Aba therapy

aba therapy

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)

Similar articles: