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ABA Therapy

ABA Therapy

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Applied Behavior Analysis (ABA) is the gold standard therapy for Autism Spectrum Disorder (ASD). Contrary to the myth, ABA is NOT an experimental procedure. Its effectiveness has been demonstrated and replicated by many carefully conducted scientific studies and is now a widely accepted scientific treatment method amongst clinicians.

In particular, a number of clinical trials and single-subject studies have been published measuring the effectiveness of long-term, comprehensive applied behavior analytic intervention for young children with ASD. Results suggested that long-term, comprehensive ABA intervention leads to positive medium to large effects in terms of intellectual functioning, language development, acquisition of daily living skills and social functioning in children with ASD.

Language-related outcomes (IQ, receptive and expressive language, communication) were improved in a superior manner. There is a dose-dependent effect with better outcome with increasing levels of total treatment hours on improvement especially in the domain of language and composite adaptation score (Virués-Ortega J. Clin Psychol Rev. 2010 Jun;30(4):387-99). 

Below are the main principles behind what Behavior Analysts and ABA therapists use.

  • Motivation
  • Motivation is at the very center of ABA. Behavior analysts use what a person finds as exciting and entertaining (i.e. what motivates them) to get the individual interested in what goals are set.
  • Reinforcement
  • Increasing desired behaviors is the number one thing behavior analysts do and this is done by using reinforcement.  Reinforcement is: a) a prompt, direct consequence following a behavior and b) that has an increase in the behavior occurring. Negative and positive reinforcement are used to make positive changes in students’ lives by increasing behavior.
  • Shaping
  • Shaping is done by steadily reinforcing the individual and increasing the likelihood of getting the desired behavior via approximation of the target behavior until the correct behavior is achieved. Though the process can be quite slow, shaping can make big changes in behavior when applied appropriately.
  • Prompts
  • Prompts are considered to be subtle directions or tips that assist the individual on the correct response given a certain situation or event. Prompts are used so that learners can get correct responses more often. Prompting can still be used with mastered skills in new conditions or when a time limit is in place. Prompts can range from subtle, which would be used with skills already mastered, to being very direct when learning a new goal.
  • Types of prompts might include, physical or hand-over-hand assistance, partial physical or guiding, modeling or demonstration, visual such as a picture, textual such as written checklist, verbal such as “What do you want?”, and gestural such as pointing.
  • Modeling
  • A great example is having a child watch another child building a tower of blocks and then having that child copy the tower. This is an example of modeling and most typical children do this on a daily basis. A model by definition is any antecedent, or action occurring before the behavior that is exact to the desired behavior. One example of modeling you may see a therapist use is by saying “Do this” while doing the desired behavior (i.e. touching nose) and reinforcing the student for touching their nose. This is a very direct form of prompt and is used in the imitation part of training.
  • Discrete Trial Training
  • Historically, discrete trial instruction (DTI) or discrete trial teaching (DTT) has been the preferred way behavior analysts have implemented ABA instruction with students with Autism. DTT has a history of success by systematically and methodically teaching skills and tracking rigorous amounts of data. DTT makes instructions very clear to the learner; it is a good match for learners that have Autism.
  • Natural Environment Training
  • Below is a list of natural environment training examples:
  • Mand Training
  • The student reaches for his iPad, instructor asks, “Do you want iPad?” The child responds “iPad” and is given the iPad and is allowed to play games.
  • Tact Training
  • The instructor holds up a car and says, “What is it?” The child responds, “Car.” The instructor then makes the car drive across the carpet, initiating play.
  • Intra-verbal Training (Beginning)
  • The instructor says, “The cat says…” The child says “meow.” The instructor says “Yes! Good job! The cat says meow!”
  • Intra-verbal Training (Advanced)
  • The instructor asks, “Where did you go today?” The child responds “The zoo.” The instructor says, “Oh, I love giraffes!” and the child responds, “Me too! I also like the lions.”
Task Analysis & Chaining

Large amounts of reinforcement, for successful completed steps, and very clear instructions are very important for learners who have Autism. Tasks analysis is done by taking complex skills and making them into easier steps. It is a step-by-step map on how to do one larger skill. The reinforcement is much greater when broken down in this way.

