Parents are always researching the best therapies for their children on the spectrum. In doing so, one of the first options that comes up is likely to be ABA therapy for autism. This approach is designed to help children build life and social skills while adapting to challenging behaviors.
However, ABA therapy for autism has become a hot topic in the autism community, with much controversy around its approaches. In this special guide, we discuss everything you need to know so you can make an informed choice about ABA therapy for your family.
What is ABA therapy for autism?
Applied Behavior Analysis (ABA) is a therapy method often used for children with autism. It modifies behavior using positive reinforcement and states that desired behaviors can be developed using a rewards-and-consequences system.
In this method, a therapist identifies and sets a goal for the child to develop a target skill or behavior and measures their progress throughout the therapy period.
ABA is generally considered the most common therapy for children with autism. It is thought to be the most established and well-documented approach due to its scientific and systematic nature.
To date, Applied Behavior Analysis is reported to be one of the most effective treatments for autism, as parents and specialists see significant improvement in the child’s behavior.
How does ABA therapy work?
ABA therapy focuses on teaching or modifying behavior using rewards and consequences. It typically begins with a behavior analyst observing your child to identify areas for improvement.
Once a challenging behavior is identified, the therapist creates a strategy using the principles of ABA to shift it into the “target behavior.”
ABA therapists might use the ABC approach when understanding your child’s behavior and applying strategies to modify it. ABC stands for Antecedent, Behavior, and Consequence.
Broken down, this means:
- Antecedent: The event that happens before the behavior
- Behavior: The child’s behavior
- Consequence: The event following the behavior
You’ve probably heard of the ABC autism therapy. However, the ABC method is used before therapy to understand how a child behaves prior to treatment. It is then used to change or adjust the antecedent to achieve the target behavior.
Example of ABA therapy for autism
For example, Applied Behavior Analysis therapy can help a child who throws a tantrum when interrupted while playing. The antecedent is the child focused on their play.
A therapist might use the ABC approach in this way:
- Antecedent: The therapist tells the child that they can play for two more minutes, but they need to put the toys away when time is up.
- Behavior: The child stops playing after two minutes and packs the toys away.
- Consequence: The therapist rewards the child verbally (“Great job!”) or with a physical gesture (high five, thumbs up).
The consequence can change if the child does not behave the way they were expected to behave. For example, the consequence could be simply taking away privileges like screen time or playing video games.
What are everyday examples of ABA?
ABA is used in everyday life to teach new skills and improve behaviors. For example, a child might be taught to greet others by saying “hi.” A therapist can encourage this by rewarding the child with a sticker or praise when they do it.
ABA also helps reduce problem behaviors, like tantrums, by teaching a child to ask for something with words or a picture card instead of crying or yelling. In communication, a child might be encouraged to say, “I want juice,” rather than pointing to the cup.
ABA also supports social skills, such as taking turns in a game where a child is praised for waiting patiently. By using positive reinforcement, ABA helps children with autism learn new skills and behaviors that they can use in daily life.
What does an ABA therapist do?
To give you a bigger picture, an ABA therapist might do the following:
- Identify challenging or undesirable behaviors: For example, this could include behaviors like tantrums, self-harm, or difficulty following instructions.
- Plan a strategy and establish specific goals: Goals might focus on reducing a challenging behavior or teaching a new skill.
- Create a system to measure changes and improvements: This often involves tracking the frequency of behaviors or how quickly new skills are learned.
- Assess and record the current status or progress: Detailed observations help determine whether the approach is working or needs adjustment.
- Teach new skills and/or lessen challenging behaviors: For example, a therapist might teach a child to use words or gestures to communicate needs.
- Determine if further behavior modification is necessary: Based on progress, the therapist decides whether to continue, adjust, or end certain interventions.
The goal of ABA therapy is to lessen or completely remove a specific challenging behavior or teach a new skill. In some cases, it is used to reduce violent and self-harming behavior in children.
Common methods used in ABA therapy for autistic children
ABA therapy uses different methods to help autistic children build skills and change behaviors. These approaches are customized to the child’s needs and can be used in clinics, schools, or at home.
Each method is designed to meet specific developmental goals. Below are some common ABA techniques.
Discrete Trial Training
Discrete Trial Training employs the ABC approach to modifying behavior and/or teaching new skills. This method is used in clinical, one-on-one sessions, where tasks are broken down into smaller steps to help the child understand and follow instructions.
