ABA and Autism

ABA is considered to be the most effective form of treatment of autism spectrum disorder.  It has been proven effective in hundreds of research studies to treat the symptoms of autism by increasing patient skill development and reducing challenging behaviors.

ABA is based upon the principles of Behavior Analysis, which state that all behavior is shaped by its interaction with the environment. Simply speaking, behavior is greatly influenced by the consequences that follow it. If a behavior is followed by something pleasant, that behavior is likely to increase over time. Therefore, ABA uses positive consequences, or “positive reinforcement” to teach and strengthen new, desired skills and behaviors, which then leads to positive behavior change and growth.

Top quality ABA programs utilize both structured (DTT) and naturalistic (NET) teaching strategies to provide optimal learning activities for each patient. For most individuals, both types of teaching are needed to provide a successful learning environment that will result in learning new skills that the child can use in everyday life.  Additionally, ABA programs approach teaching new skills by breaking them down into small steps which are easier to learn. Those steps are then linked together to form more complex skills that the individual can then successfully perform. Learning activities and targets are individually selected, designed, and progressed according to the needs of each person, therefore every ABA program is uniquely tailored for every learner.

For more detailed descriptions of ABA, Discrete Trial Teaching, learning measurement procedures and more, see below.

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.

The Report of the Maine Administrators of Services for Individuals with Disabilities (MADSEC) Autism Task Force (2000) provides a succinct description, put together by an independent body of experts:

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

  • Populations (individuals with mental illness, developmental disabilities and learning disorders),
  • Interventionists (parents, teachers, and staff),
  • Settings (schools, homes, institutions, group homes, hospitals, and business centers), and
  • Behaviors (language, social, academic, leisure and functional life skills, aggression, self-injury, oppositional, and stereotyped behaviors)

ABA 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). At CARD®, all appropriate teaching approaches based on the well-grounded principles of ABA are utilized.

Discrete Trial Training

Discrete Trial Training (DTT) is a particular ABA teaching strategy that 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 individual 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 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 basic communication, play, motor, and daily living skills.

Initially, ABA programs for individuals 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 the Center for Autism and Related Disorders (CARD®), continue to evolve, placing greater emphasis on the generalization and spontaneity of skills learned. As patients progress and develop more complex social skills, the strict DTT approach gives way to treatments that include other components.

Specifically, there are a number of weaknesses with DTT, including the fact that DTT is primarily teacher initiated, the reinforcers used to increase appropriate behavior are typically unrelated to the target response, and rote responding can often occur. Moreover, deficits in areas such as 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 efficient means to do 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 Natural Environment Training (NET), may be used to address more complex skills. NET specifically addresses the above-mentioned weaknesses 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 individual is taught to say the word for a preferred item such as a “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 strict DTT include errorless teaching procedures and Fluency-Based Instruction (FBI).

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., & Plauché 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.
U.S. Department of 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.

Reliable Measurement

ABA is an objective discipline. ABA focuses on the reliable measurement and objective evaluation of observable behavior. Reliable Measurement (RM) 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 recorded (Sulzer-Azaroff & Mayer, 1991). For example, a goal to reduce a individual’s aggressive behavior might define “aggression” as: “attempts, episodes or occurrences (each separated by 10 seconds) of biting, scratching, pinching, or pulling hair.” “Initiating social interaction with peers” might be defined as “looking at a classmate and verbalizing an appropriate greeting.”

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:

  • Selection of interfering behavior or behavioral skill deficit;
  • Identification of goals and objectives;
  • Establishment of a method of measuring target behaviors;
  • Evaluation of the current levels of performance (baseline);
  • Design and implementation of the interventions that teach new skills and/or reduce interfering behaviors;
  • Continuous measurement of target behaviors to determine the effectiveness of the intervention; and
  • Ongoing evaluation of the effectiveness of the intervention, with modifications made as necessary to maintain and/or increase both the effectiveness and the efficiency of the intervention (MADSEC, 2000, p. 21-23).

As the MADSEC report describes above, treatment approaches grounded in ABA are now considered to be the gold standard of therapeutic and educational interventions for individuals with autism. The large amount of scientific evidence supporting ABA treatments for individuals with autism has 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).

Socially Significant Behaviors

“Socially significant behaviors” include reading, academics, social skills, 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 and value, home and community orientation, and work skills.

ABA methods are used to support individuals
with autism in at least six ways:

  • To increase behaviors (e.g., reinforcement procedures to increase on-task behavior or social interactions);
  • To teach new skills (e.g., systematic instruction and reinforcement procedures to teach functional life skills, communication skills, or social skills);
  • To maintain behaviors (e.g., teaching self-control and self-monitoring procedures to maintain and generalize job-related social skills);
  • To generalize or to transfer behavior from one situation or response to another (e.g., from completing assignments in the resource room to performing as well in the mainstream classroom);
  • To restrict or narrow conditions under which interfering behaviors occur (e.g., modifying the learning environment); and
  • To reduce interfering behaviors (e.g., self-injury or stereotypy).