Applied Behavioral Analysis (ABA)
Applied Behavior Analysis (ABA) is based on the idea that by influencing a response associated with a
behavior may cause that behavior to be shaped and controlled. ABA is a mixture of psychological and
educational techniques that are utilized based upon the needs of each individual child. Applied Behavior
Analysis is the use of behavioral methods to measure behavior, teach functional skills, and evaluate progress.

Applied Behavior Analysis (ABA) techniques have been proven in many studies as the leading proven
treatment and method of choice on treating individuals with autism spectrum disorder at any level. ABA
approaches such as discrete trial training (DTT), Pivotal Response Training (PRT), Picture Exchange
Communication System (PECS), Self-Management, and a range of social skills training techniques are all
critical in teaching children with autism. Ultimately, the goal is to find a way of motivating the child and
using a number of different strategies and positive reinforcement techniques to ensure that the sessions are
enjoyable and productive.

In all ABA programs, the intent is to increase skills in language, play and socialization, while decreasing
behaviors that interfere with learning. The results can be profound. Many children with autism who have
ritualistic or self-injurious behaviors reduce or eliminate these behaviors. They establish eye contact. They
learn to stay on task. Finally the children acquire the ability and the desire to learn and to do well. Even if the
child does not achieve a “best outcome” result of normal functioning levels in all areas, nearly all autistic
children benefit from intensive ABA programs.

History of ABA Therapy

ABA therapy was first developed in the 1960s by psychologist Ivar Lovaas, PhD, at the University of
California; Los Angeles (UCLA), ABA therapy for autism makes use of the idea that when people affected by
autism are rewarded for a behavior, they are likely to repeat that behavior. In ABA treatment, the therapist
gives the child a motive, like a question or a request to sit down, along with the correct response. The
therapist uses attention, praise or an actual incentive like toys or food to reward the child for repeating the
right answer or completing the task; any other response is ignored.

In a landmark 1987 study, Lovaas found that nearly half (47%) of the children who received 40 hours per
week of ABA therapy were eventually able to complete normal first-grade classes and achieved normal
intellectual and educational functioning by the end of first grade. While none of children who received the
therapy only 10 hours per week were able to do the same.

Other researchers have partially replicated Lovaas's success, among them psychologist James Mulick, PhD,
of Ohio State University, who finds an association between a form of ABA therapy he calls Early Intensive
Behavioral Intervention and improvement in children's IQ scores. Such promising results lead Mulick and
other supporters of intensive behavioral intervention to argue that, despite its expense, it should be available
to all autistic children.

ABA Strategies

ABA therapists work with applied behavior analysis techniques in order to teach children with autism
through intensive one-on-one therapy sessions. ABA can help children with any level of autism spectrum
disorder. ABA therapy works on communication, academic, social and behavioral skills or any other deficits
that a child might have. Specific targets of the interventions are chosen based on the child's individual

problems and disorder. Children with autism often exhibit behaviors such as their unwillingness and a
reduction in these behaviors is often the first intervention target. After behavior problems are controlled, the
intervention aim can shift to dealing with other aspects of autism, such as improving communication and
social interaction. Goals in an intensive behavioral intervention program will also change as the child
improves or when there is a change in the environment.

Treatment is based heavily on functional assessment, information, and family input. Children work on 25
different skill areas that include such skill areas as receptive language, expressive communication, visual
performance, mathematics, and other academic and life learning skills. Behavior modification and
socialization skills are incorporated into a child's program if and when necessary. Therapists use
reinforcement and other behavior modification techniques during the sessions to slowly shape a child's
behavior. The same principles are also used to reduce negative behavior.
 

Basic principles of behavioral and educational intervention approaches

Behavioral therapies include specific approaches to help individuals acquire or change behaviors. All
behavioral therapies are based upon some common concepts about how humans learn behaviors. At the
most basic level, operant conditioning involves presenting a stimulus (request) to a child, and then providing
a consequence (a "reinforce" or a "punisher") based on the child's response.

