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Res Dev Disabil. 2013 Dec;34(12):4515-33. doi: 10.1016/j.ridd.2013.09.030. Epub 2013 Oct 31.

Psychosocial interventions for reducing vocal challenging behavior in persons with autistic disorder: a multilevel meta-analysis of single-case experiments.

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  • 1Faculty of Psychology and Educational Sciences, KU Leuven, Belgium. Electronic address:


Vocal challenging behavior (VCB) forms a common problem in individuals with autistic disorder. Since VCB is associated with negative outcomes for the individual and his or her environment, it is important to know how to manage this type of CB. To evaluate the effectiveness of several psychosocial interventions applied to decrease VCB in individuals with autistic disorder, we conducted a meta-analysis of single-case experiments (SCEs). Fifty-two SCEs, including 74 participants, were combined using a multilevel meta-analysis. The overall treatment effect was large and statistically significant. However, the effect varied significantly over the included studies and participants. Examining this variance, evidence was found for a moderator effect of VCB type and intervention type, with, on average, the largest effects for interventions used to reduce VCB including stereotypical VCB and for interventions containing both antecedent and consequence components. Age, gender, primary treatment setting, publication year, and study quality did not significantly moderate the intervention effect.

Copyright © 2013 Elsevier Ltd. All rights reserved.


Autism; Autistic disorder; Interventions; Meta-analysis; Single-case; Systematic review; Vocal challenging behavior; Vocal problem behavior; Vocal stereotypy

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