“Applied behavior analysis is the science in which the principles of the analysis of behavior are applied systematically to improve socially significant behavior and experimentation is used to identify the variables responsible for behavior change.” (Cooper, Heron & Heward, 2007).
The intervention process of ABA is guided by the child's learning pattern and current level of functioning. Skills are identified and then taught. As the child progresses through each program, assistance (prompting) is provided and systematically reduced (faded) until the child demonstrates independence. As simple skills are acquired (mastered), the child is then taught to combine them into more complex behaviours, and to use these skills in a variety of settings and with a variety of people (generalization).
The child’s progress through the program is regularly documented. Data recording provides continuous records of the child’s progress, and enables precise “fine-tuning” of teaching procedures. The main goal of ABA is to give children with autism the prerequisites necessary to learn naturally from the environment, through explanation, modelling, and other appropriate cues available in the situation.
The core of ABA is that almost all recurring human behaviour is maintained by the events immediately following that behaviour. Skills are broken down into small steps and each step is taught using a combination of repetition and rewards. This can be broken down as follows:
Antecedent (what happens before) + Behaviour = Consequence (What happens afterward) or simply A + B = C.
A = you need to cook dinner
B = you try a new recipe
C = your family is impressed and tells you how good it tastes
You are more likely to make this recipe again due to the praise than if your family told you it tasted badly.
Transferring this to ABA to teach a skill might look like this:
A = Therapist asks the child “What sound does a cow make?”
B = Child answers “moo”
C = Therapist praises child and might give a reward such as a small piece of candy (reinforcer)
These rewards, or reinforcers, are removed (or “faded”) over time; leaving only verbal praise delivered after a correct response/behaviour in the same way you would praise a typically developing child. The idea is that pairing the verbal praise with rewards like treats, and trinkets in the very beginning makes the verbal praise become motivating for the child.
Generally, ABA for children with ASD consists of a tremendous amount of structure with high concentrations of reinforcement while using specific teaching techniques. Data is collected so that we know when a skill is learned or mastered. The most important job of the parent in ABA is to learn to provide your child with lots of opportunities to take the skills learned in a clinical setting and transfer these into your their everyday life.
Any action (desirable and undesirable) that can be seen or heard
It must be observable
Behaviour is not:
ABA treatment can be generally classified within two categories: comprehensive ABA and focused ABA. Based on your goals and the results of your assessment, your clinical team will make a recommendation on what type of program is most appropriate for your child and youth. Remember that all ABA programs should have a parent and caregiver training component so your child or youth can practice skills at home and in the community.
The following section is taken from the Behavior Analyst Certification Board ABA guidelines for ASD.
Focused ABA refers to treatment provided directly to a child or youth for a limited number of behavioral targets. Focused ABA plans are appropriate for individuals who need treatment only for a limited number of key functional skills or who present with challenging behaviour that is a priority goal. Parent and caregiver training is a key component to focused ABA treatment, in order to successfully generalize and maintain skills in a client’s natural environment, and support family and caregivers in managing challenging behaviours (BACB 2014).
Comprehensive ABA targets skills across multiple developmental domains, such as cognitive, communicative, social, emotional, and adaptive functioning. Challenging behaviors, such as noncompliance, tantrums, and stereotypy are also typically the focus of treatment.
Although there are different types of comprehensive treatment, one example is early intensive behavioral intervention where the treatment goal is to close the gap between the client’s level of functioning and that of typically developing peers. Initially, this treatment model typically involves 1:1 staffing and gradually includes small-group formats as appropriate.
Comprehensive treatment may also be appropriate for older individuals diagnosed with ASD, particularly if they engage in severe or dangerous behaviors across environments. Parent and caregiver training is essential to this model in order to generalize and maintain new skills, in addition to managing problem behaviour (BACB 2014).
Individuals with ASD would usually learn things in a particular order. A typically developing child might be able to anticipate enough to be able to skip steps. This is why it is of utmost importance to address any missing skills in an ABA program.
Some parents and professionals are concerned that ABA results in robotic behaviour. The apprehension exists because during the actual teaching, the skill is automatic and certainly do not look natural. Due to learning difficulties, certain elements that are present in all learning must be greatly exaggerated and highly structured (examples include clear and specific instructions for tasks that are required of the child; clear and specific programming material; distraction-free teaching environments). With proper teaching and follow-through, the generalization of the responses and behaviour become far more natural over time (examples include more varied instructions and programming materials).
Curricular assessments are used in ABA treatment to identify a child/youth’s areas of strength and need, in addition to barriers that the child/youth is experiencing. Your clinical team may use one or more of these curricula, in conjunction with other information sources to get a better understanding of your child/youth’s skill level.
The following are some examples of curricular assessments commonly used in ABA programs for children and youth with ASD. Please note this is not an exhaustive list and your team may choose to use other assessment tools based on your child/youth’s specific goals and skills. Select the link to read more information about the assessment.
