If your child has been diagnosed with an Autism Spectrum Disorder (ASD), you have probably heard about Applied Behavior Analysis (ABA) Therapy. ABA therapy is simply a method of therapy that is used to improve or change specific behaviors.
This therapeutic approach is often used to help children improve their social skills, communication patterns, fine motor skills, grooming, and academic skills. ABA has also been used to help individuals improve their job proficiency and learn simple skills, like maintaining a clean and organized room.
History of ABA Therapy
For those of you who took Introduction to Psychology at some point in your past, ABA therapy is based on the work of psychologist B.F. Skinner. Skinner developed a theory of operant conditioning. Skinner’s theory looks at how one can control behavior by altering the consequences of that behavior. Parents generally use the same principles when they punish a child for doing something wrong and reward them for doing something well.
To help you better understand ABA therapy, we will look at some of the techniques that an ABA therapist is likely to use with your child.
ABA Therapy Techniques
Below is a list of some of the common techniques used by ABA therapists. It is important to remember that the strategy and techniques used by an ABA therapist will be tailored specifically for your child.
So without further ado, here are some ABA therapy techniques:
Positive Reinforcement:
In the most general of terms, positive reinforcement is providing someone with a reward or praise to encourage them to continue to behave in the way you would like them to. The praise or reward needs to quickly follow the desired behavior. If a reward or praise quickly follows a behavior, the person will associate the positive reinforcement with the behavior. This makes the person more likely to increase the rewarded behavior.
Your child’s ABA therapist will work with your child to identify an appropriate positive reinforcement. The therapist will provide positive reinforcement as soon as your child performs the behavior he/she is trying to get your child to do. The behavior can be something as simple as looking into the eyes of the person they are talking to. The positive reinforcement can be something as simple as a word of encouragement.
Say your child’s ABA therapist is working to get your child to ask for toys rather than grabbing for them or simply taking them from a sibling or peer. When your child asks for the toy he or she wants, the ABA therapist will quickly provide the child with the toy. This will motivate your child to ask for the toys he/she wants.
Discrete Trial Training:
Discrete Trial Training (DTT) is one of the major teaching strategies used in ABA Therapy. DTT is a technique where skills are broken down into small, “discrete” (or distinct) elements. The therapist then introduces each element of the skill to your child, one at a time. Your child will receive positive reinforcement after each correct response to the discrete element being taught.
If an ABA therapist is engaged in teaching your child emotions, for example, he/she may break the concept of emotions into the individual emotions. Each emotion will be broken down into specific lessons. First, your child may be taught to distinguish the emotions.
For example, the ABA therapist may begin by having your child identify emotions. He/she may begin by introducing happiness. Your child may be given an array of photographs in which children portray a variety of emotions. Your child may be asked to point out the picture of the child expressing happiness. When your child correctly points out the image of the child expressing happiness, he/she will be positively reinforced with the praise or reward that was identified previously.
Once your child has learned to positively identify happiness, the therapist will move on to another emotion. Once your child has learned all of the emotions that he/she is being taught, the therapist will move on to teaching your child another step in the process.
This step may be something as simple as learning to say each of the emotions when shown a photograph depicting a child expressing that emotion. Again the therapist will introduce each emotion, one at a time.
Antecedent-based Interventions:
To understand Antecedent Based Interventions (ADI), it is helpful to understand how ABA Theory looks at learning. ABA Theory looks at learning as a three-stage process (Antecedent Behavior Consequence). According to this ABC process, an antecedent (A) occurs that triggers a behavior (B). The behavior (B) then leads to a consequence (C).
For example, your child may become hungry. Hunger is the Antecedent that leads your child to eat an apple (B). Eating an apple (B) has the consequence (C) of reducing your child’s hunger. In this example, the consequence (C) should be a positive outcome and should lead your child to be more likely to eat an apple when he/she feels hungry.
However, if your child chose a snack that makes him/her feel unwell, the C would be negative and less likely to reoccur. Say your child is allergic to strawberries. If you child feels hungry (A), and chooses to eat strawberries (B), he/she will have an allergic reaction (C).
