If you’ve heard of ABA, or applied behavioral analysis therapy, then you might have heard of the concept “antecedent interventions”. But what does it mean?
Well, the aim of ABA therapy itself is to help individuals with autism spectrum disorder learn to communicate better, increase self and situational awareness, improve self regulation, and alter atypical behaviors into behaviors that are more functional, thus improving the quality of life. ABA therapy can be used with anyone in any type of environment, however ABA is most commonly used with children who are diagnosed with autism spectrum disorder who have challenging behaviors.
Autism professionals agree that: “Although there are interventions that may be effective in alleviating some symptoms and improving skills that help autistic persons lead more productive lives, proven benefits were observed only with applied behavioral analysis (ABA) and some psychopharmacologic agents,” (Medavarapu, Marella, Sangem, & Kairam. 2019).
ABA strategies, when used well, can help a child with challenging behavior with interventions that use reinforcement to decrease negative or undesired behaviors and change them into a preferred behavior or activity. The strategies of ABA can help parents, a teacher, and other caregivers who may feel that their child with ASD is out of control or consistently makes undesirable choices.
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ABA Therapy for Autism
To really understand the idea of antecedent interventions, we need to wrap our heads around the ABA model of ABA.
ABC model of ABA
The ABCs of ABA therapy include Antecedent (what happened prior the behavior), Behavior (what the problem behavior is), and Consequence (what happens after the behavior).
Using the ABCs of applied behavior analysis allows parents, caregivers, teachers, and therapists to get an idea of why certain behaviors are happening and how the antecedent can be altered using antecedent intervention to change the function of the following behavior and consequence.
“The ABC shows promise as an instrument for identifying children with autistic disorders, both in clinical and educational contexts” (Marteleto & Pedromonico 2005). The ABC model can help identify the reasons why problematic behaviors happen so that antecedent intervention strategies can be used to increase preferred behaviors.
Types of antecedents
Antecedents can be positive or negative. Children with ASD will engage in a variety of daily habits and choices that affect the events of their day. A positive antecedent would be the child receiving a reinforcement or engaging in preferred activities. An example of this in a more common and realistic setting could be surprising the child with tickets to a favorite show. The behavior that follows would be full of joy and excitement. The consequence, or what happens after the behavior, could be the child hugging the parents with gratitude for an unexpected and exciting gift.
Negative antecedents can trigger maladaptive behaviors in children with ASD. An example of a negative antecedent could be a student in school where a teacher announces to the class that they will be having a pop quiz. The negative behavior occurs directly after the presence of the antecedent. The student might try to run out of the classroom or hide in an attempt to avoid having to participate in the pop quiz. The consequence could result in a panic attack, shouting at the teacher, crying, or a trip to the principal’s office.
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Strategies for antecedent interventions
Antecedent strategies are ABA based interventions that work on modifying the environment so that the behavior or activity that occurs that is less desirable will occur less.
“Parent training interventions for children with a diagnosis of or suspected ASD may be classified based on their theoretical paradigms or their targeted goals” (Beaudoin, Guillaume, & Couture. 2014).
All behavior serves a function and learning what the function is will help you understand why behaviors are happening or occurring. Modifying behavior and making positive changes can be challenging, especially if the child is seeking attention. Helping children to understand expectations can help modify behaviors in children with autism or ASD.
Letting children make choices can help with behaviors at home and in the classroom. Allowing children to make choices helps them feel like they are in control, even when we are modifying the environment. An example of allowing a child to make a choice could be seen in the following example:
A child does not want to go to school so the child is refusing to get dressed. Instead of the parent pleading with the child to get dressed, which only reinforces the negative behavior, the parent will use antecedent intervention.
Knowing the child gets upset when it’s time to get ready for school, the parent can use offering choices as part of their antecedent interventions: “It’s time to get dressed for school. Would you like to wear the black or brown shoes today?”
Allowing the child to make a choice changes the environment using ABA based interventions and strategies and the behavior and function is now altered. In this example, the antecedent (what happened prior to the behavior) is the child having to get dressed for school. The behavior was avoidance and noncompliance until the intervention strategy of offering choices was used to modify the behavior to choosing what shoes he/she wants to wear that day. The consequence (what happened after the behavior) was modified from avoidance and escape to putting on his/her shoes that he/she got to choose.
Prompting is another antecedent intervention used in ABA therapy to modify behaviors. Prompting can be verbal or physical and directs the child’s attention to make the right choice.
An example of prompting could be used when a teacher or parent tries to get the student or child to wash his/her hands after eating a sticky snack. A verbal prompt could be when a teacher says: “Your hands are so sticky! What do we do when our hands are sticky?” The child’s focus is redirected to the task at hand and the verbal prompt helps him/her remember he/she is supposed to wash their hands, but allows him/her to come up with the correct choice or answer on their own.
A physical prompt could be a teacher pointing to the sink as visual support to remind the child to wash his/her hands. In this example, the antecedent was having a snack which caused the child’s hands to get sticky. The behavior was washing his/her hands. Prompting was the antecedent intervention used to prevent negative behaviors and helped to direct the child into making the correct choice and staying focused on completion of that task. The consequence (what happened after the behavior) was the child washed their hands and received positive reinforcement and praise for their positive change in behavior.
Antecedent interventions are used to help modify or alter behavior for students or children with ASD that have difficulties with expectations and emotional control and self-regulation.
Common challenging behaviors can be overcome in the classroom and at home with contingency planning that uses antecedent strategies and intervention. Using schedules can help give students predictability in their environment and can likely reduce occurring atypical behaviors so that students have an understanding of what expectations are and how to follow through with a strategy in place.
Beaudoin, A., Guillaume, S., & Couture, M. (2014). “Parent Training Interventions for Toddlers with Autism Spectrum Disorder”, Autism Research and Treatment, vol. 2014, Article ID 839890, 15 pages, 2014. https://doi.org/10.1155/2014/839890
Medavarapu, S., Marella, L. L., Sangem, A., & Kairam, R. (2019). Where is the Evidence? A Narrative Literature Review of the Treatment Modalities for Autism Spectrum Disorders. Cureus, 11(1), e3901. https://doi.org/10.7759/cureus.3901
Marteleto, M., & Pedromônico, M. (2005). Validity of Autism Behavior Checklist (ABC): preliminary study. Brazilian Journal of Psychiatry, 27(4), 295-301. https://doi.org/10.1590/S1516-44462005000400008