An ABA program should address the core features and characteristics of ASD (i.e. social skills, communication, and repetitive patterns of behaviour), as well as any barriers to learning (i.e. challenging behaviours, stereotypy, etc.). The goals in each area should be highly individualized for each child's developmental level as well as their learning strengths and weaknesses.
Programming should also consider transition planning to prepare the child for the next learning environment (example of transitions include home to daycare, daycare to primary school, primary school to high school, high school to a community-based program etc.) Knowledge of typical child development is also crucial in providing a guideline for intervention in the areas. The following areas have been identified as essential to meeting the needs of young children with ASD. Depending on your child or youth’s needs, you may target all of these domains at once or you may target a few priority domains at a time.
The following domains are commonly targeted within ABA programming,
A common feature of ASD is how difficult the child/youth finds it to interpret and prioritize the various external and internal stimuli continually bombarding them (for example, a fly buzzing around the room; internal perseverative thoughts such as recitation of math facts; tags on clothing). As a result, many of children with ASD can exhibit the following:
Variable attending skills: The child demonstrates attending skills that vary significantly depending upon his interests. For example he attends well to what is interesting or "makes sense", such as the computer, videos, puzzles, etc., but attends poorly to large group listening activities.
Difficulty in shifting attention from one stimulus to another: For example, if the child is engaged in a visual perceptual task of putting a puzzle together, he may not be able to shift his attention to focus on a verbal instruction given by the teacher.
Difficulty attending in situations where there are multiple stimuli: Because the child with ASD has significant difficulty shifting attention, as well as prioritizing stimuli, attending to the "essential information" is challenging. For example, if the child's focused attention is on sitting appropriately in a small group setting, he may not be able to focus on the information being taught by the teacher.
Imitation is a critical developmental skill for children with ASD. Learning throughout life relies on the ability to imitate, and the ability to imitate impacts learning in all areas, including social skills, life skills, and communication. Various imitation skills must be identified and directly taught to the child with autism. These may include:
Children with ASD exhibit significant communication difficulties in their ability to comprehend and express language appropriately. Many children at the early intervention level, have not learned the "power" of communication; that is, that communication is valuable and needs are met with communication. They have not developed the "intent" to communicate or the understanding that a listener is required for communication. Some children will try to obtain the desired item or activity themselves and not seek out others for assistance. Children with ASD have difficulty understanding that communication is an intentional exchange of information between two or more people. In order to teach this intent to communicate at this early intervention level, many children with ASD must be "tempted" to communicate by using their highly desired objects and actions (e.g., the therapist plays with the child’s favourite toy and the child learns to ask for the toy). Therefore, early on in programming, it is crucial that these most valued items and activities be reserved for programming so that the child remains highly motivated to communicate for these things.
Children with ASD exhibit marked difficulty engaging in appropriate play skills with toys often due to repetitive and stereotyped patterns of behaviours that interfere with play. Appropriate play skills with toys and play with peers will need to be specifically and directly taught to children with ASD.
Play skills that may be taught in an ABA program include:
A core feature of ASD is difficulty understanding and engaging in social interactions. At the early intervention level, children with ASD typically exhibit significant difficulty engaging in social play with peers. Social play skills that may be taught in ABA programs include:
Parallel/proximity play: The child plays independently beside, rather than engaging with, the other children. There is simultaneous use of the same play space or materials as peers.
Cooperative play: The child engages in activities directly involving one or more peers, including turn-taking; giving and receiving assistance and directives, and active sharing of materials. There is a common focus across children during play.
Typically developing peer models are essential to facilitate developmentally appropriate social and play behaviour in children with ASD.
Positive reinforcers are rewards used in ABA for correct responses in learning a skill, gaining compliance, or in reducing challenging behaviours. A reward given after a desired response or behaviour will help to increase the chances that the child will engage in that desired response or behavior again in the future under similar conditions. Reinforcement ALWAYS increases the likelihood that the child will engage in the behavior again in the future. When reinforcing with a tangible item (something edible such as food or something concrete like a toy) be sure to pair with verbal praise and social interactions, such as tickling (social reinforcers) so your child learns these are also good things. This will help in fading the tangible reinforcers, which should be done as quickly as possible.
Many individuals with ASD have restricted or limited interests which can make finding items and activities to use as reinforcers challenging at times. In addition, many individuals with ASD have fleeting motivation, which simply means, that from moment to moment, or day to day, their desire to have items that are presumably highly preferred comes and goes. Therefore, it is imperative to identify a variety of items and activities that can be used as potential reinforcers for programming so that these items and activities can be changed up from moment to moment as the child’s motivation fluctuates.
Tangible: foods, drinks, toys, tokens, stickers, certificates and money. When frequent learning opportunities are required, it may be useful to limit access to the reinforcer by providing small amounts of it or short periods of time with it to increase the likelihood that the child will continue to want it.
