A number of interventions and treatments are frequently recommended for individuals with Autism. After comprehensive evaluation, health professionals often suggest a combination of methods in order to address each child’s unique needs. During our last blog, a parent and colleague mentioned not fully understanding one of these treatments, Applied Behavior Analysis (ABA) before her son began services. This was because she associated behavior therapy with a way to address predominantly aggressive or defiant tendencies. She was surprised to learn that it involved so much more. And, I must admit, so was I.
Applied Behavior Analysis
Applied Behavior Analysis is considered among the most comprehensive and effective alternatives for the autistic community. Although most successful when started before age 5, it can benefit students from Pre-K through adulthood. ABA does target behavior; however, the therapy is not limited to negative actions or those that an individual has already displayed. Behaviors addressed can encompass everything from brushing one’s teeth and dressing to taking turns and time management. For older students it may include cooking and work skills. It is research based and can include training in academics, life skills, communication or speech, and cognitive abilities.
ABA in Three Parts
ABA is defined at autismspeaks.org as having three parts: a preceding stimulus (command or request), a resulting behavior (response or absence of one), and a consequence (typically positive reinforcement in the form of a reward). While it cannot build emotional skills, ABA has been successful in improving self-care, play, communication, life skills, and academics in addition to reducing inappropriate behaviors. According to autismpartnership.com, the goal of ABA is to teach skills aimed at supporting development and attaining “the greatest degree of independence and the highest quality of life possible”.
ABA is not a cure. The main premise is that appropriate behaviors can be taught at home, school, or within the community using scientific principles. Skills are broken down into smaller steps in which participants receive swift rewards for desired behaviors when prompted. For example, a lesson in which the correct response to the words “please sit down” is modeled may be followed by a high five or time spent playing with a desired toy. When the words are repeated, the appropriate response should result in that same reward.
Autism Speaks describes a typical Applied Behavioral Analysis sessions as lasting for 2-3 hours and consisting of programs in which “every aspect of intervention is customized to each learner’s skills, needs, interests, preferences, and family situation”. Structured time on a specific task occurs in short intervals (3 to 5 minutes). There are hourly breaks and students receive 25-40 hours of therapy per week. It is also recommended that parents receive additional training. This training can be used to provide additional practice for skills taught and foster new learning.
ABA-based therapies include discrete trial learning, incidental teaching (natural environment training), verbal behavior, pivotal response training, and natural language paradigm. Each relies on structure, data collection, and positive tactics to modify behaviors. Not every student will work 2-3 hours per day. As with all programs, timing is specific to the individual child.
Results Will Vary
A US Surgeon General’s report notes that “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and increasing communication, learning, and appropriate social behavior”. We have had the privilege of working with many children who are diagnosed with autism spectrum disorder, some who have participated in ABA prior to starting Fast ForWord, others who have not. As with all therapies, programs and/or treatments, there will be a range of results. Talking to your healthcare provider about how ABA will be administered is an important step. Understanding what types of instruction and reinforcements that will be used is important when considering any program. While ABA has its detractors, many consider it an invaluable part of their children’s education.