Treatments for automatically reinforced vocal stereotypy for individuals with autism spectrum disorder: A literature and meta-analytic review

Individuals with Autism Spectrum Disorder may engage in repetitive vocal behaviors which interfere with a structured environment and social inclusion. If untreated, these vocal behaviors maintain into adulthood potentially impeding gainful employment and independent living. This analysis specifically focused on treatments available for presumed or functionally determined automatically reinforced repetitive vocal behaviors, also known as vocal stereotypy. For this review, a systematic keyword search of the literature identified 66 articles and a Tau-U measure of effect size was calculated for 34 eligible studies in order to determine impact of interventions on vocal stereotypy. Of the single-component interventions assessed, three interventions demonstrated a very large effect: interactive activity (0.94), self-management (0.89), and response interruption and redirection (interrupted measurement, 0.86). Additionally, 92% of treatment packages reached a very large effect (0.85-1.00), all of which included stimulus control and/or response cost intervention components. Theoretical and practical applications are discussed, as well as implications for future research.