What is ABA Therapy?

What is ABA Therapy?

Applied Behavior Analysis (ABA) is a therapy in which an individual works one-on-one with a Behavior Technician with BCBA oversight. Research based strategies are used to strengthen and build skills and reduce interfering barriers to learning. The therapy is intensive and should occur frequently- several hours a day on a regular basis.

The goal of ABA is:

• to help the individual improve communication and social skills

• increase their ability to learn new skills from their environment

• decrease harmful behaviors across home, educational and community settings

ABA Therapy was developed in the 1960’s from research on how to teach autistic children through prompts, modeling, and positive reinforcement. This became the basis for what’s now known as Applied Behavior Analysis- ABA.

You are probably reading this because a doctor has recommended ABA Therapy for your child.  Although ABA Therapy is highly recommended, it is not a cure for your child’s autism.  Not every child with autism participates in ABA Therapy and success can vary.   If you decide that ABA Therapy is not right for your child, ask your physician for other options.  Your child can also make great gains with other types of interventions such as Speech Therapy, Occupational Therapy and Floortime Therapy.  My Autism Ally is also happy to discuss these and other therapy treatments available in our community.

Are there different types of ABA Therapy?

Therapy is not like an assembly line. You cannot put together “A” with “B” and get the desired outcome. Each individual with autism is different and because of that different interventions and strategies will work differently with each person. So, if you were to visit 10 different ABA centers, you would observe 10 different ways to implement ABA therapy. Each center uses different combinations of interventions and strategies in its practice. Below is a list of evidence based practices that you may hear providers talk about in their programming.

ABI - Antecedent-Based Interventions -interventions that occur prior to the skill or behavior occurring. Ex: You know your husband is a very nervous flyer, so you remind him to bring the book he's been reading and his iPad to ensure he has things to help distract him from being on the plane.

Assistive Technology-equipment that helps to increase the functional capabilities of an individual. Some of this is low tech, such as PECS tokens or choice boards, and some is high tech such as an AAC device or an electric wheelchair.

AAC - Augmentative and Alternative Communication-this is a term that refers to any communication that is not fully vocal verbal speech, and includes PECS but also includes electronic communication devices such as iPads with speech generating software

BMI - Behavioral Momentum Intervention-this is an intervention where tasks are organized by difficulty and the amount of effort they require, and the tasks which are most likely to be difficult or non-preferred for a learner and mixed in between tasks which are much easier and more preferred, to increase the persistence of the individual and increase the likelihood of the more difficult task being completed.

CBIS - Cognitive Behavioral/Instructional Strategies-this is an intervention where the therapist works with the individual to define the behavioral concerns and help them to recognize that there is a problem. Then the learner will describe the problem from their perspective and explain their thoughts. A plan is built, and the therapist works with the learner to practice the steps of the plan and to teach any self-regulation and self-monitoring strategies or techniques. The learner then works with the therapist to practice those skills and also to talk about alternative strategies for the problem and then those ideas are evaluated to see which ideas are safe and fair for the situation. Then a plan is decided on and the learner practices the plan they have chosen in real life as the problem scenarios naturally occur. The learner then reviews how the use of the plan and the strategies went, and works with the therapist to determine if their solution worked or if it needs to be adjusted.

Differential Reinforcement-this is an intervention where you provide reinforcement for desirable behaviors, but only in the absence of the target undesirable behaviors. So, if your target behavior was yelling, and the child was sitting at their desk working attentively you would only praise them for attending to their work at the desk as long as they were not yelling. There are several types of differential reinforcement, which all revolve around the same basic idea of reinforcement ONLY in the absence of the target behavior, but may include prompts for the learner to engage in another task or behavior. For example, if you are using DRI (differential reinforcement of incompatible behavior) you would instruct the learner to do a task that is incompatible with the behavior and reinforce that behavior. Ex: target behavior is yelling, you instruct the learner to take a drink of water and as soon as she does you reinforce that behavior. If you were using DRA, (differential reinforcement of alternative behavior) you would reinforce any behavior other than yelling, even if it wasn't a vocal behavior or an incompatible behavior. In a DRO, (differential reinforcement of other behavior) you are reinforcing units of time where the target behavior did not occur. If you were using a DRO on a 5 minute interval you would provide reinforcement each time the learner went for 5 minutes without yelling behavior.

