There is confusion and controversy regarding Applied Behavior Analysis (ABA), particularly when used as a comprehensive treatment for individuals with autism. Applied Behavior Analysis within the autism community is endorsed by many and criticized by others. It is a topic that evokes passion and emotional responses because of the perceptions, sometimes inaccurate, of how ABA is practiced and used. It is confusing for parents/caregivers who are trying to determine treatment options and select providers for their child. In addition, some families and autism self-advocates/individuals with autism/autistics may have experienced or heard of āABAā treatments that are not reflective of best practices, may not focus on individual strengths and preferences, or may have been mislabeled as ABA. It is important for families to ask questions about their treatment priorities when selecting a provider.
What is ABA?
Applied Behavior Analysis (ABA) represents a range of systematically implemented teaching strategies developed from the science of learning and behavior. ABA has been around for almost 100 years and like any science has evolved with knowledge and experience. There is an established and growing evidence-base for the application of behavior analytic strategies in school, home, clinical, and community settings. The practice of behavior analysis includes thorough assessment, which helps to identify skills that enhance quality of life and happiness, as defined by the individual and their family.
What matters most?
Modern and high-quality ABA services prioritize the values and goals of the individual. These programs emphasize meaningful skill development targeted in natural environments and activities, with close collaboration with the individual and their family.
The Autism Society of North Carolina encourages this community to advocate for person-centered behavior analytic services that promote individually determined forms of empowerment, independence, and overall happiness for the individual.
Many fundamental skills and rights are focal points within a modern, high quality ABA program, such as the rights to:
- Be heard and valued
- Express wants, preferences, needs, feelings, ideas
- Reject, terminate, negotiate
- Safety and privacy
- Move oneās body to feel calm
- Leisure opportunities that they enjoy
- Meaningful vocational opportunities
- Social connections that are valuable to the individual
- Seek and receive accommodations, support, validation and understanding
These and many other pivotal rights comprise the broader concept of empowerment.
What does it look like in practice?
ABA is good teaching. Good teaching happens when a learner is relaxed and content. As it relates to autism intervention, good teaching requires understanding of the individualās learning characteristics, viewing challenging behavior through the autism lens first and foremost, and building on strengths and interests. Good teaching involves establishing a strong, positive relationship rooted in collaboration, trust, transparency, and respect between the person with autism and the professional. It involves careful assessment using input from all relevant sources and tools, identifying critical skills and concepts, and breaking those down into teachable parts. For example, when supporting an individual in finding a job, there are many important skills (e.g., building a resume, online searches, interview rehearsal, follow-up contacts) within the process. Each skill is organized and broken down into manageable and understandable steps. As a different example, when a young child is learning how to independently dress themselves, there are many parts to this broader skill (e.g., putting each item on, advocating around clothing preferences, assuring privacy, selecting attire based on weather or situation, etc.). Each part is broken down into steps, and systematically taught over time.
The teaching procedures are clearly defined so that anyone could replicate those (as is true of any scientific approach). Sensitivity to changes in the individualās motivation, affect, and engagement is critical. Learning opportunities occur frequently and are naturally embedded into the places, activities, and routines that are relevant for that individual. For young learners, the āplaceā for learning is in play and natural routines that happen in the childās environments (e.g., the home, the preschool, the playground). Like Fred Rogers said, āPlay is really the work of childhood.ā
Intrinsic motivation and reinforcement strategies strengthen skills and behaviors. Skills and concepts are systematically targeted across environments and across increasingly complex situations to promote generalization. Ongoing observation and data collection, input from and collaboration with team members, and good common sense drive decision making.
Compassion and creativity are essential to behavior analytic teaching. Stakeholders should look for signs of contentment, enjoyment and connection in any program. Teaching through tears and power struggles is not representative of todayās high quality, contemporary ABA. In all cases, the individualās unique strengths and talents should be highlighted, emphasized, and encouraged.
Who is involved?
In modern ABA programs, goals expressed by the individual are prioritized. Parents and caregivers are treated as equal partners when developing the program. Natural supports, such as family members and caregivers, are coached to understand and use effective strategies in their natural routines and interactions with the individual. Modern, high-quality ABA programs aim for strong coordination and communication with all team members, including parents and caregivers, the school-based team, occupational and speech-language therapists, medical providers, etc. In short, it takes a team.
Applied Behavior Analysis is fully compatible with other treatments such as speech therapy, occupational therapy, and other evidence-based practices (EBPs). Several prominent EBPs, including Structured Teaching (TEACCH), Naturalistic Developmental Behavioral Interventions (e.g., the Early Start Denver Model; Pivotal Response Training), and cognitive-behavioral interventions (CBI) are heavily influenced by and work with behavior analytic principles and strategies. This is likely one of the biggest areas of confusion for families and professionals. One evidence-based approach does not have to be chosen over another. These approaches should work well together. Collaboration is the key.
Evidence-based practices ā those that have been shown to be effective through review and research ā such as visual supports, video modeling, social skills interventions, social narratives (including Social StoriesĀ©), peer-mediated interventions, parent-mediated interventions, incidental teaching, and/or exercise, should be integrated within a comprehensive ABA program. Other strategies and curricula, such as Social ThinkingĀ© and Zones of RegulationĀ©, are also used to enhance modern behavior analytic approaches.
Lastly, and most importantly, we at the Autism Society of NC are committed to engaging with and listening to self-advocates/autistics/individuals with autism, families, and other stakeholders to continuously advance the application of behavior analysis within and beyond our organization.
The Autism Society of North Carolina’s Clinical Department can provide a variety of supports for you or your loved one. To reach the Clinical Department, please email clinical@autismsociety-nc.org.
Tags: ABA, Applied Behavior Analysis, ASNC, autism, autism resources, Autism Spectrum Disorder, autism treatment