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Q&A – Applied Behavior Analysis (ABA) and Autism - June 2009

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Q&A – Applied Behavior Analysis (ABA) and Autism

By: Kenneth Larsen, M.Ed

Q: What are the key-features of Applied Behavior Analysis?

A: Applied Behavior Analysis is the science in which tactics derived from the principles of behavior are applied systematically to improve socially significant behavior and experimentation is used to identify the variables responsible for behavior change (Cooper, Heron, & Heward, 2007). Applied Behavior Analysis should be applied, behavioral, analytic, technological, conceptually systematic, effective and capable of generalized outcomes (Baer, Wolf, Risley, 1968):

The fact that ABA should be applied, as it says in the name, is the commitment to use the science of behavior to deal with issues and affect behavior that would enhance peoples quality of life.

The behavioral aspect of ABA states that behavior analyst study and seeks to affect the behavior, not studies about behavior. This means that behavior analyst will study the actual behavior as they occur. Behavior analysts will also work to improve measurable behaviors, and the precise and reliable measurement of behavior is one of the critical features of applied behavior analysis.

The analytic dimension means that applied behavior analysis focus on the analysis of the relationship between the environment, including other persons, and the behavior in question. ABA seeks to demonstrate the functional relation between manipulated events and reliable change in some dimension of the behavior they seek to affect.

The application of applied behavior analysis is technological when all procedures used are indentified and described in a such manner that others has a fair chance of replicate the procedure and get the about the same result. The control and prediction of this dimension is central to the science of behavior as for all science. This technological dimension of ABA makes it an open and cumulative science.

All applications of ABA must be in conceptually systematic in terms of identifying the principles involved in changing the behavior. Out of this comes that it’s not ABA just to implement an effective procedure to change behavior, but the behavior analyst must also identify the principles involved.

Applied behavior analysis is an effective application of the science of behavior. And by effective ABA means that it should change the behavior in question on a socially significant level. The change must make, or be a part of, a change that makes a difference in the person’s life.

All behavior changes must be generalized over time, environments and spread to other behaviors. If not reached it’s not likely to affect the persons quality of life.

Q: Is ABA a treatment for autism?

A: This is a quite common misunderstanding. Applied behavior analysis is a science of behavior that can be applied to the behavior of all persons. Applied behavior analysis has been demonstrated to affect the behavior of all persons. There have been demonstrations of effective teaching of typically developing children, effective treatment of psychiatric patients, effective treatment and habilitation of persons with different disabilities, effective programs for children with behavior problems and their families, etc. The list is extremely long. And in addition to the focus on individuals and groups, behavior analysis is applied to organizations and business.

But of course ABA has contributed greatly to the treatment of autism, and has shows great improvements for children with autism.

Q: What are the results for children with autism receiving ABA services?

A: Several studies have shown great results for children with autism receiving Early Intensive Behavior Intervention (EIBI) or ABA. Ole Ivar Lovaas at UCLA did the first seminal study. This was published in 1987, and showed that 49 % of the children receiving EIBI scored within the normal range at tests, started school in regular educations, and could not be distinguished from their peers. Another 40 % had significant improvements but did not reached scores within the normal range.

After Lovaas´ study there has been done several studies showing similar results. There have also been published thousands of studies showing the effectiveness of ABA in specific skill areas for persons with autism.

Q: How is ABA or EIBI implemented for children with autism?

A: There is some differentness among those providing ABA services, but all EIBI services build on these features (Karlsen, 2004):

All services, as all other treatment and education, should be individualized. As there are published several manuals in providing ABA treatment for children with autism, is the behavior analysis that makes the focus, and therefore calls for individualizing the treatment.

Studies have shown that children with autism starting ABA at a young age get the best effect. Research indicates that children should start ABA as early as possible, and at least at the age of 4. Although this seems to predict the best outcomes, there are some studies showing that older children also can benefit from intensive ABA treatment (Eikeseth, et al., 2001).

Intensity of the program is a much-debated issue. The Lovaas study provided 40 hours pr week of ABA-treatment, and studies done later shows that any autism treatment should provide at least 25 hours pr week. It’s necessary to provide a large number of hours to build the skills children with autism need, but behavior analysis should be implemented not only in structured teaching or therapy sessions, but through out the day. The intensity also refers to the teaching. Not only do the behavior analysts need to teach many hours, but these hours includes numerous learning opportunities. Depending on the teaching strategy and the skills targeted between five to fifteen per minute.