This means that your child feels unwell. This would be considered a negative reinforcement, meaning that your child would be less likely to eat strawberries (B) in the future when hungry (A).
One of the things that create issues with learning is that there can be many things occurring within an environment that interfere with, or replace, the intended Antecedent. For example, if your child is on the autism spectrum, he/she may be highly influenced by sound.
In a regular learning environment, your child may have to deal with sounds that other children don’t appear bothered by. A conversation taking place across the room may impact your child’s’ ability to focus on what the teacher is presenting (the intended Antecedent).
ABI Strategies focus on modifying the environment to reduce the likelihood that something in the environment could trigger an interfering behavior. For this reason, your ABA Therapist may engage your child in an environment that has few distractions. Teaching your child in this type of environment, helps your child to focus on the intended antecedent.
Aspects of ABI Therapy include:
- Modifying learning environments
- Providing choices
- Engaging your child with motivating items.
One example of an ABI intervention is offering a child, who tends to behave defiantly, a choice. Rather than asking your child to complete a worksheet, your ABA Therapist may present your child with three worksheets and allow your child to choose one. This intervention will likely result in your child happily completing the chosen worksheet rather than defiantly saying no.
Exercise:
You may be surprised to learn that your child’s ABA Therapist may engage your child in exercise as part of his/her therapy session. Exercise not only improves one’s physical health, it has been proven to have many other benefits.
Exercise can:
- Increase your child’s feelings of happiness
- Create a sense of calm that helps your child focus
- Reduce sensations of pain
- Improve your child’s ability to sleep
- Encourage your child to use social and verbal skills
- Improve your child’s memory
- Help your child improve gross motor skills by working his/her major muscle groups
- Help your child improve fine motor skills needed for things like holding a pencil, by working his/her small muscle groups.
You may, for example, notice that your child’s ABA therapist engages him/her in a game of ball or a series of stretching exercises at the beginning of a therapy session or during a break between more traditional learning activities.
Extinction:
Extinction in ABA is simply a procedure used to help reduce problem behaviors. Different strategies are developed to reduce problem behaviors based on the way the particular behaviors are being maintained.
Some problem behaviors are maintained because they are being positively reinforced. Your child may obtain positive reinforcement in the form of attention when he/she becomes overly loud, for example.
Some problem behaviors are maintained because they are being reinforced by the removal of a negative. Your child may find that when they are openly defiant to doing work, they are withdrawn from the learning environment.
For example if a child is removed from the classroom and placed in a quiet space to reflect after being defiant about completing homework. he/she may find that the removal of the offending work if reinforcing although the situation is intended as punishment.
Some problem behaviors are maintained because they are automatically reinforced by the behavior itself. For example, some children get great joy out of rolling the windows in a moving car up and down.
Although this may seem to be a simple act of defiance, the change in the physical sensation of wind rushing across their face may be engaging for the child and therefore automatically reinforcing the unwanted behavior.
Regardless of why the negative behavior occurs, your child’s ABA therapist may use extinction to reduce it. To extinguish the problem behavior, it must become paired with a lack of reinforcement. A behavior that historically resulted in the removal of negative stimulus, must no longer have the same outcome. Ultimately, over a period of time, a child learns that the behavior fails to get them whatever was maintaining it.
Functional Behavior Assessment:
A Functional Behavioral Assessment (FBA) is the process your child’s ABA Therapist uses to identify the behaviors that need to be altered to help your child learn. This process helps your child’s ABA therapist identify specific behaviors, determine the purpose of these behaviors, and figure out the factors that are maintaining these behaviors. Your child’s FBA will become the basis for the interventions your child’s ABA Therapist uses to help your child learn and grow.
To develop your child’s FBA, your child’s ABA Therapist will spend time observing your child. Your child’s ABA Therapist may also speak to parents, teachers, and medical providers to get a better understanding of your child.
Functional Communication Training:
Functional Communication Training (FCT) uses differential reinforcement (DR) to teach a child to replace one behavior with another. Generally, a child is taught to replace a problematic behavior with an appropriate phrase or some other way of communicating. FCT interventions progress through a set of stages.
