available to a variety of individuals, who might be teachers, parents, therapists, or even those who wish to modify their own behavior. With proper planning and training, many interventions can be applied by almost anyone willing to invest the effort. Empowering: ABA provides tools that give the practitioner feedback on the results of interventions. These allow clinicians to assess their skill level and build confidence in their effectiveness. Optimistic: According to several leading authors , behavior analysts have cause to be optimistic that their efforts are socially worthwhile, for the following reasons: The behaviors impacted by behavior analysis are largely determined by learning and controlled by manipulable aspects of the environment. Practitioners can improve performance by direct and continuous measurements. As a practitioner uses behavioral techniques with positive outcomes, they become more confident of future success. The literature provides many examples of success in teaching individuals considered previously unteachable. Use in the treatment of autism A large majority of ABA practitioners specialise in autism, although BCBA certification does not require any autism training. ABA-based techniques are often used to teach adaptive behaviors or to diminish behaviors associated with autism, so much that ABA itself is often mistakenly considered to be synonymous with therapy for autism. According to a paper from 2007, it was considered to be an effective "intervention for challenging behaviors" by the American Academy of Pediatrics. A 2018 Cochrane review of five studies that compared treatment vs. control showed that ABA may be effective for some autistic children, but noted that the evidence for this is weak. The effectiveness of ABA treatments for autism may be overall limited by diagnostic severity, age of intervention, and IQ. Efficacy 2020 onward reviews Justin B. Leaf and others examined and responded to criticisms of ABA in a 2021 paper. The results of two studies surveying autistic adults who went through ABA as a child found that a majority perceived ABA to have a detrimental impact on their lives, although in common with most ABA research, the studies had methodological concerns and a risk of bias. Two 2020 reviews found that very few studies directly reported on or investigated possible harms; although a significant number of studies mentioned adverse events in their analysis of why people withdrew from them, there was no effort to monitor or collect data on adverse outcomes. 2010-2019 reviews In 2011, investigators from Vanderbilt University under contract with