When taught through chaining, it is important the steps be taught in order. At times, chaining is taught using a forward chaining procedure in which the steps are targeted beginning with the first step. Reiforcement is provided for successfully completing this step. When the learner can perform one step independently on a few occasions, the teacher requires that two steps be completed to earn reinforcement.

Backward chaining is another way to teach chaining. With backward chaining, the last step is completed independently, while all the previous steps are assisted. Eventually, it becomes the last 2 steps, then 3 steps, then 4 steps independently until all steps are independent. The major advantage to this is reinforcement of completing the last step.

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Precision Teaching with Rate Building

Precision Teaching focuses on building the rate at which learners can demonstrate skills, and focuses on the attainment of fluency. Fluency refers to the combination of accuracy plus speed of performance. When people are fluent in skills, they can do them effortlessly and fluidly. Learners with Autism can exhibit skills, but are not fluent at them.

If compared to how others did those tasks, it often looks more laborious and takes more time to do the tasks compared to a fluent and competent peer. Precision Teaching works by paying attention to the rate at which the learner can perform the task. In addition, attention is paid to the concept of component complex skills. For example, component skills include reaching, pointing, and grasping, which could all impact on skills such as matching or identifying objects.

Antecedent-Based Interventions

Behavior analysts attempt to change what happens before and after a behavior to make it more or less likely to occur. While there is a heavy emphasis on consequence-based strategies in the past, researchers and clinicians are now learning more about how to change behavior in more sophisticated ways. The focus on changing the environment before a behavior occurs is advantageous for several reasons.

First, in the situation of challenging behavior, the goal is to prevent the behavior. We may achieve prevention by using antecedent-based strategies.

Second, the search for effective antecedent-based strategies can improve our understanding of the learner’s experiences.

Third, a thorough assessment of the context can lead to endless possibilities for intervention. Possibilities include offering choices in the types, number, and order of tasks; altering the demand by reducing the effort required; mixing easy and hard tasks; reducing distractions; increasing visual supports; and incorporating the student’s preferences.

Positive Behavior Support

Positive behavior support (PBS) incorporates understanding why the behavior is happening, teaching the individual how to act more appropriately, and improves the individual’s quality of life. PBS accomplishes these three things by combining well researched assessment and intervention strategies of ABA with the social values of personal choice, independence, community integration, systems change, and quality of life.

Parents’ input is actively solicited and used to make an appropriate plan that can easily be implemented at home and in the community. Whenever possible, the individual with Autism has a voice in the development of goals and plans. Socially meaningful goals are developed for the individual, to put the individual in more contact with people and experiences they find rewarding, and that increases the positive aspects of their relationships.

Generalization

When teaching learners with Autism, we have to plan for generalization to occur. One way to convey that is to say, “We cannot just teach and hope.” While teaching a new skill is certainly the first step, there are likely to be many more steps in teaching when to do the skill, when not to, and how to behave just right in a particular situation. The learning process is not complete until widespread generalization has occurred in meaningful situations.

Generalization occurs when a person learns something in one environment and can independently apply it in another. Spontaneous generalization occurs when the learner can do so without any additional training. Learners with Autism often have a difficult time generalizing skills to new environments. They may need more intensive teaching to learn how to exhibit new skills outside the teaching situation. While it may be important to teach new skills in a controlled manner, it is also important to make sure the person can use the skill in a functional and meaningful way.

Jane Yip

3 Comments so far

Ms.Courtney WilliamsPosted on  2:15 pm - Feb 12, 2017

Iam a parent of 2 autism boys ages 10 and 5 im very 8nterested in any and all info and availiable services for my boys.Thanks

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