•        A reinforce is anything that, when presented as a consequence of a response, increases the probability
or frequency of that response. Examples of possible reinforcers for young children may include verbal
praise, or offering the child a desired toy.

•        A punisher is a consequence that decreases the probability or frequency of that response. Possible
punishers for young children may include verbal disapproval or withholding a desired object or activity. The
term "punisher" is a technical term used in behavioral therapy and does not imply the use of physical abuse
such as hitting, slapping, spanking, or pinching.

Reinforcers and punishers are different for each child. Part of operant conditioning approaches is to perform
a functional assessment of possible reinforcers or punishers to determine which are most effective in
shaping a child's behaviors. While all behavioral therapies have some basic similarities, specific behavioral
techniques vary in several ways. Some techniques focus on the prior conditions and involve procedures
provided before a target behavior occurs.

Other techniques focus on the consequence of a behavior and involve procedures implemented following a
behavior. Still other techniques involve skill development and procedures teaching alternative, more adaptive
behaviors. Many different specific behavioral and educational techniques have been used as part of
interventions for individual children with autism. These techniques are effective in a wide body of research
based on a common set of behavioral and learning principles. Behavioral interventions involve the therapist
controlling the activity and/or consequences to shape the child's responses.

ABA Therapy Approaches

A default in social motivation is a characteristic in autism. Children with autism typically lack the motivation
to learn new tasks and participate in their social environment. Some traits you may observe when placed in
social situations are temper tantrums, crying, noncompliance, inattention, fidgeting, staring, attempting to
leave, or unwillingness. The use of ABA therapy can increase the desire in children with autism, therefore,
significantly enhancing the effectiveness of the teaching environment.

Discrete Trial Training


Discrete trial training consists of a series of distinct repeated lessons or trials taught one-to-one. Each trial
consists of a prior, a “directive” or request for the individual to perform an action; a behavior, or “response”
from the person; and a consequence, a “reaction” from the therapist based upon the response of the person.
Positive reinforcers are selected by evaluating the individual’s preferences.

Many people initially respond to recognizable or concrete reinforcers such as food items. These concrete
rewards are faded as fast as possible and replaced with rewards such as praise, tickles, and hugs. Early
intensive behavioral intervention such as the Lovaas program is usually implemented when the person is
young, before the age of six. Services are highly intensive, typically 30- 40 hours per week, and conducted
on a one-to-one basis by a trained therapist in the family’s home.

Parent training is a necessary part of an effective Lovaas-based program. The person’s progress is closely
monitored by the collection of data on the performance of each trial. After a skill has been mastered, another
skill is introduced, and the mastered skill is placed on a maintenance schedule. A maintenance schedule
allows for periodic checking so the person does not regress in mastered skills. Discrete trial training is a
technique that can be an important element of a comprehensive educational program for the individual with
an autism spectrum disorder. In some cases, a much less intensive, informal approach of discrete trial
training may be provided by a knowledgeable professional to teach specific skills such as sitting and
attending.

Pivotal Response Therapy

Pivotal response therapy (PRT), also referred to as pivotal response treatment or pivotal response training, is
a behavioral intervention therapy for autism. Pivotal response therapy advocates believe that behavior
connects primarily on two 'pivotal' behavioral skills, motivation and the ability to respond to multiple cues,
and that development of these skills will result in overall behavioral improvements.

Initially attempts to treat autism were mostly unsuccessful, and in the 1960s researchers began to focus on
behavioral intervention therapies. Lynn and Robert Koegel theorized that, if effort was focused on certain
pivotal responses, intervention would be more successful and efficient. As they saw it, developing these
pivotal behaviors will result in widespread improvement in other areas. Pivotal Response Theory (PRT) is
based on a belief that autism is a much less severe disorder than originally thought.

The two primary pivotal areas of pivotal response therapy involve motivation and initiation of activities.
Three others are self-management, feelings and the ability to respond to multiple signals, or cues. Play
environments are used to teach pivotal skills, such as turn-taking, communication, and language. This
training is child-directed: the child makes choices that direct the therapy. Emphasis is also placed upon the
role of parents as primary intervention agents.

