What is Applied Behavior Analysis (ABA)?
Applied Behavior Analysis is the study of behavior in applied settings. What that means is that Behavior Analysts look for the causes of behavior within the natural environment. We then use that knowledge to change the environment to support appropriate behaviors and decrease inappropriate behaviors. For children with autism, this involves identifying reinforcers and breaking complex skills down to simpler steps. For disruptive behaviors, appropriate alternative behaviors are taught.
What is Autism?
Autism is a clustering of abnormalities in three domains: communication, socialization, and behavior. Professionals look for excesses and deficits within these domains. With Applied Behavior Analysis ABA, we teach children with autism the appropriate behaviors that occur too little and teach appropriate rates for behaviors that occur too much.
What skills can you teach?
With Applied Behavior Analysis (ABA), one can target any behavior for change. In regards to children with autism, I fundamentally target the areas of communication, socialization, and behavior because those are the areas involved in the diagnosis. Those domains are broad, however, and I target any specific skills and behaviors that are relevant to the child with autism and the family. I teach communication skills, including vocal speech, signs, and picture exchange systems. I can teach academic and pre-academic skills to help children succeed in school. I target daily living skills, self-help skills, independent leisure activities, play skills, toileting, and meal time routines, including addressing some feeding issues. I address social skills with family members, siblings, peers, and in community settings. I also work to reduce problem behaviors across all environments.
Where do I start?
So, you just received a diagnosis of an Autism Spectrum Disorder for your child. Now what? The first thing I recommend to all parents is to start educating yourself on the diagnosis and your treatment options. Autism Speaks has a great "100 Days" tool kit available on their website. I also have provided a copy below. The links above also can provide some information on Applied Behavior Analysis (ABA) and the qualifications of good providers, those that are Board Certified Behavior Analysts (BCBAs).
My second recommendation is to start finding ABA providers to work with your child and to train you to use ABA throughout your daily routines. Below is a document on selecting quality behavior analytic providers to coordinate your child's ABA program. This document is from the Autism Special Interest Group (SIG) of the Association for Behavior Analysis.
It is important to make sure that you feel comfortable with your ABA provider(s) and that they are a good fit with your family. If your child is going to receive Early Intensive Behavioral Intervention (EIBI), it is recommended to provide 25-40 hours per week of services. This means providers could be in your home, or your child could be at a center or school program for that amount of time. You want to find providers that will help your child make progress, as well as meet the needs of your family. Autism Speaks provides a document on ABA and what good ABA looks like (see below).
What is good ABA?
Some of the important elements within a successful ABA program are teaching new skills, reducing interfering behaviors, data collection, and team meetings.
It is important to teach new behaviors to your child in a way that they can learn and understand. Children on the Autism Spectrum do not learn in the same way as typically developing children. They do not always learn by watching others or being told one or two times. Often, new skills must be broken down into their simplest form in order for the child to learn. Once they learn the most basic level of a skill, the provider modifies the program slightly to continue to make progress and eventually teach the most complex version of the skill. For example, if I was working with a child who had limited requests, I may start by teaching non verbal requests (pointing), then one word requests ("bubbles", "juice", "candy"), then two word requests ("bubbles please", "more juice"), then short phrases ("want more juice" "want bubbles please"), before finally teaching sentences ("I want more juice please", "I want bubbles please"). In this way, I can make sure that the child is successful at an easier level before moving to a harder skill.
Along with teaching new skills, it is vital to address the behaviors that interfere with your child's learning. These behaviors could include inattention, tantrums, aggression, noncompliance, or self-stimulatory behaviors. These and other behaviors can make learning difficult for your child, as well as keep them out of a more natural setting with their typically developing peers. When we address interfering behaviors, we have to keep in mind that all behavior happens for a reason. This means that your child is engaging in problem behaviors because they get something out of it. Perhaps a lack of attention means that the child is left alone by peers who may be seen as "scary" to your child. Maybe throwing a fit in the grocery store means that the shopping trip will end early or that the child will get a game or candy while shopping. Once we identify the reason for the interfering behavior, we can teach new skills that are more appropriate for getting the thing the child wants. For example, instead of crying and screaming in the checkout line in order to get a candy bar, we can teach the child to ask "May I have some candy please?"
Data collection is extremely important to quality ABA programming. We collect data on every new behavior we teach and every interfering behavior we reduce. By collecting data, we can objectively determine the child's progress. Much like schools give homework and tests to assess a child's mastery of new objectives, we collect data on a regular basis (usually every session) to monitor progress. By taking frequent data, we can adjust our teaching to meet your child's needs immediately. With children on the Autism Spectrum, time is of the essence. Instead of waiting on a report card to see if there has been improvement or if the child needs additional help, we can review data after every session and make changes within days of your child mastering a skill or having difficulty with a skill. Data collection allows us to be sensitive to the individual learning needs of your child. In this way, we can make progress as quickly as possible.
Finally, team meetings are an important component of a quality ABA program because these meetings allow for everyone to be "on the same page" about the teaching programs and your child's progress. Team meetings should consist of the BCBA consultant who is supervising the program, direct providers working with your child, parents and other caregivers who interact with your child on a regular basis, and any other service provider who is working with your child, such as Speech Pathologists and Occupational Therapists. I hold team meetings approximately every 2 or 4 weeks, depending upon the child's skill level and rate of learning. I encourage any and all people involved in the care of your child to attend every team meeting. I have had parents, grandparents, babysitters, SLPs, OTs, teachers, and paras attend team meetings. During a team meeting, I review the child's data since the last team meeting for every program or skill we are targeting. At that time, I make changes to the program, if necessary, to speed the child's learning. I review these programs with the direct providers to make sure they are running the programs as designed. I also use this opportunity to teach parents how to practice these skills in their daily routines. This is also an opportunity to add new programs to teach new skills or to address additional interfering behaviors. Parental involvement during team meetings is especially important because, as the parent, you are an expert on your child and you have the best perspective on how your child is doing in their everyday activities.
This information is just a starting point. I am happy to help parents and caregivers find additional resources to meet their needs. Please feel free to contact me with any questions.