Direct Instruction-this is usually only seen in the classroom setting with a group of learners. It uses scripted lessons with the students responding individually as well as choral responding where the class answers together.

DTT - Discrete Trial Training-teaching method where each trial of the new skill includes the instruction from the adult, the child's response, and then the response is either reinforced as accurate or the correct response is prompted and then reinforced.

Extinction -removing the reinforcing element from a behavior you want to reduce. Example: a student makes inappropriate jokes at school, it is determined that peer attention is reinforcing this behavior, so all students in his class are told not to laugh and not to look at the student if he makes an inappropriate joke. When the other students top giving him attention, the jokes stop.

FBA - Functional Behavior Assessment-an assessment that systematically determines what the function of a targeted behavior is based on how often the behavior occurs or how long it occurs under specific scenarios.

Functional Communication Training-a method of reducing certain behaviors by giving the individual new communication skills to allow them to express their wants and needs in a more effective way.

Modeling-a method of teaching new skills or behaviors by demonstrating them for the learner to imitate. The type of modeling is defined by who is performing as the model.

• Peer modeling - when peers are demonstrating the skill or behavior for the learner to imitate

• Video modeling - using a video of a person demonstrating the skill or behavior, this can also be a video of the learner themself modeling the skill or behavior

• Parent modeling - when a parent is demonstrating the skill or behavior for the learner to imitate

MMI - Music-Mediated Intervention-these are interventions that use rhythm and melody to help teach skills and support learning, such as teaching the alphabet with a song.

NET - Naturalistic Teaching or Natural Environment Teaching-this refers to using strategies to teach new skills during activities and routines the learner is already participating in. For example: using a learner's favorite train toys to teach colors, or working on independent hygiene skills during the learner's daily bath time.

PII - Parent-Implemented Intervention -any intervention which is implemented in the home or community environments by the parents themselves. Ex: following the same step by step instructions the individual uses at therapy to wash their hands, following the same behavior plans at home that have already been shown to be effective for the individual in the school or clinic environments

Pairing-pairing is the act of presenting two stimuli at a time to associate them with each other. In ABA, we often use this term to describe when a clinician pairs the stimuli of themself with stimuli the learner enjoys, so they are associated with that enjoyment as well. This is how the individual will build a therapeutic working relationship and helps to show the learner that working with them is fun and a time that is associated with favorite reinforcement items.

PBII - Peer-Based Instruction and Intervention-when you utilize a learner's peers to help teach or practice skills. Typically, PBII interventions are going to be almost exclusively social goals, but they may also be things like practicing the rules to a game.

PECS - Picture Exchange Communication System-Using small image icons to facilitate communication between the learner and communicative partners. This is a much more universally understood way to communicate than sign language and can also be a supplemental way to assist with verbal speech

Pivotal Response Training-a naturalistic intervention that uses the individual's interests to teach new skills by taking what they are most interested and motivated by and using those things to teach new skills, the most popular target areas to teach with PRT are communication and language or social behaviors and skills.

Positive Reinforcement-adding a stimulus immediately after the occurrence of a behavior which results in the behavior occurring more often in the future. Ex: You made a balloon arch for your child's birthday party, and all the parents told you how great it looked and took photos with it for social media. You now make sure to take the time to build a balloon arch for all birthday parties at your house. Social attention and praise was added and resulted in your balloon arch behavior increasing.

Prompting -this is when you assist the learner in performing the target behavior or skill. These prompts may be verbal, such as giving a hint at the answer when the learner is unsure or not answering, they could be gestural, such as pointing to the paper towels when the learner has washed their hands but is not sure what to do next or is not initiating drying on their own, or it could be physical, such as guiding a learner's arm into their coat sleeve when they are learning to put on their own jacket.

Reinforcement-a stimulus being added or removed following a learner's behavior or response that increases the future likelihood of the learner engaging in that behavior or response. For example, a learner ties her shoe by herself and her mom gives her a high-five in celebration, or a learner who is given a worksheet of math problems is told as soon as he gets 5 correct he can be finished, he completes the first 5 accurately and the worksheet is removed.

Relational Frame Theory-this is an approach that teaches new skills by providing outlines and rules about already known skills. Ex: You can show someone many different colors and types of flowers and teach them that each is called a "flower" and through relational frame theory the individual can see a flower they have never encountered before and know it is called "flower" because they've learned that relational frame of plants with colorful blooms are flowers.

RIRD - Response Interruption and Redirection-placing a prompt or other distraction immediately when an interfering behavior begins to occur which is designed to divert the learner's attention away from continuing to engage in that behavior.

SM - Self-Management-teaching the learner to discriminate between appropriate and inappropriate behaviors and how to track the occurrence of the behavior chosen to be targeted for decrease. Then, the therapist reinforces the learner when they accurately identify the target behavior as well as the replacement behavior as well as when the learner accurately tracks their own behaviors.

Scripting-scripting is a term used in 2 ways in ABA, this refers to the actual intervention of scripting, which is teaching specific useful scripts and the scenarios in which you would use them to communicate. Ex: you might teach a learner to say "Excuse me, can I ask you something" rather than pulling at an adult's hand or clothing to get their attention, or teaching "Can I have a turn?" as a replacement for taking toys from others.

Social Narrative-this approach describes social situations to highlight the elements of the target behavior or the target skill and show examples of appropriate responding or how the skill is used in those specific scenarios.

Social Skills Training-this can be for an individual or a group and is a method of teaching learners how to participate in interactions with other people in appropriate ways.

Task Analysis-this is an intervention that takes a skill or activity and breaks it down into smaller steps which can be taught individually and then pieced back together to create the full task performance as those smaller pieces are learned. For example, we might use a task analysis to teach the steps of brushing your teeth, or we could use it to teach a learner how to make his favorite meal.

Token Economy-a token economy is a way to visually show a learner how close they are to earning a larger reinforcer. This is something used once a learner is able to work for longer periods of time and complete more tasks before taking a break, and serves as a visual to show progress towards earning that reinforcer. For example, a student may earn iPad time for every 20 minutes of reading at school, but she is not able to read for 20 minutes all at once, so instead she earns a token for every 5 minutes of reading she completes throughout the day. Once she has all 4 tokens she can trade them for iPad time.

-alternatively, you might use a token economy for a specific skill or behavior. A child may earn a token for every morning he wakes up dry during potty training. Each time he earns 3 tokens he can trade them in for a new toy car.

Video Modeling-this intervention uses video footage of a skill or task being performed accurately to help teach the skill or task. The individual in the video can be a stranger, someone the learner knows, or can even be the learner themself.

Visual Supports-any visual item that helps the learner to engage in the skill or behavior without any additional prompt. For example, a visual schedule might be used showing the tasks a learner needs to complete to get ready for school in the morning, or an individual might use a shopping list at the store of either written words or images to assist them in remembering all needed items.

Is ABA Therapy harmful to my child?

ABA Therapy performed by a properly trained behavior technician, with adequate oversight from a properly trained BCBA- Board Certified Behavior Analyst along with parent training from the ABA center can help your child greatly, improving their quality of life and setting them up to become the most independent adult they can be.

The reverse is also true. Any medically recognized therapy provided by poorly trained staff will lead to less than desired outcomes.

Some autistic individuals as adults have voiced their concerns about treatments they received as children. These are valid concerns and the primary reason why you as a caregiver must ask detailed questions to any prospective ABA therapy provider for your child.

Finding a quality ABA provider is key to success. Check out our helpful list of questions to help you find the right ABA provider for your child.