An FCT intervention is developed and taught by:
- Conducting an assessment of the problem behavior
- Determining appropriate communication
- Teaching the child the new communication skill
- Reinforcing every use of the appropriate communication
- Reminding your child to use the new communication
- Ignoring the problem behavior whenever it happens
For example, your child may be throwing his/her pencil whenever frustration builds. Your child’s ABA Therapist may work with him/her to replace the pencil throwing with the phrase, “I’m getting frustrated.”
Children who are non-verbal may be taught to replace the pencil throwing with using a gesture from sign language or a picture to express themselves.
Modeling:
Modeling is, simply put, when one person intentionally shows another person what an ideal behavior looks like. In ABA therapy, your child’s therapist may use modeling to help your child understand the behavior that he/she is looking for.
For example, if your child’s ABA therapist is helping your child learn to hold a pencil correctly, they may spend time showing the child how they position their fingers and the pencil to prepare for writing. They may then draw attention to how they move their fingers to make a mark.
Modeling is simply applying learning through watching.
Parent-implemented Intervention:
Some ABA programs have used Parent-implemented Intervention (PII) with great success. PII involves ABA practitioners training and collaborating with a child’s parents to provide ABA interventions. Studies indicate that this practice can be a highly effective way of teaching and supporting children on the autism spectrum.
With the growth in the numbers of children being identified as struggling with autism spectrum disorders, there is often a lag between identifying a child who could benefit from ABA Therapy and getting this type of support.
Studies show that Parent-implemented Intervention is beneficial for children on the autism spectrum. PII allows parents to engage their children in their natural settings. This allows the child to learn without the anxiety of traveling to a clinic. It also allows children to learn without the delays that can occur in finding appropriate professional care.
You may for example work with your ABA therapist to learn how to support the use of ABA strategies to help your child while you are waiting to get into seeing an ABA therapist. Or, in times like this, when we are all practicing social distancing, you may work with an ABA therapist to provide support to your child when face-to-face therapy isn’t a reasonable option.
Picture Exchange Communication System:
A Picture Exchange Communication System (PECS) is a modified ABB program that allows people without the ability to speak to use images to communicate. Studies have shown that suing PECS can improve your child’s language skills. A PECS can also help your child communicate needs and help reduce behaviors associated with the frustration of being misunderstood or unable to communicate.
For example, if you child is unable to ask for specific foods, he/she may be provided with a PECS of a variety of foods to pick from at snack time.
Pivotal Response Training:
Pivotal Response Training (PRT) is a variation of ABA therapy. This method is based on the idea that there are pivotal behaviors that influence other behaviors. Therapists using PRT focus on these pivotal areas instead of looking at specific behaviors. PRT often occurs through gameplay.
As your child progresses through PRT improvement in the pivotal area focus upon, you should see this behavior generalized to other areas of communication, social engagement, learning, etc. For example, if your child is learning to ask for toys during play sessions, he/she will be positively reinforced for asking for the toys available for play. You can expect that your child will begin to ask for other things that he/she desires in other settings as well.
Redirection:
Redirection is a technique used by many therapists, educators, and caregivers. An ABA therapist using this technique quill distract a child from a problem behavior that is happening. The child’s attention is drawn toward more appropriate behavior.
Suppose for example that your child hits another child to get their attention. Upon seeing this behavior, your child’s ABA therapist may either say something or tap your child on the shoulder. This breaks into the behavior that is occurring. The therapist may then direct your child to repeat a phrase like, “excuse me”. This allows your child to then to practice the appropriate behavior.
Scripting:
Scripting means repeating the same words over and over again. ABA therapists may use scripting to help your child learn a new skill. The therapist will create a description of a skill or situation. The therapist will practice the script with your child before the skill is used. A script may be as simple as, “ook the person you are talking to in the eye.”
Scripts may be useful when your child is anticipating social situations. Once the steps of a new skill have been practiced and learned, the ABA therapist will work with your child to fade the script.