Activity: favourite games and activities (biking, book, music, TV, toys, iPad, computer, free time). When frequent learning opportunities are required, keep the activity time to a few minutes to help maintain interest in it.
Social: praise in the form of words (verbal), physical contact, or gestures (examples: “nice quiet voice”, hugs, pats on the back, smiles, and thumbs up). Social rewards can be effective as they can be given immediately and in any location.
REMEMBER, a reinforcer will help a child learn both desirable and undesirable behavior. If you do not give your child the toy he or she is having the tantrum to access, you decrease the likelihood that your child will engage in a tantrum the next time they want a toy in the store. If you do give your child the toy following the tantrum, they may engage in a tantrum the next time they want a toy because it worked and got them what they wanted the last time.
There is also negative reinforcement, which is to take away something that the child does not like. For example, “You may leave class after circle time”. The reward for staying during circle time is that the child may leave the room (which is what he wants).
In conclusion, positive reinforcement adds something desirable to the environment; negative reinforcement removes something undesirable from the environment. Both can be rewards for completing a desired task, and they both increase the probability of that behaviour occurring again.
A prompt is a cue or a hint given to the child to help them complete a task or behaviour correctly. An example of a prompt might be gesturing to the correct item during choice-making trials, or even taking your child’s hand and guiding them to the correct item (hand-over-hand).
Prompts are used to teach the child a skill. When teaching commences, the child may have no idea of what is expected. Guiding (prompting) the child to the correct response repeatedly in the beginning, then reinforcing this correct (prompted) response will help the child experience success, reduce frustration, and associate the reinforcers including praise with the response being taught.
When you make your request, for example, “touch head”, the response should be evident within three to five seconds. If it takes longer, intervene with a prompt.
Prompts come in different levels, from most (used at the beginning of teaching a skill) to least. Some different prompts are:
The type of prompt you use depends on the skill you are teaching as well as the child’s tolerance of the prompt type. For example, you wouldn’t typically use a verbal prompt when teaching “touch head”, unless you are making an encouraging comment like “keep going!”
Prompts are not delivered in a rough or forceful manner; they are meant to be gentle guidance!
Your goal is always to have your child produce the correct response independently. If you have more than one person working with your child it is important everyone knows what level of prompting you are using. This ties in to taking data. If you have four individuals working with your child and three of them are getting a 40% correct rate, while the fourth is getting 90%, it could be that the fourth person is using a stronger prompt than the others.
Decide (beforehand) how much prompting is needed if there is no experience with the skill, start with the highest prompt level (for example, hand-over-hand). You should always use the least intrusive but most effective prompts where possible. Prompts should be faded as quickly as possible, to avoid “prompt dependency”. It should always be clear to all therapists involved what the prompt level is every day. This is one of the items you would be discussing at your regular staff meetings.
Once a skill is mastered, it should be revisited regularly. When the entire program is mastered, it goes into maintenance, and maintenance programs are reviewed as often as your child needs. Some children require maintenance once or twice per week, others only need it monthly.
Data collection is the basis for all decision making in ABA programs. Data ensures objectivity and allows you to compare teaching effort and learning accomplished. Data also provides accountability in the intervention, showing clearly whether or not progress is occurring. If progress is not occurring as expected and as indicated by the data, teaching strategies and program goals should be modified. Data collection methods will vary by service provider and supervising clinicians but some examples of data collection methods include trial by trial data, probe data, and frequency counts. Regardless of the type of data being collected, all data should be summarized in a graph to allow for a visual analysis of progress. Graphs allow for clinicians to quickly evaluate whether or not the child is learning a particular skill or a challenging behaviour is reducing as expected.
Children with ASD may sometimes exhibit a behaviour or skill only in the context that it was taught. Generalization is a term we use to describe the process of taking a skill your child learns in a clinical setting and applying it to everyday life. Generalization occurs when a learned behaviour or skill is performed in a novel context without having to be trained (e.g., your child says “hello!” to a child at the park, after learning to say “hello” in the therapy setting), or when a new form of the behaviour occurs without training (e.g., your child is taught to say “hello”, and later responds with a variety of related responses (e.g., “hi”, “hey”). We can assist with generalization by encouraging the child to use a skill across environments, behaviours, and time. When skills are being generalized, they are typically being taught in the context in which they would occur in “real life” so there is meaning. For example, if your child has learned to respond with their name when asked “what’s your name” in their ABA program, it would be expected that he/she would respond to their name when asked by others in their natural environment. Your child must not only be able to execute a skill during programming, but also at pre-school, grandma’s house, the next door neighbour’s, the park, and on and on. Generalization teaches your child to apply what they have learned in other settings and with various people.
When teaching life-skills (like brushing teeth), generalization happens naturally. After all, your child will be brushing his or her teeth at least twice per day in a natural setting. You may be surprised at how quickly the skill will be taught and generalized in this setting.