“Applied behavior analysis is the science in which procedures derived from the principles of behavior are systematically applied to improve socially significant behavior to a meaningful degree and to demonstrate experimentally that the procedures employed were responsible for the improvement in behavior” (Cooper, Heron & Heward, 1987).
The intervention process of ABA is guided by the student's learning pattern and current level of functioning. Skills are targeted 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 (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 they told you it tasted bad.
Transferring this to ABA to teach a skill might look like this:
A = Worker asks “What sound does a cow make?”
B = Child answers “moo”
C = Worker praises child and might give a reward such as a small piece of candy (reinforcer)
These rewards, or reinforcers, are removed (or “faded”) quickly; leaving only verbal praise delivered in the same way you would praise a typically developing child. The idea is that pairing the verbal with rewards like treats, trinkets and “high-fives” 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 generalize these learned skills into your child’s everyday life.
Any action (desirable and undesirable) that can be seen or heard
Behaviour is not:
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 of the skill, the response is automatic and certainly does not look natural. Due to learning difficulties, certain elements that are present in all learning must be greatly exaggerated. With proper teaching and follow-through, the generalization of the responses and behaviour become far more natural over time.
The purpose of an ABA program is not entirely to teach your child individual skills, but to teach him or her how to learn. In a successful program, your child’s brain changes, and he or she learns to learn in the style of his or her typically developing peers. As teaching progresses, the learning becomes more natural.
Whether you decide on home programming run by yourself, receive funding through the Ontario IBI Program for Preschoolers, or use a private ABA provider, you need the following:
A recent psychological assessment to establish what needs to be taught (for example new skills and missing skills).
An understanding of your child’s developmental age (even though your child may be able to multiply, he or she might be missing prerequisite skills like matching, so matching needs to be taught).
The knowledge that your child may have to learn skills that are generally appropriate to a much-younger child; often, children with ASD have uneven development.
The knowledge that proficiency in one particular area does not indicate your child’s skill level reaches that developmental age in general.
You also need:
Programs (including implementation), prior agreement of prompt levels to use for each program amongst all staff members and reinforcers
Someone to write the programs (such as private ABA provider, etc. – if you are not comfortable with doing this yourself)
Program binder, data sheets, graphs to show progress
Toys and therapy equipment
Space and storage for materials and the programming itself
Training for everyone involved, including you.
Be aware that, depending on the number of ABA hours involved, there will be major adjustments to your family’s lifestyle, as your home may have a staff member or two present most of the time. It will also impact on your budget significantly.
The areas of an early childhood program should address the core features and characteristics of ASD. The goals and objectives to address each area should be highly individualized for each child's developmental level as well as his learning strengths and weaknesses. 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.
A common feature of ASD is how difficult the child finds it to interpret and prioritize the various external and internal stimuli continually bombarding him (for example, a fly buzzing around the room; internal perseverative thoughts such as recitation of math facts). As a result, many of these children 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, as learning throughout life relies the ability to imitate; the ability to imitate impacts learning in all areas, including social skills and communication. Various imitation skills must be specifically and directly taught to the child with autism. These include:
Imitating fine and gross motor movements
Imitating actions with objects
Imitating designs with manipulatives
Imitating sounds and words
Children with ASD exhibit significant communication difficulties in their abilities to comprehend and express language appropriately. Many children, at the early intervention level, have not learned the "power" of communication that is, the cause and effect of communication. They have not developed the "intent" to communicate. Some children will try to obtain the desired item 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. Therefore 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.
Children with ASD exhibit marked difficulty engaging in appropriate play skills with toys can include the following:
No interaction: The child shows no interest in touching or holding toys.
Manipulative/explorative play: The child holds and gazes at toys; mouths, waves, shakes, or bangs toys; stacks blocks or bangs them together; lines up objects.
Functional play: The child puts teacup to mouth; puts brush to hair; connects train sections and pushes train; arranges pieces of furniture in dollhouse; constructs a building with blocks.