The effectiveness of pivotal response therapies has yet been proven, but ongoing research of its effects on
autistic children is being conducted. Pivotal response training is specifically designed to increase a child’s
motivation to participate in learning new skills. Pivotal response training involves specific strategies such as

•        clear instructions and questions presented by the therapist
•        child choice of stimuli (based on choices offered by the therapist)
•        intervals of maintenance tasks (previously mastered tasks)
•        direct reinforcement (the chosen stimuli is the reinforce)
•        reinforcement of reason for purposeful attempts at correct respond
•        Turn taking to allow modeling and appropriate pace of interaction

Pivotal response training has proven to be a naturalistic training method that is structured enough to help
children learn simple through complex play skills, while still flexible enough to allow children to remain
creative in their play.  The child can be reinforced for single or multiple step play. The therapist has the
opportunity to model more complex play and provide new play ideas on his/her turn. Research indicates that
children with autism who are developmentally ready to learn symbolic play skills can learn to engage in
spontaneous, creative play with another adult at levels similar to those of language-age matched peers via
pivotal response training .

Reciprocal imitation training

A variation on the pivotal response training procedure for teaching play skills is reciprocal imitation training
(RIT). Reciprocal imitation training was developed to teach spontaneous imitation skills to young children
with autism in a play environment; however, this intervention technique has also been shown to increase
pretend play actions. Reciprocal imitation training is designed to encourage mutual or reciprocal imitation of
play actions between a therapist and child.

This procedure includes unexpected simulation in which the therapist imitates actions and vocalizations of
the child. A study found that very young children with autism learned imitative pretend play with an adult
using this procedure and this play generalized to new settings, therapists, and materials. Several of the
children also increased their spontaneous use of pretend play. In addition, the children exhibited increases in
social behaviors such as coordinated attention after reciprocal imitation training, suggesting that both the
imitative and the spontaneous play had taken on a social quality.

Self-management training

Self-management has been developed as an additional option for teaching children with autism to increase
independence and generalization without increased reliance on a teacher or parent. Self-management typically
involves some or all of the following components: self-evaluation of performance, self-monitoring, and self-
delivery of reinforcement. Ideally, it includes teaching the child to monitor his/her own behavior in the
absence of an adult.

This therapy uses a self-management treatment package to train school-age children with autism to engage
in increased levels of appropriate play. In a study children displayed very little independent appropriate play
before training, and typically engaged in inappropriate or self-stimulatory behavior when left on their own.
With the introduction of the self-management training package, the children increased their appropriate play
in both supervised and unsupervised settings, and across generalization settings and toys. Decreases in self-
stimulatory and disruptive behaviors were maintained in the unsupervised environments.

The study shows preschool-age students using self-management training learned new activities using
favorite toys that typically required assisted play. Children were prompted to engage in new behaviors with
the toys, and were asked to take a token whenever they displayed a variation in the target behavior. All the
children exhibited increases in variability of play after self-management training, with the behavior
maintaining at a 1 month follow-up. Self-monitoring procedures have also been used to increase social
initiations while reducing disruptive behavior and to increase independent interactions with typical peers.

Video modeling

Video modeling, like in vivo modeling, uses predictable and repeated presentations of target behaviors;
however, these behaviors are presented in video format, thus reducing variations in model performance.
Video modeling has been shown to improve various skills in individuals with autism, including conversational
speech: verbal responding, helping behaviors, and purchasing skills. This medium has also been claimed to
increase vocabulary, emotional understanding, attribute acquisition, and daily living skills.

Video modeling interventions have used both self-as-model and other-as-model methods. In the first
performance, individuals act as their own models, and the video is edited so that only desired behaviors are
shown. The second and perhaps more essential method of video modeling employs taping other individuals,

typically adults or siblings, performing target behaviors.

Video self modeling has been theorized to be more effective than traditional video modeling because it may
promote increased attention from the individual, although factual studies have not substantiated this claim.
Applications of video modeling as an intervention technique are now being extended to teaching and
increasing play in children with autism.
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