Role of ABA
Efficacy of Treatment
Applied Behavior Analysis is based on the scientific foundation of experimental analysis. It has been scientifically evaluated and refined over decades of applied research (Cooper & Heron, 2007). The seminal research study citing the efficacy of ABA in working with individuals with ASD was conducted in 1987. This study found a significant increase in educational and intellectual functioning for individuals with ASD receiving ABA compared to those not receiving services (Lovass, 1987). Since then, thousands of articles have been published providing continued support for the use of ABA principles in working with individuals with ASD and other developmental disorders. Research has consistently shown significant effectiveness of ABA-based interventions in many developmental domains including communication, social skills, adaptive behavior, vocational skills, play development, and executive functioning (Ivy & Schreck, 2016; Yu, Q. Et al., 2020; Lang, et. al., 2014; Hume, Loftin, & Lantz, 2009).
While the science of ABA has many complexities, in its most basic form, ABA utilizes a combination of antecedent based interventions with operant learning. In application, one looks at what is occurring before and after a behavior or skill and then adapts the environment or contingencies to effectively promote learning. The learner is put in position to be successful, is prompted to promote a positive outcome, and is reinforced to support learning and growth.
Goals of Treatment
The diagnostic criteria for ASD includes delays in the areas of social communication and restricted, repetitive behaviors. Social communication refers not just to one’s ability to talk, but how one interacts with others. Social communication skills include, but are not limited to, pointing and enjoying a shared experience, engaging in a back and forth conversation on various topics, displaying and responding to personal emotions and the emotions of others, understanding facial expressions, and sharing in a joint play experience. Restricted and repetitive behavior can include an extreme interest in one topic or object, making stereotyped movements such as rocking, pacing, repetitively moving fingers in front of eyes, or repeating the same vowel sounds or words. This can also include a resistance to change. These behaviors may present themselves through one’s reactions to sensory stimuli as a result of being over or under stimulated. Examples include an aversion to loud sounds or crowded environments, seeking out sounds or lights, and engaging in excessive movement. In addition to the diagnostic criteria, individuals with ASD may have challenges in daily living skills or adaptive behaviors, display challenging behavior, and/or have challenges in other areas such as executive functioning skills.
The goals of ABA treatment vary from person to person. When ABA is applied to individuals with ASD, the main domains of communication, social skills, challenging behavior, and executive functioning skills including daily living and school readiness are focal points of treatments.
Communication Skills
It is important to focus on communication development to help individuals actively participate in their world. ABA has displayed a long history of effectiveness in increasing communication skills, as a common goal is to increase one’s ability to express themselves, both verbally and non-verbally (Ogletree & Oren, 2001). Programs, plans, and goals are different for each child based on existing skill level. Improved communication can decrease stress and reduce challenging behaviors as well as increase engagement, learning, and satisfaction.
Social Skills
Social skills form the basis of our interactions with others. In early childhood, play is a hugely important component of social interaction. Play skills help children practice verbal and nonverbal communication, respond to and negotiate peers’ feelings, learn to take turns, experiment with social roles, experience others’ points of views by working through conflicts, and cope with personal feelings and experiences.
As individuals grow, the development of and expectation for social skills change. Play as a space for interaction decreases while reciprocity of conversation and understanding unwritten rules increases. These ever changing expectations can make generalization and maintenance of social skills challenging for individuals with ASD as they continue to develop and enter into new experiences. The principles of ABA are utilized in teaching these skills as they have been found effective in teaching a wide variety of play and social skills (Reichow & Volkmar, 2010; Jung & Sainato, 2013).
Executive Functioning Skills
Executive functions can be thought of as the CEO of our brains. Our executive functions are in charge of our working memory, self-monitoring, ability to plan and prioritize, task initiation, organization, impulse control, emotional control, and flexibility in thinking. There are many components of daily living that can be challenging for some individuals. These may include, but are not limited to, eating independently, toileting, brushing teeth, picking out appropriate clothes, or getting oneself ready in the morning. Similarly, there are a variety of areas of school readiness that may be impacted for some, including controlling impulses, following a schedule, sitting in a chair, attending, etc. Research has shown various strategies of ABA to be effective for teaching individuals these skills (O’Reilly et al., 2002; Carr & Punzo, 1993; Agran et al., 2005).
Challenging Behavior
An individual engaging in challenging behavior can be difficult for any family to handle. Whether the behavior is physical, vocal (such as yelling, screaming, or arguing), or self-injurious in nature, it can have a detrimental impact on both the individual and the people around him/her. ABA uses evidence based principles to not only decrease challenging behaviors but also increase replacement behaviors. When looking at challenging behavior through the lens of ABA, we focus on 4 functions, or reasons, for behavior. These include:
Escape: to avoid a demand or task
Attention: to gain the attention of another person
Tangible: to gain access to something
Sensory/Automatic: to self soothe or for sensory input
A plan can be developed that includes antecedent and consequence based interventions to reduce the challenging behavior. At the same time, evidence based strategies are used to teach a replacement behavior. The skills and programs are individualized for each client.
