Applied Behavior Analysis (ABA) is a type of therapy utilized for children with Autism Spectrum Disorder (ASD). There are controversial thoughts surrounding this type of therapy, but it has been researched as an evidence-based practice by The American Psychological Association and various studies.
There are many forms of therapy that offer more holistic approaches and strategies, but from a professional perspective, these therapies still utilize strategies, activities, games and concepts that are frequently included in ABA therapy.
In this article I will discuss successful strategies that therapeutic modalities, including ABA and AIMS, utilize in their programs. To create a practical experience for parents and professionals, I will link each strategy with a way of utilizing it in a child-friendly and adaptive manner.
As the understanding of what our children with autism require evolves, so should the strategies, goals and manner in which we implement.
Top 10 (adapted) ABA therapy techniques:
1. Discrete trial training (DTT)
In ABA therapy programs it is common to expect “discrete trials”, which include specific goals that are broken into smaller parts and asked repeatedly until a child has “mastered” each goal. For example, if you’re teaching a child colors, you will ensure he/she provides a correct answer (or trial) for at least 80% of the time.
Adapted: if a child is interested in a topic, I don’t advocate to utilize discrete trials as it will most likely frustrate the child. If however, your child is not interested in maths and it is a subject he or she has to learn, I would at times utilize a rote memory activity (this is if you have tried to involve the concept of maths first within his or her interests and it is still not a favorite). You can explain to your child, in a manner he/she will understand, that it is a worksheet they need to complete to be able to move on to a fun, interest-based activity. Provide praise and motivation for your child to complete this activity as it will not be one that they will request for repeatedly (excuse the pun).
A strategy that is extremely effective is generalization from one therapeutic setting (such as 1:1 sessions with an ABA therapist, speech therapist, occupational therapist or other) to the home environment (or another environment). Parents often ask therapists how to generalize what their child is learning from therapy to the home environment or during outings.
Adapted: I suggest parents always ask their child’s therapist to provide them with the goals they are working on and ways to generalize this to the home environment as we all know – for any program to be effective we need consistency and our children need practice. Similarly to us wanting to learn a new sport, we need to practice this on a daily basis and in various conditions – not just in an “ideal” therapeutic setting.
3. Natural environment teaching
ABA therapists would suggest DTT at the start of a child’s program and then gradually work towards Natural Environment Teaching (NET). This usually involves taking a child on an outing and teaching the concepts or programs in a more natural location.
Adapted: Ideally we want our children to learn naturally from the start, so adapting an NET program is easy – we can teach our children through their interests “in vivo” (real life scenarios) from a young age or the start of their program. If your child is interested in plants, skip the flashcards and go plant some seeds and grow a vegetable garden with him/her. It will make more sense to your child and I can almost guarantee it will be a lot more motivating for both of you to see the fruits of your work grow in front of your eyes!
When applied behavioral therapists work on increasing communication, they usually introduce a program called “pairing”. This entails the therapist pairing specific sounds with motivating activities. Usually the therapist would pause the activity until the child imitates the sound.
Adapted: A suggestion here to include more opportunities for your child to model the pairing sound would be to ask a speech therapist to help identify the sounds that your child can comfortably say (or work towards). As you know some sounds are easier to produce than others and if you know the sounds that your child is able (or working towards) to say, you can incorporate these as pairing sounds during activities such as blowing bubbles (if your child is motivated by this activity) and not placing any other demands on him/her during this time. I would not suggest pausing the activity as this strategy has the potential to decrease your child’s motivation to engage in that activity, which minimizes opportunities for you to increase spontaneous vocal imitation. I would rather include pairing more often throughout the day to increase the likelihood of your child imitating the sounds. A great idea is also to change the sounds with the specific activities as you don’t want your child to associate one sound with each activity.
