According to estimates from the CDC, around one in 54 children has Autism Spectrum Disorder (ASD). This condition is diagnosed four times more in males than females. It is found equally throughout all ethnic, racial, and socioeconomic groups in the U.S.
Children with autism often have difficulty communicating (understanding and spoken language). They may also have difficulties with socially significant behaviors like focusing, sleeping, socializing, and managing their behavior.
Various therapeutic approaches aim to improve the behavior of autistic people. However, the only evidence-based treatment for autism is Applied Behavior Analysis (ABA) therapy. This support has come from decades of research and is supported by many educational, medical, governmental and private organizations.
But what is ABA therapy, and why is there so much support for its use? How does it benefit those with autism?
The Background of ABA Therapy
Positive reinforcement is the cornerstone of Applied Behavior Analysis (ABA). It is based on the work of renowned psychologist B.F. Skinner. His theories on operant conditioning and positive reinforcement are the underpinnings for ABA. His decades of work in learning about and understanding human behavior is the reason ABA is so successful today.
In using positive reinforcement, a person learns a new behavior that replaces a previous, undesirable behavior. In short, we all exhibit positive reinforcement in our daily lives, and it affects our behavior. Positive reinforcement provided in the form of attention, activity, something tangible, or a sensory experience increases desirable behavior. It is a natural way to change behavior.
Examples of positive reinforcement occur in everyday life. Do you receive a paycheck? That is positive reinforcement for doing your job. Do you give your children rewards for doing chores? You are using positive reinforcement. As you can see, positive reinforcement is embedded in everything we do.
ABA helps autistic individuals change their behavior so that it is more socially significant. Using positive reinforcement, autistic individuals can learn how to communicate, socialize and learn new skills.
ABA therapy is suitable for children, teens and adults. In fact, it is even used in other areas, like economics, human resources and marketing.
The ABCs of ABA
With ABA therapy, people with autism and their caregivers work with Board Certified Behavior Analysts (BCBAs) and Registered Behavior Technicians (RBTs). They establish areas of need that help the autistic person function as independently as possible. Their focus is to develop an individualized treatment package to teach socially significant behaviors.
How do BCBAs know exactly how to teach those socially significant behaviors? This is where the ABCs come in – Antecedent, Behavior and Consequences. ABCs tell us WHY the behavior happens.
A—The antecedent is something that happens to trigger a behavior. It could be environmental (such as a loud noise) or internal (such as an uncomfortable thought). It could also be verbal (such as a question or instruction) or physical (such as pain).
B—The behavior is the person’s response (or lack of response) to the antecedent.
C—The consequence happens following the behavior: for example, a loud noise ending or other positive reinforcement if a desirable behavior occurs.
Understanding these ABCs is beneficial to all parents and caregivers. It tells us why the behavior happens and what we can do to teach a more appropriate behavior. Instead of providing positive reinforcement for an inappropriate behavior, parents and caregivers work with the BCBA to provide positive reinforcement for appropriate behavior.
ABA relies on this approach to understand behavior. BCBAs and ABA therapists show people with autism new ways to communicate their wants or needs. This allows for a deeper understanding between them and their parents or caregivers.
Applied Behavior Analysis Therapy Techniques
Now that you understand how ABA is used, we can explore some specific strategies used to increase appropriate behavior. Depending upon your child’s need, one or more than one of the following strategies may be used.
Discrete Trial Training (DTT)
In discrete trial training, an ABA therapist works with individuals in a one-on-one capacity, usually within a controlled environment. Discrete trial training is used during early intervention to teach foundational skills or skills that a child would typically learn naturally from exposure within their environment. A larger skill is broken down into smaller parts. Those parts are taught using prompting, and when the child responds correctly, they are provided positive reinforcement. For example, you may use DTT to teach letters or numbers. ABA Therapists will show an individual a picture of a letter, prompt them to say the correct letter, and then provide positive reinforcement.
ABA therapists teach these targets in several different settings, with several different models and with several different people. This way, the individual learns or “generalizes” the target skill in a natural environment.
Picture Exchange Communication System (PECS)
PECS is considered augmentative communication, meaning it’s a way to speak without speaking. PECS can be used to complement or supplement vocal language. It can also be used to support the learning of language while vocal language is emerging.
When using PECS, the instructor takes pictures of important items in the individual’s environment. They are then taught that they can access that item when they hand the object to the instructor. PECS teaches the individual new words, objects, phrases and even modifiers (such as the word “red” in “red car”).
Reinforcement systems use the ABCs to teach individuals with autism appropriate behavior. By providing reinforcement after a desired behavior, the individual learns new behavior. Performing the appropriate behavior results in a reward.
Sometimes individuals may receive tokens that serve as reinforcement. This is called a token economy. When using token economies, ABA therapists pair tangible positive reinforcement with an arbitrary item called a token. These tokens function similarly to money. The client earns tokens and then exchanges them for what they want, e.g., activities, candy or special toys.
Natural Environment Teaching (NET)
This approach allows the individual to learn in their natural environment. During NET, the ABA therapist enriches their environment with items that will promote communication and imitation skills. In this individual-led strategy, individuals are provided free access to the enriched environment, and when the individual accesses the item, the ABA therapist provides opportunities to imitate motor and communication skills.
For example, if an individual starts playing with blocks, an ABA therapist may model stacking the blocks. They may prompt the individual to say, “block,” or have them imitate stacking the blocks. They may create opportunities for the individual to fill in phrases or songs. For example, the ABA Therapist may say, “1, 2” and prompt the client to say “3” before knocking the blocks over. The client will say “3” to get the therapist to knock the blocks over.
Shaping is a technique that focuses on teaching tiny steps that lead to a larger goal. Reinforcing those tiny steps leads the client to accomplish larger goals.
Shaping is present with any form of language learning, especially with younger children. Caregivers may use shaping to teach babies to say, “mama” or “dada.” By reinforcing vocals that sound like the word and building on those approximations, the client learns how to say the word.
For example, the therapist may teach “mama” by positively reinforcing the first correct pronunciation of the sound “mmm” and again when the individual consistently says it. Then the therapist will encourage adding the “aaa” sound until the client can say “ma.” This continues until the client successfully says “mama.”
ABA Centers of America
Autism is a complex condition that varies from one individual to the next. Some or all of these strategies may be beneficial to an individual’s treatment plan. Applied Behavior Analysis Therapy has been proven by many research studies to be effective in treating autism. If you have any questions about ABA therapy, our treatments or services, click here to contact us today.