What is ABA?
Applied behavior analysis is the extension of operant (focus on observable behavior in individuals) methodology to the modification of human behavior.
History of ABA (very brief):
Behavioral treatment applied to autism focuses on increasing behavioral deficits and decreasing behavioral excesses.
'ABA' is a general term. There are several different behavioral treatments for many disorders including autism.
Behavioral Treatments/Programs for Autism
Like behavioral treatments for other disorders, behavioral treatments for autism focus on observable, measurable actions of the individual. It is assumed that behaviors are under control of the environment Change is accomplished by manipulation of that environment.
There are many behavioral treatment programs for people with autism. Each program has many variations and improvements are consistently being attempted, often successfully. Major differences between programs are based on philosophical differences and include variations in intensity and specific behaviors targeted for intervention.
Review of Principles of ABA
The "ABC's" (Antecedents, Behaviors and Consequences)
A Antecedents are the events that happen before the behavior occurs.
B Behavior is the specific way the child acts.
C Consequences are the events that happen to the child immediately following the behavior
A Patrick is in speech therapy. His speech therapist tells him to "sit down"
B Patrick hits the therapist.
C The therapist takes him back to his classroom.
In order to change behaviors they MUST be well defined!
Measuring behaviors allows us to determine whether or not a behavior is increasing, decreasing or staying the same.
Measurement is important to let us know if a program is effective.
Frequency: The number of times the behavior occurs in any given time interval.
Duration: The amount of time that passes from the beginning to the end of the behavior
An antecedent is the event that happens just prior to occurrence of the target behavior. It includes: General circumstance- the circumstances that set the stage for the behavior (e.g. at breakfast, at speech therapy) Specific trigger event (e.g. "no", a command)
Identification is important for 2 reasons:
There is always an antecedent however, it is not always readily identifiable (e.g. with self-stim)
Consequences are events that follow a behavior. They include Reinforcers, Punishers and neutral events.
In general: Behaviors followed by pleasant consequences are more likely to occur again. Behaviors that are not followed by pleasant consequences are less likely to occur again.
This principle is important to remember when you are working with your child. If you are teaching a skiII and the behavior is not increasing, you may not have a powerful reinforcer. If you are trying to decrease a problem behavior and it continues to increase, you may not have an effective consequence.
By examining and understanding antecedents and consequences maintaining behaviors, we can change them to alleviate problem behaviors and increase desired behaviors.
The next two pages contain vignettes. Identify:
How would you treat (behaviorally) the problem?
Paul's dad takes him to the grocery store. In the store Paul sees a toy he wants but his dad tells him no. Paul throws himself on the floor, kicking and screaming. His father, quite embarrassed by the tantrum, buys the toy for Paul.
Sarah screams and bites her hand whenever her parents try to teach her a new activity, pointing to pictures. As soon as she begins to scream, they terminate the teaching session.
Matthew jumps up from the table at mealtimes and runs around the house. One of the family members always chases after him and brings him back to the table.
A-B-C Pattern Examples
Instructions: For each example, identify the antecedent(s),..specific behavior and consequence maintaining the inappropriate behavior.
(1) Rachel's father asks her to pick up her toys and Rachel refuses by saying "no." Her father asks two more times without success and then he picks up the toys himself.
(2) Jackie is able to dress herself and does so independently without making a fuss on the weekends and when changing into her pajamas at bedtime. However, every weekday morning she fusses and whines as her mother stands over her urging Jackie to dress quickly before the school bus comes. Her mother, annoyed, helps Jackie finish dressing as the bus pulls up in front of the house.
(3) Nicholas' father fixes him a well-balanced dinner of foods his teacher reports he will eat for lunch at school. However, at home, Nicholas refuses to eat pushing his plate away. His father, not wanting him to go hungry, gives Nicholas his favorite food, jello.
(4) Tammy often rocks and bangs her head against the wall as her mother attends to her new baby sister. Tammy's mother reacts to this by immediately hugging and attending to Tammy, often offering her food and toys.
(5) Archie has a language delay but has been observed to use some appropriate language at school. Archie's parents have not been able to elicit the same language at home. Before giving Archie something he clearly wants, his parents prompt him to use his words to ask for it. Archie responds by tantrumming until his parents finally give him what he wants.
(6) Kathy's parents have decided that it is time she learn to eat with a fork and spoon. To start out, they have decided to teach her during dessert time. After Kathy finishes eating her dinner with her hands, she is presented with a bowl of ice cream and a spoon. Her parents put the spoon in her hand, and guide it toward her mouth. Kathy reluctantly takes the first bite then shoves the bowl off the table as her parents prompt her to take another. Kathy's parents remove the bowl, clean her up then continue their typical evening.
Theoretical persuasion of the service provider influences what is emphasized in assessment. Areas that are considered theoretically important for intervention are considered most important for assessment. At one end of the spectrum Behavioral theory emphasizes an assessment based on behavioral excesses and deficits. At the other end of the spectrum Psychodynamic theories emphasize an assessment of underlying causes for observable behaviors. There are other schools of thought which utilize combined theoretical approaches and observation to determine relevant areas to assess in an individual with autism. Once assessments are conducted, analysis of those data are completed to further formulate goals for intervention.