5. Prompting and fading
During ABA sessions, you’ll notice that a therapist using prompts (providing assistance) to your child to complete tasks. These prompts might range from physical hand-over-hand prompts to a simple gesture or a visual cue card. We all support our children in completing tasks without feeling frustrated, but we want to ensure we provide processing time before we “over prompt” and encourage a child, unknowingly, in becoming prompt-dependent. Autism therapists also believe in fading their prompts from most invasive to least invasive, which means that ultimately they want the child to complete tasks independently.
Adapted: I would suggest providing your child processing time and the opportunity to try an answer or an activity without receiving a prompt at first. Although we want our children to feel successful, we also do not want to “tell” them what the correct answer is all the time. We do live in a grey world and we want to explore their creative minds and provide that extra bit of time for them to feel comfortable enough to make mistakes or better yet – show us there are different answers to our preconceived ideas. More often than not our children have a different way of thinking of problems and can solve them in ways we might not understand at first.
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Most parents are aware of the term “reinforcement” and will use this strategy in a natural way – when your child acts appropriately, you will reinforce him/her with a “good work” or even including a token economy for a prize or reward. This is a wonderful approach for all children. The issue comes in when interests are used as reinforcers and taken away from your child or only provided in extremely short bouts.
Adapted: Try and involve interest-based activities as part of the learning experience for your child – this way the positive reinforcement is already combined with the activity and your child will most probably be more motivated to engage in the activity, rather than waiting for the short amount of time with their reinforcer.
7. Social stories
Social stories is a specific method to introduce social scenarios to children diagnosed with ASD. It involves a scenario that your child might struggle with and provides a reference on how to react “appropriately” when a novel person or character finds him- or herself in these situations. Although social stories have shown to be quite successful with many children, the idea to depict characters instead of your child, their name and actual events can be reconsidered.
Adapted: I would suggest including your child within the stories and keeping it positive and including many different coping skills and strategies within the social story. Keep it fun and interest-based. Also, ask your child to help create these stories with you as this might increase his or her motivation to want to read (and learn) through it.
8. Video modeling
For a child to imitate sounds, words, actions or games from a video model is a relative novel idea. Children on the autism spectrum have shown considerable progress in their imitation skills by observing characters or people on videos.
Adapted: I would suggest recording your own videos of people that your child knows and playing these videos to him or her. It might also be less invasive if it is mom, dad or grandma dancing on a video than a complete stranger. You can include dance moves, sounds (clearly recording your mouth movements), obstacle courses, yoga routines and plenty more. The goal here is for your child to observe an action and copy or imitate this. Have fun with it!
9. Sensory and movement breaks
During any ABA session in an ABA program, each student is provided specific break activities. They might choose to jump on a trampoline or listen to a song on their iPads. These breaks are crucial and needed for any child or person throughout their day. It is important to remember that during break activities there should not be expectations placed on your child. It is their time to relax and recharge for more fun activities with you or their provider.
Adapted: It is strongly recommended that you offer a “sensory tent” or “sensory corner” that is filled with toys that are safe and comforting to your child. They should have free access to this area and also provided breaks every 15-20 minutes throughout their day (again, without any expectations during these times).
10. Visual schedules and visual choice boards
Visual strategies are important in any child’s program – whether this is a home program, therapy setting or a combination of both. The more ways we can provide our children with subtle and successful cues, the more they will feel supported and less frustrated.
Adapted: There is a plethora of high-quality information on visual schedules and visual choice boards, but the important factor here is to keep it functional, fun and interest-based (again!). Use real photos of activities or sensory input that your child enjoys and keep visual choice boards always readily available. We always want our children to know that there is a way for them to communicate – no matter what mode they prefer on that day.
Like anything in life, there are certain strategies that will ensure the successful implementation of the above techniques:
-Consistency is key
-Clear and concise instructions (keep it simple!)
I believe that you’ll find these techniques will support your child as well as your family. Thank you for being the parent you are and constantly learning and searching for more ways to help your child – in the end, you know which of the therapeutic modalities, treatment and strategies would work best for your child. YOU are the true expert!
A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders: