Picturing therapists’ feedback within the context of ABA therapy for Chinese children with ASD

Abstract Background Autism Spectrum Disorder (ASD) is characterised by deficits in social communication, alongside restricted and repetitive behaviours, interests or activities. To help individuals with ASD reduce problem behaviours and promote desired ones, applied behavior analysis (ABA) has been proved to be an effective therapy. Within the ABA framework, therapists’ feedback plays a significant role in influencing therapy outcomes. However, a notable gap exists in the exploration of therapists’ feedback in the context of ABA therapy context for Chinese children with ASD. This study aims to investigate the various categories and resources of feedback employed by therapists, as well as the relationship between different categories of therapists’ feedback and the corresponding responses of children with ASD during ABA sessions. Methods This study employed both qualitative and quantitative approaches to analyse feedback occurring during 7 hours and 17 minutes of video-recorded therapeutic interactions involving five therapists and ten children with ASD during ABA therapy sessions. The analysis was conducted within the framework of discourse analysis. Results Therapists utilized corrective feedback to help children with ASD make corrections, as well as affective feedback to reinforce successful corrections. Specifically, explicit corrective feedback and explicit affective feedback were primarily employed and were effective in facilitating the corrections of children with ASD during therapy sessions. Regrading resources for delivering corrective feedback, paralinguistic signal, explicit correction paired with paralinguistic signal, explicit correction alone proved effective. For affective feedback, paralinguistic signal, confirmatory phrase, high-assessment phrase combined with paralinguistic signal were identified as effective resources. Moreover, statistically significant differences were observed in the corresponding responses between explicit and implicit corrective feedback, as well as between explicit and implicit affective feedback. Additionally, a statistically significant difference was found in the corresponding responses between explicit affective feedback and a combination of explicit and implicit affective feedback. Furthermore, strong positive correlations were identified between the three subcategories of corrective feedback and the accuracy of corresponding responses of children with ASD, along with a strong positive correlation between explicit affective feedback and the accuracy of corresponding responses of children with ASD. Conclusions This study underscores the critical role of explicit feedback provided by therapists in assisting children with ASD in making corrections and reinforcing successful corrections, given their reduced error monitoring abilities and aberrant reward responsiveness from a neurobiological perspective. Therapists can tailor feedback implementation to accommodate the atypical neurobiological substrates of children with ASD, thereby enhancing outcomes in ABA therapy.