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.
Applied Behavioral Analysis (ABA)
ABA Therapy - Information on ABA Therepy - What is ABA?  Bright Tots - Information on early childhood development
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