Initial assessment is important for the following reasons:
Behavioral assessment utilizes available information from many sources (See types of assessment above). Information is categorized as behavioral excesses and deficits.
Behavioral excesses: Behaviors that occur too frequently and/or with too much intensity. Examples are self-stimulatory behaviors, aggression, tantrums. Behavioral deficits: Behaviors that occur at too low a frequency and /or intensity or not at all. Examples are language, social behaviors, self-help skills..to name a few.
Areas of normal behavior: Behaviors that occur at a similar rate and intensity in typical children of the same age. An example is gross motor skills. Infrequently, children with autism exhibit special areas of skill such as memory or mathematical or artistic skills.
Functional analysis helps the treatment provider find the meaning of the child's behavior for that child. Once the meaning of the behavior is found, a more acceptable behavior (functional equivalent) can be taught to serve the same purpose.
The function of the behavior may vary depending on the situation in which it occurs.
A Functional Equivalent of a problem behavior is an alternative, acceptable behavior that serves the same purpose for the child.
Example: Tommy hits his teacher sometimes when she sits next to him at his desk during a color sorting drill. Ms teacher reacts by explaining to Tommy why he shouldn't hit and putting him into time-out. When he comes back she gives him another activity to do.
If a problem behavior has developed, it has been rewarded in the past. To decrease a problem behavior, the consequences must be changed.
BUILDING ON SKILLS
LONG TERM GOALS
ELIMINATE DISRUPTIVE BEHAVIORS
INCREASE SOCIAL SKILLS
INCREASE SELF-HELP SKILLS
INCREASE ACADEMIC PROFICIENCY
SHORT TERM GOALS
Concepts for Individualized Programming. Behavioral "Tool Chest"
The population of persons with Autism is heterogeneous, each having some similar characteristics but so divergent that individual programming is essential. There are a myriad of different treatments for autism. Some are comprehensive programs and some address only specific areas of the disorder. Treatments not considered to be behavioral include Biological treatments (e.g. naltrexone, Fenfleuramine, nutritional supplements, etc.), Sensory integration therapy, Facilitated communication, Psychoanalytically influenced treatments (e.g. holding therapy, play therapy, etc.) and Auditory integration training. Behavioral treatments (those incorporating ABA principles) have to this date shown the most promise experimentally. Numerous studies are now showing neurological correlates to Autism suggesting future success in treating autism biologically. The other treatments mentioned have had mixed results and few if any conclusive, valid studies have been performed on them. Ideas to Keep in Mind
A Review of Popular Programs
The above programs have been implemented with large numbers of children and have been empirically validated as effective, although different studies report different success rates. These programs each place emphasis on different areas of intervention. Discrete trial methods are effective to teach novel responses, discriminations, chains of responses to form new skills and some academic skills. Naturalistic strategies such as PRT are most effective for teaching emerging skills, spontaneous responses, for fostering generalization and for developing functional/social use of skills. Programs that emphasize environmental structure such as TEACCH are most effective for teaching functional routines, fostering generalization and providing structure and predictability in the child's daily routine.
None of these programs alone provide a complete intervention. Using the 3 approaches together in some form may be the most optimal programming for children with Autism. A possible combination is to rely primarily on naturalistic strategies within a structured environment using discrete trial methods to hasten acquisition of certain skills.
In general, the program curriculum is adapted from Teaching Developmentally disabled children: The ME Book (Lovaas, 198 1). Categories include Learning Readiness/Attending skills, Non-verbal/Verbal Imitation, Receptive/Expressive Language, Self-help skills, Academic skills and Social skills all from beginning to advanced levels.
Short-term targets for intervention include mastery of the comprehensive curriculum. Long-term goals are improvements in global (cognitive) measures and freedom from visible signs of autism and integration independently into a classroom setting with typical peers.
|Stimulus presentation ==>||Response ==>||Consequence presentation|
Pivotal Response Training (PRT)
Pivotal Response Training (PRT) ( is another behavioral program that like Discrete Trial utilizes empirically validated methods based on the Principles of Learning. It incorporates the Stimulus ----->Response ~> Consequence paradigm that unlike Discrete Trial emphasizes Child directed activities, Reinforcement of goal directed attempts as well as correct responses, Turn taking, and Direct reinforcement. Because it is easily adapted to any environment at any time PRT is an ideal strategy to be implemented by parents, siblings and peers. PRT shares some ideas of Incidental Teaching (A teaching strategy that relies on naturally occurring opportunities in the environment to promote learning) although it is more structured. Older references to the language component of PRT are labeled Natural Language Paradigm.
Adapted from How To Teach Pivotal Behaviors to Children With Autism: A Training Manual. (1989). By: Robert L. Koegel, Laura Schreibman, Amy Good, Laurie Cerniglia, Clodagh Murphy and Lynn Kern Koegel.
Structured Teaching (e.g. TEACCH: Schopler, Mesibov & Baker, 1982)
Teacch is a program whose principles have been implemented for over 20 years. It is wen adapted to classroom use as it promotes independence in students. TEACCH is designed to improve environmental adaptation. This is accomplished through structured teaching by a) modifying the environment to accommodate the child with autism's individual needs and b) by teaching specific skills
The 4 components of structured teaching are: