6 years)

0.6 years (0–10 years)

–

4.8 years

3.9 years

1.6 years

2.3 years

(6 months to 15 years)

(6 months to 10 years)

(6 months to 10 years)

(1–11 years)

–

–

23 with an employment contract, 17 external consultants. b Includes 159 ABA tutors, 46 trainees, 17 lead tutors, and eight ‘others’ such as supply/sickness cover tutor. c Includes 13 curriculum managers/class teachers, 10 speech and language therapists, 10 occupational therapists, seven headteachers, three classroom assistants, and five ‘others’.

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Table 5 The highest education levels of ABA staff members.

PhD or equivalent MSc/MA degree or equivalent Postgraduate certificate/diploma Bachelors degree or equivalent A levels (18 year old school leaving qualifications) or equivalent GCSEs (16 year old school leaving qualifications)/diploma or equivalent Missing data

Consultants

Supervisor/lead tutor

ABA tutors/trainees

7 7 2 19 0 1 4

0 3 4 36 2 3 14

1 17 10 120 21 22 41

Table 6 Current highest level of ABA credentials of staff (including ABA credentials staff are in process of completing). Consultant: Supervisor/lead Supervisor/lead tutor: ABA tutors/trainees: Non ABA Consultant: obtained ABA ABA credentials tutor: obtained ABA credentials in obtained ABA staff members credentials in process ABA credentials process credentials and credentials in process BCBA1/CABAS1 senior behavior 11 analyst/senior research scientist MSc in ABA/CABAS1 Master 2 teacher/Teacher II and Teacher I 5 Postgraduate certificate in ABA BCaBA1 18 Internal training 1 Workshop training 0 No ABA qualifications 3 Missing data 0

6

1

3

0

0

5

14

13

31

0

0 0 0 0 26 3

2 3 2 0 39 1

2 5 14 0 25 0

2 0 0 0 197 2

0 0 25 3 17 3

for definitions of ABA roles). As expected, the largest category of ABA staff was ABA therapists/tutors/trainees (n = 232), and the smallest category was ABA consultants (n = 40). ABA supervisors had been employed by the schools for a longer period of time and had more previous ABA experience than therapists/tutors/trainee tutors. ABA consultants were responsible for the programs of between 2 and 75 children (mean = 18.1 children, SD = 18.5), and just under half (n = 19) worked full time hours at the school. Diverse roles and working patterns for supervisor/lead tutors were reported. In some schools, supervisors/lead tutors did 35 h per week of 1:1 ABA therapy with children, and some did not do any 1:1 work with children at all (mean = 17.1 h per week, SD = 10.7 h). Supervisors/lead tutors spent between 0 and 30 h per week (mean = 10.1 h, SD = 8.9 h) providing supervision to ABA tutors/trainees, and themselves received supervision for a mean of 3.4 h per week (Range 0–5 h per week, SD = 1.5). ABA tutors/trainees were fully trained on (i.e., worked with most of the time) between 0 and 18 children’s programs (mean = 4.0, SD = 2.1). In addition, they were also partly trained on a mean of 6.2 (SD = 10.8; range 0–60) other children’s ABA programs, which they could cover if necessary. Approximately 20% of staff at ABA therapist/tutor level were trainees. Table 5 shows staff members’ highest level of education. The majority of all staff members are graduates or had a higher academic qualification (67.7%) and a larger proportion of consultants had PhD or masters level qualifications than supervisors/lead tutors or ABA tutors. Table 6 shows the level of ABA specific qualifications/training that ABA staff members had, and were in the process of obtaining. All qualifications shown are the highest level qualification for individual staff members. For example, if a staff member was both a Board Certified Behavior Analyst1 (BCBA1) and had a masters degree in ABA, then just the BCBA1 has been included below because a masters level qualification is required to gain the BCBA1 certification. A total of 37 (92.5%) of ABA consultants had ABA credentials, and 11 (27.5%) were in the process of obtaining ABA credentials or higher ABA credentials. Thirty-seven percent of ABA supervisors/lead tutors were reported to have ABA credentials and 59% were in the process of obtaining ABA credentials, whereas 14.3% of ABA tutors/trainees had ABA credentials or were in the process of obtaining ABA credentials. 4. Discussion The census of ABA schools/classes throughout the UK demonstrates that there are a small number of children and young people with autism within the UK education system being provided with ABA intervention in a school environment. Schools did not report any difficulties in matching the roles of their ABA staff with the three-tier staff hierarchy category definitions. Therefore, the overall staffing structure in these environments was similar. Staff: child ratios varied substantially in these schools/classes. It is unknown how staff to child ratios affect ABA teaching or child progress, but the large differences may be suggestive of a variation of resources available to ABA schools/classes across the UK.

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A diverse range of children attend ABA schools, in terms of age (3–17 years), educational abilities, ethnicity, socioeconomic status, and severity of challenging behaviors. At the time of the census, a typical child with autism in an ABA school setting in the UK was male, 10–11 years of age, and currently with no or minor challenging behaviors. It is unknown whether challenging behaviors occurred but did not cause a problem because they are well-managed within the ABA program, or whether they did not occur. These data, therefore, may under-estimate the extent of problem behaviors in children placed in ABA school settings in the UK. Likewise, the finding that 26% of children were recorded as having an intellectual disability diagnosis is likely to be a considerable under-estimation of the true prevalence. The vast majority of child attainment was currently in the P4–P8 range, indicating that most children had a degree of intellectual disability. Our results may be due to the open-ended nature of the census question (‘‘What are the child’s diagnoses as specified on their SEN statement?’’). Many responses to this question were ‘‘ASD’’ which is the often the reason for the SEN statement. Thus, other additional disabilities may not have been listed. In terms of socio-economic status, 12.7% of children at ABA schools received free school meals. This is considerably lower than the national average of children who attend special schools who were eligible for free school meals in 2010 (34.9%; Department for Education, 2010). However, the current data may be an underestimation, as the census only recorded those who received free school meals, therefore there may be children in the current sample who are eligible for free school meals but do not receive them. The neighborhood deprivation data did suggest a reasonably even distribution of children living in relatively deprived and affluent localities. Compared to data collected by the Department for Education (2010), there were more children from ethnic minorities (defined as being other than ‘‘White British’’) in ABA schools than in primary schools in the UK (42% vs. 25.5%, respectively). Caution is needed when comparing these two datasets as there are no national data available specifically about child ethnicity in special needs schools in the UK. Moving on to consider data on ABA staff, it is encouraging that 92.5% of ABA consultants had formal ABA credentials, and 27.5% had obtained the highest available qualification in ABA (BCBA1 or equivalent). In a survey of supervisors of home, school, and clinic based programs (equivalent to our definition of consultants in ABA schools in terms of having overall responsibility for ABA programs) Love et al. (2009) found that 53% had behavior analysis credentials. Although possessing ABA credentials does not guarantee positive outcomes, our data suggest that consultant level staff in ABA schools in the UK have a good theoretical knowledge and also considerable experience of working as ABA practitioners. A lower percentage of supervisors/lead tutors and ABA tutors/trainees had obtained any ABA credentials (35% and 14% respectively). The lack of specific ABA qualifications among ABA tutors/therapists is not surprising given the lack of a definitive career path into ABA teaching/delivery. The data on ABA credentials for supervisory level staff may reflect at least two different employment and training processes in the UK: 1. Service providers may not require ABA credentials to employ ABA supervisors, and 2. There are few BCaBA1 training opportunities available in the UK (Hughes & Shook, 2007). The vast majority of ABA staff were also receiving supervision from a more senior ABA practitioner. An inherent restriction with a census methodology is that only limited, primarily descriptive, data can be collected and indepth questioning is not possible. Thus the census can only provide a ‘snap-shot’ of ABA schools/classes in the UK. As with any census, the data were reliant on the understanding and interpretation of census questions by participants. Some representatives may have interpreted the staff categories differently, and there is some evidence of this. In category D (Non ABA-staff) only seven headteachers were included. However, as it is unlikely that there are schools registered in the UK without headteachers, so we might assume that some schools did not record this information. Thus, there may be other nonABA staff members that were also omitted. Additionally, a small number of schools completed the census around six months after the census date, which may have increased the chance of error, as schools would have to recall circumstances from a few months previously rather than report on current children and staff members. As with the more general uses of census methods to contribute to an understanding of population changes over time, it would be interesting to repeat the ABA schools census on a regular basis to track how ABA schools/classes develop within the UK education system. A single cross-sectional application of a census method could also be considered as the first step in an audit cycle. For example, there may be a need in the UK to increase the availability of BCaBA1 qualifications for ABA supervisors in autism and other sectors. A repeat of the census in future could help monitor whether an increase in training provision affects the qualifications gained by staff in ABA school settings in the UK. The same census methodology could also be adopted across national boundaries to make international comparisons (i.e., allowing international ‘‘benchmarking’’). Acknowledgements We would like to thank all the ABA schools and classes who participated in this census. References Department for Education. (2010). Schools, pupils, and their characteristics, January 2010 Retrieved from http://www.education.gov.uk/rsgateway/DB/SFR/ s000925/sfr09-2010.pdf. Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2007). Outcome for children with autism who began intensive behavioral treatment between ages 4 and 7; a comparison controlled study. Behavior Modification, 31, 264–278doi:10.1177/0145445506291396. Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2009). Meta-analysis of early intensive behavioral intervention for children with autism. Journal of Clinical Child and Adolescent Psychology, 38, 439–450.

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