Incidental Training
Incidental training has the same goal and approach as DTT, but it can be done outside a clinical setting. This method is designed to be implemented in school and at home.
Pivotal Response Training
Pivotal Response Training takes place in the child’s natural settings (school, home, playground). This strategy is less structured and more focused on using the child’s interests in teaching skills.
The idea behind pivotal response training is that four key areas are essential to a child’s development:
- motivation,
- self-initiation,
- self-management, and
- responsiveness.
Goals of ABA therapy for autism
Applied Behavior Analysis aims to minimize challenging behaviors and enhance social, emotional, and communication skills in children with autism. These goals are tailored to each child’s needs and focus on building skills that improve their quality of life.
In general, goals include:
- Increase social interaction with others: For example, teaching turn-taking during play or initiating conversations.
- Improve communication skills: This might involve using verbal requests, sign language, or communication devices.
- Enhance focus on academic tasks: Strategies like breaking tasks into smaller steps or using visual aids can help improve attention and task completion.
- Lessen or extinguish self-injurious behaviors: Techniques such as teaching alternative behaviors or addressing triggers are used to reduce harm.
- Lessen tantrums or other outbursts: ABA therapists often teach children to express emotions or needs in healthier ways to reduce frustration.
ABA therapy follows a systematic and scientific approach and can sometimes be repetitive, which can provide the structure that most children with autism prefer.
The strategies applied in therapy can also be accomplished outside of the treatment center. Therapists can train clients to continue ABA strategies at home, in school, or at other outdoor venues and events.
Where to find ABA therapy near you
Ideally, ABA therapeutic services are provided by board-certified behavior analysts (BCBAs). These professionals undergo Applied Behaviour Analysis training and certification before they can practice.
In some treatment centers with limited BCBAs, therapists and registered behavior technicians (RBTs) can provide sessions under the supervision and training of a BCBA.
There are also a number of other considerations, which we covered in our guide on how to choose an ABA provider.
The best person to ask for a recommended therapist would be your child’s pediatrician or doctor. You can also discuss or ask any questions you might have about ABA.
Another way to find a behavior therapist in your area is to go to Google.com and type in “best ABA therapy near me,” or you can visit the BCBA registry website to find a therapist near your location.
How to prepare for an ABA session for autism
Before starting therapy, you may want to go through some checklists to ensure that you are prepared for ABA and getting the best treatment for your child.
To help you prepare for your child’s first visit, you can do the following:
- Have a support system: Inform family members of this treatment plan and ask for their support.
- Have a “therapy” space at home: Have a dedicated spot for carrying out ABA treatment sessions at home.
- Prepare your child: Establish routines and structure with your child. When this is done, they will be more likely to do well during ABA therapy.
- Learn more: Read as much as you can about ABA, how it works, and the many ways you can implement its strategies at home.
Cost of ABA therapy: Main questions to ask
ABA is not cheap. In fact, one ABA session can cost an average of $120. Fortunately, Applied Behavior Analysis is covered by most insurance plans.
It is covered by Medicaid for children under 21 years old and with a doctor’s recommendation. Note that this policy may vary according to where you live.
Before choosing an ABA therapy center, you can ask these questions first to help you make an informed decision:
- What type of insurance do you accept?
- How many applied behavioral therapists and BCBAs do you have?
- How many therapists will be working with my child?
- How do you manage safety concerns?
- How do you determine the goals for my child? Do you consider input from parents?
- How is progress evaluated?
- How many hours per week can you provide?
- Do you have a waiting list?
ABA is not for every child on the spectrum. It is, therefore, your responsibility to do proper research and talk to professionals before choosing this treatment for your child.
Controversy about ABA therapy
Despite its popularity, ABA therapy has faced criticism from parents and advocates. Some believe that certain practitioners use strategies that are seen as inhumane and disrespectful.
This conduct started in the 1960s when clinical psychologist Dr. Ole Ivar Lovaas created Discrete Trial Training. This method involves treating people with autism based on the principles of ABA.
Dr. Lovaas used positive reinforcement to reward good behavior. However, he also applied harsh methods even to severely impaired patients.
Thankfully, harmful and painful negative reinforcement is no longer being practiced in ABA therapy today. Instead of punishment, some ABA therapists might take away privileges or withhold a desirable object from the child when they don’t act out a target behavior.