Symbolic/pretend play: The child pretends to do something or to be someone else with an intent that is representational, including role-playing (for example, child moves hand to mouth, signifying drinking from teacup; makes a puppet talk; uses a toy person or doll to represent self; uses a block as a car, accompanied by engine sounds).
Appropriate play skills with toys and play with peers will need to be specifically and directly taught to children with ASD.
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 with peers can range from the following:
Isolation: The child appears to be unaware of, or oblivious of others. He may occupy himself by watching anything of momentary interest.
Orientation: The child has an awareness of the other children, as evidenced by looking at them or at their play materials or activities. However the child does not enter into play.
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.
Common focus: The child engages in activities directly involving one or more peers, including informal turn-taking; giving and receiving assistance and directives, and active sharing of materials. There is a common focus or attention on the play.
Typically developing peer models are essential to facilitate developmentally appropriate social behaviour for children with ASD.
Positive reinforcers are rewards used in ABA for correct responses in learning a skill or compliance. A reward given after a desired response or behaviour will help to increase that behaviour. Reinforcement ALWAYS increases behaviour (good and bad). While reinforcing with a tangible item (something edible such as food or something concrete like a toy or a treat) be sure to pair with verbal praise and social treats, 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.
Tangible: foods, drinks, objects, tokens, stickers, certificates and money. When frequent trials are required, keep food and drink amounts very small to enable more opportunities for practice before the child has had enough.
Activity: favourite games and activities (biking, book, music, TV, toys, free time). When frequent trials are required, keep the activity time to a few minutes to help maintain interest in the activity.
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 are very effective as they can be given immediately and in any location.
REMEMBER, a reinforcer will help a child learn undesirable behaviours as well as it can help to learn desirable behaviours. If your child is having a tantrum in the store because he or she wants a toy, your response to the situation is important. If you get “worn down” and give in, you are reinforcing that negative behaviour and your child has learned that tantrums gets rewarded.
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). Remember that “time-out” is often not an effective strategy for children with ASD. If your child has a tantrum during circle time and is removed from the classroom, he or she will be reinforced for the tantrum behaviour if that is what they wanted all along because they have “escaped the demand”. They have learned that when they want out of the classroom, they just need to tantrum. Time-out only works if it is “time-out” from a situation the child finds reinforcing; most children with ASD do not enjoy group activities and would prefer to be left alone.
Negative reinforcement can also simply be the lack of feedback or positive reinforcement when a skill is incorrect (for example, withholding praise or tangible/edible reinforcer). An effective way to handle a tantrum is to ignore the behaviour if it is attention-seeking, however, never ignore self injurious, aggressive or destructive behaviour. It is important to seek professional advice on how to handle this type of troubling conduct. Additionally, if there appears to be a change in your child’s basic personality (such as new or even more challenging behaviours) it is prudent to get a full physical examination performed (include a trip to the dentist) to rule out illness or discomfort.
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 the behaviour occurring again.
A prompt is a cue or a hint given to the child to help them complete a task or behaviour. 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 be successful in the beginning and he or she will associate the 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 the strongest (used at the beginning of teaching a skill) to the weakest.
Some different prompts are:
Pointing to the correct object when offering a choice of responses
Placing the correct object closer to the child when offering a choice of responses
Saying part of a word when the requirement is verbal, such as “What is it? It’s a d___” (for “dog”)
Ranging from the strongest, such as hand-over-hand, to a slight “nudge” in the right direction
The type of prompt you use depends on the skill you are teaching. 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 strongest prompt (for example, hand-over-hand). Prompts should always be as weak as possible. They 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 part of a skill is mastered, it is reviewed regularly. When the entire skill is mastered, it goes into maintenance, which is performed as often as your child needs it. Some children require maintenance once or twice per week, others only need it monthly.
Generalization is a term for taking a skill your child learns and applying it to everyday life. Skills are taught in context so there is meaning. 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.
When teaching life-skills (like tooth-brushing), 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.