Conflicts of Interest in Autism Intervention Research

Conflicts of interest (COIs) occur when researchers can benefit when a study shows a particular result, either financially, personally, or professionally. For example, imagine a situation where a researcher who developed an intervention is also studying whether the intervention leads to improvements in autistic children’s language. This would be considered a COI because the researcher could benefit from showing that the intervention is effective- they could sell manuals telling others how to provide the intervention, they could receive money for consulting with other professionals about interventions, or they could get a career boost. Prior research has shown that the presence of COIs is associated with research results that show the intervention is effective. This could mean that having a COI makes it less likely that researchers will implement quality controls in their research that reduce the chances of ‘false positives’, which occurs when research shows something is effective when in reality it isn’t.  However, the presence, types, and effects of COIs, as well as how often they are properly disclosed in early intervention autism research have not previously been studied.

So far, we have conducted two studies on this topic. In our first study, we looked through the 150 research reports that were collected as part of Project AIM – a meta analysis examining group-design intervention research for young autistic children. First, we determined whether the authors reported a COI. We then did an internet search to determine if the authors held any COIs from a list of eight that we compiled from previous research. Finally, we used a statistical approach (meta-regression) to determine whether the outcomes of studies were influenced by the presence of each of the eight COIs. In the second study, we examined a specific type of COI – when the researcher is also employed as a clinician or a consultant- in autism research published in journals devoted to applied behavior analysis (ABA) over a one-year period. In these journals, most of the studies use a ‘single case design’, so they were not included in the Project Aim analysis.

In the first study, we found that most of the group studies that had COIs did not disclose that this was the case. Of the studies that reported a COI, very few described all the COIs that were present. We found some preliminary evidence that COIs could influence study outcomes; this will need to be examined further in future research. In the second study, we found that most researchers who publish autism research in ABA journals are also employed as ABA clinicians or consultants. Similar to the first studies, these COIs are rarely disclosed, even though at least some of the journals that we examined have policies stating that they should be. Many of the studies included statements from the authors indicating that the authors held no COIs, but the vast majority of these statements were false, as we were able to locate COIs related to employment as a clinician or consultant.

At present, many academic journals that publish autism early intervention research do not have clear guidelines for helping researchers understand what COIs they need to report. This has resulted in an underreporting of COIs in early intervention autism research. If researchers are transparent about how their work impacts them financially, personally, and professionally, we can better determine the impact that COIs have on intervention research. In ABA journals, even COIs for which there are clear guidelines indicating that they should be reported, are not being disclosed by researchers. Journal editors need to do better at ensuring COIs are reported, and holding researchers accountable when they are not.