All EIBI or ABA-program should of course draw up on the principles from the science. This is sadly not always the case, as some uses some techniques developed within ABA, but to not rely on the science. So an EIBI of ABA program should use a wide variety of the techniques derived from behavior analysis, based on the individual child and the behaviors or skills in question.

A central feature of ABA and then also for ABA-programs for children with autism, is the measurability. All teaching and skill building within an ABA-program should focus on small measurable behavior units, insuring effective and traceable progress.

All good designed ABA-programs are also characterized by frequent review of data. All behavior analysts collect the relevant and necessary data to monitor progress, and adjust the intervention or program to insure maximum effect and progress.

ABA or EIBI is as mentioned not only the structured teaching sessions, but also a way to interact with other people. All EIBI programs therefore emphasize collaboration between the behavior analysts, parents, and other significant persons in the child’s life.

Q: How do you implement an ABA teaching session?

A: The large body of research done in applied behavior analysis has revealed numerous effective teaching techniques. Within ABA-programs for children with autism all teaching builds on the principle of positive reinforcement.

Positive reinforcement occurs when a stimulus following the behavior has the effect of making the behavior it follows after more likely to occur in similar situations. What makes a stimulus a positive reinforcer varies greatly for each child, and a comprehensive reinforcer assessment must be done before teaching. Positive reinforcers can be objects and edibles, activities, praise and other social events.

Of directed teaching strategies a well-designed ABA-program uses a specter of strategies, depending on the skills that are targeted. The most common is discrete-trail teaching, incidental teaching, natural environment teaching, shaping etc.

The most known strategy may be Discrete-trail teaching (DTT), which is a highly effective and structured teaching strategy. Discrete trails consists of a clear discriminative stimulus (instruction/task), prompts (help), child’s response, positive reinforcement/error correction, and a between trail interval.

DTT is one effective teaching strategy, but other strategies building upon captioning the child’s initiative must be included to promote the flexibility and generalization of the skills taught. Strategies capturing the child’s motivation can be incidental teaching, natural environment teaching etc.

Q: Can ABA treatment for children with autism be implemented in regular education?

A: Yes. Although children with autism often will need some one-on-one intervention, providing it in settings with typical developing peers can enhance the effectiveness of the program.

The contact with the mainstream environment can greatly enhance generalization, and as the goal of EIBI is to assist the children with autism to learn for typical environments, the provision of these strategies in mainstream setting allows this to happen gradually.

In Norway most of the children with autism receiving ABA attends regular kindergartens. They often has access to a separate room where one-on-one teachings sessions occur, but a lot of ABA teaching takes place in groups with typical developing children, on the playground and in routine situations with all the other children.

Q: What about Speech and Language therapy, Occupational Therapy and other therapies?

A: To implement an efficient ABA-program for children all persons, both family and professionals need to cooperate, and other exercises from other therapies can be implemented into the ABA-program.

The first that needs to be coordinated is the learning objectives for the child. It’s essential that the objectives and learning goals are coordinated and based on a task-analysis and a developmental sequence. The staff-meetings where the behavior specialist supervises the program can be used to coordinate the goals and learning sequence for the child.

The other thing that should be coordinated is the teaching techniques. If all skills and exercises are implemented and designed in accordance with behavioral principles it should strongly reinforce the effect of the ABA-program. There exists several good stories of this being possible, and one is beautifully described in Catherine Maurice’s book Behavioral Intervention for Young Children with Autism.

Q: Where can I learn more about ABA?

A: There are published thousands of books and scientific articles on ABA, many of the great reading. There are of course also several excellent web sites giving information on ABA. I would recommend ABA-International, http://www.abainternational.org, as a great place to start.

This Month's Featured Author Kenneth Larsen, M.Ed

We Thank Kenneth Larsen for providing the Q&A for this months Newsletter.

Kenneth Larsen is the leader of a team providing ABA services to young children with autism at a regional centre covering the south-eastern area of Norway. The centre offers supervision to about 100 children with autism. Kenneth Larsen is also gives lessons and lectures on autism and applied behavior analysis. Kenneth Larsen has worked in the field of autism and applied behavior analysis since 1998.

Tags: Applied Behavior Analysis Q&A June 2009 Newsletter Autism OT School Based Psychology Article