Another criticism of Applied Behavior Analysis is its tendency to be repetitive, which might be considered tiresome and disrespectful to the child being treated.
This might have been true in earlier instances of ABA. Nowadays, however, certified behavior analysts and therapists are trained to be energetic, creative, and spontaneous when interacting with children.
Lastly, some ABA therapists focused too much on eliminating undesirable behavior rather than redirecting children into the tasks that they should be doing. It goes back to Dr. Lovaas’ ideals that autistic children act the same way as their neurotypical peers rather than accepting neurodiversity.
ABA therapy and autism today
Today, the majority of ABA practitioners have acknowledged the method’s early faults. They have adjusted it to be more flexible and respectful of each child’s learning and developmental capacity.
If you are concerned that Applied Behavior Analysis therapy might not suit your child, be ready to ask questions and bring up these concerns directly to an ABA specialist. They will help you come up with your assessment.
If you do decide to start ABA therapy, make sure to monitor each session and keep up with your child’s progress.
FAQs
Q: What does ABA therapy do for autism?
A: ABA therapy focuses on improving specific behaviors and skills in individuals with autism through positive reinforcement. It helps increase desired behaviors while reducing challenging ones, promoting independence and social skills.
Q: What is an example of ABA therapy?
A: An example of ABA therapy is using a reward system to encourage a child with autism to engage in eye contact during conversations. The therapist may offer a preferred toy or praise as a positive reinforcement when the child successfully makes eye contact.
Q: At what age is ABA most effective?
A: ABA therapy is most effective when started at a young age, ideally before 5 years old. Early intervention helps shape developmental milestones and can lead to better outcomes in social, communication, and adaptive skills.
Q: Who can benefit from ABA?
A: Individuals with autism spectrum disorder, from young children to adults, can benefit from ABA therapy. It is also effective for people with varying levels of functioning, from those with severe challenges to those with mild symptoms.
Q: How long should an ABA session last?
A: ABA sessions typically last between 1 to 3 hours, depending on the individual’s needs and the intensity of the therapy. Sessions may vary in duration, with some programs requiring multiple sessions per week.
References
Yu, Q., Li, E., Li, L., & Liang, W. (2020). Efficacy of interventions based on applied behavior analysis for autism spectrum disorder: a meta-analysis. Psychiatry investigation, 17(5), 432. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265021/
Vančová, A., & Nagyová, K. (2019, September). Applied Behavioral Analysis Therapy in Special Education Practice. In CBU International Conference Proceedings (Vol. 7, pp. 686-692). http://ojs.journals.cz/index.php/CBUIC/article/view/1438
Lanovaz, M. J., Argumedes, M., Roy, D., Duquette, J. R., & Watkins, N. (2013). Using ABC narrative recording to identify the function of problem behavior: A pilot study. Research in Developmental Disabilities, 34(9), 2734-2742. https://www.sciencedirect.com/science/article/pii/S0891422213002308
Leaf, J. B., Cihon, J. H., Leaf, R., McEachin, J., Liu, N., Russell, N., … & Khosrowshahi, D. (2022). Concerns about ABA-based intervention: An evaluation and recommendations. Journal of autism and developmental disorders, 52(6), 2838-2853. https://link.springer.com/article/10.1007/s10803-021-05137-y
Wilkenfeld, D. A., & McCarthy, A. M. (2020). Ethical concerns with applied behavior analysis for autism spectrum” disorder”. Kennedy Institute of Ethics Journal, 30(1), 31-69. https://muse.jhu.edu/pub/1/article/753840?utm_source=jhup&utm_medium=blog&utm_campaign=2022top25&utm_content=JHUP
Eckes, T., Buhlmann, U., Holling, H. D., & Möllmann, A. (2023). Comprehensive ABA-based interventions in the treatment of children with autism spectrum disorder–a meta-analysis. BMC psychiatry, 23(1), 133. https://link.springer.com/article/10.1186/s12888-022-04412-1
Gitimoghaddam, M., Chichkine, N., McArthur, L., Sangha, S. S., & Symington, V. (2022). Applied behavior analysis in children and youth with autism spectrum disorders: a scoping review. Perspectives on behavior science, 45(3), 521-557. https://link.springer.com/article/10.1007/s40614-022-00338-x
