ABA Treatment

What is ABA?

Behavior Analysis is the scientific study of behavior. Applied Behavior Analysis (ABA) is the application of the principles of learning and motivation from Behavior Analysis, and the procedures and technology derived from those principles, to the solution of problems of social significance. Many decades of research have validated treatments based on ABA.

Over the past 40 years, several thousand published research studies have been documented the effectiveness of ABA across a wide range of:

  • Populations (children and adults with mental illness, developmental disabilities and learning disorders)
  • Interventionist (pediatricians, parents, teachers and para-professionals)
  • Community settings ( schools, homes, institutions, group homes, hospitals and business offices), and
  • Behaviors (verbal behavior; social skills, academic skills, leisure and functional life skills; Anti-learning behaviors including:aggression, tantrums, gazing, fidgeting, non-compliance, fears and phobias, self injury, oppositional and stereotyped behaviors).

Applied behavior analysis is the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behavior (Baer, Wolf & Risley, 1968; Sulzer-Azaroff & Mayer, 1991)

Socially Significant Behaviors

“Socially significant behaviors” include reading, academics, social skills, Verbal Behavior (communication), and adaptive living skills. Adaptive living skills include gross and fine motor skills, eating and food preparation, toileting, dressing, personal self-care, domestic skills, time and punctuality, money value and it’s applications, home and community orientation, and vocational/career skills. ABA is an objective discipline. ABA focuses on the reliable measurement and objective evaluation of observable behavior.

Reliable Measurement

Reliable measurement requires that behaviors are defined objectively. Vague terms such as anger, depression, aggression or tantrums are redefined in observable and quantifiable terms, so their frequency, duration, or other measurable properties can be directly observed and recorded (Sulzer-Azaroff & Mayer, 1991). For example, a goal to reduce a child’s aggressive behavior might define “aggression” as: “attempts, episodes or occurrences (each separated by 10 seconds) of biting, scratching, pinching or pulling hair, with some form bruising or bleeding evoked.” “Initiating social interaction with peers” might be defined as: looking at classmate, with eye contact duration of at least 2 seconds and verbalizing an appropriate greeting in the appropriate tone and volume.”

ABA interventions require a demonstration of the events that are responsible for the occurrence, or non-occurrence, of behavior. ABA uses methods of analysis that yield convincing, reproducible, and conceptually sensible demonstrations of how to accomplish specific behavior changes (Baer & Risley, 1987). Moreover, these behaviors are evaluated within relevant settings such as schools, homes, and the community. The use of single case experimental design to evaluate the effectiveness of individualized interventions is an essential component of programs based upon ABA methodologies. This process includes the following components:

1)        Functional analysis and assessments of all significant repertoires and domains.

2)        Selection of interfering behavior or behavioral skill deficit.

3)        Identification of goals and objectives.

4)        Establishment of a method of measuring target behaviors.

5)        Evaluation of the current levels of performance (baseline).

6)        Design and implementation of the interventions that teach new skills and/or reduce interfering behaviors.

7)        Continuous measurement and graphing of target behaviors to determine the effectiveness of the intervention, and

8)        Ongoing evaluation of the effectiveness of the intervention, with necessary modifications to maintain and/or increase both the effectiveness and the efficiency of the intervention.

Treatment approaches grounded in ABA are now considered to be at the forefront of therapeutic and educational interventions for children and adults with disabilities. The large amount of scientific evidence supporting ABA treatments for children with disabilities have led a number of other independent bodies to endorse the effectiveness of ABA, including the U.S. Surgeon General, the New York State Department of Health, the National Academy of Sciences, and the American Academy of Pediatrics (See reference list below for sources).

Discrete Trial Training

Discrete Trial Training (DTT) is a particular ABSA teaching strategy which enables the learner to acquire complex skills and behaviors by first mastering the subcomponents of the targeted skill. For example, if one wishes to teach a child to request a desired interaction, as in “I want to play,” one might first teach subcomponents of this skill, such as the individual sounds comprising each word of the Mand (request, or labeling enjoyable leisure activities) as “play.” By utilizing teaching techniques based on the principles of behavior analysis, the learner is gradually able to complete all subcomponent skills independently. Once the individual components are acquired, they are linked together to enable mastery of the targeted complex and functional skill. This methodology is highly effective in teaching Verbal behavior (basic and advanced communication), play, motor, and daily living skills. Initially, ABA programs for children with Autism utilized only (DTT), and the curriculum focused on teaching basic skills as noted above. However, ABA programs, such as the program implemented at LBC, continue to evolve, placing greater emphasis on the generalization and spontaneity of skills learned. As learners progress and develop more complex social skills, the strict DTT approach gives way to treatments including other components.

Specifically, there are a number of weaknesses with DTT including the fact the DTT is primarily teacher initiated, that typically the reinforcers used to increase appropriate behavior are unrelated to the target response, and that rote responding can often occur. Moreover, deficits in areas such “emotional understanding,” “perspective taking” and other Executive Functions such as problem solving skills must also be addressed and the DTT approach is not the most effective and generalized means in doing so.

Although the DTT methodology is an integral part of ABA-based programs, other teaching strategies based on the principles of behavior analysis such as National Environment Training (NET) may be used to address these more complex skills. NET specifically addresses the above mentioned weakness of DTT in that all skills are taught in a more natural environment in a more “playful manner.” Moreover, the reinforcers used to increase appropriate responding are always directly related to the task (e.g. a leaner is taught to say the word for a preferred item such as “car” and as a reinforcer is given access to the car contingent on making the correct response). NET is just one example of the different teaching strategies used in a comprehensive ABA-based program. Other approaches that are not typically included in DTT include errorless teaching procedures and Fluency-Based Instruction. At LBC, all appropriate teaching approaches are based on the well-grounded principles of applied behavior analysis, education, and counseling.

 

References

Baer, D., Wolf, M., & Risley, R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91 – 97.

Baer, D., Wolf, M., & Risley, R. (1987). Some still-current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 20, 313 – 327.

Maine Administrators of Services for Children with Disabilities (MADSEC) (2000). Report of the MADSEC Autism Task Force.

Myers, S. M., & Plauche Johnson, C. (2007). Management of children with autism spectrum disorders. Pediatrics, 120, 1162 – 1182.

National Academy of Sciences (2001). Educating Children with Autism. Commission on Behavioral and Social Sciences and Education.

New York State Department of Health, Early Intervention Program (1999). Clinical Practice Guideline: Report of the Recommendations: Autism/ Pervasive Developmental Disorders: Assessment and Intervention for Young Children (Age 0 -3 years).

Sulzer-Azaroff, B. & Mayer, R. (1991). Behavior analysis for lasting change. Fort Worth, TX: Holt, Reinhart & Winston, Inc.

US Department or Health and Human Services (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.