What is ABA therapy now, really?

Meme Hieneman, Viviana Gonzalez, & Paula Chan

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Applied Behavior Analysis (ABA) is a popular intervention approach for individuals with disabilities, especially young children with autism. Unfortunately, however, there are widespread misconceptions regarding what ABA really entails. Many people associate ABA with a narrow set of practices rather than understanding the wealth of applications it offers and the ways in which ABA can be used to improve children’s behavior and lives. The purpose of this article is to define ABA in practical terms, helping families to seek the best and most appropriate applications for their children.

What is ABA? Applied behavior analysis was defined as a field in the late 1960s after years of preliminary research (Baer, Wolf, & Risley, 1968).

The overriding goal was to extend scientific principles of human behavior beyond highly-controlled or laboratory environments to resolve real life problems. The key features of ABA were, of course, that it was applied, behavioral, and analytic.

Applied means that interventions are geared toward achieving socially-important goals, helping people be more successful in natural settings such as homes, schools, and communities. Behavioral means that ABA focuses on what people say or do, rather than interpretations or assumptions about behavior. And analytic means that assessments are used to identify relationships between behavior and aspects of the environment (e.g., screaming occurs most when Johnny is given a difficult task and allows him to delay or avoid that activity) before proceeding to intervention.

In addition to these basic characteristics, behavior analytic interventions are expected to be defined clearly so they can be used consistently and to only include behavioral strategies that are sound in both theory and in practice. ABA involves ongoing data collection to evaluate whether behavior is changing in the desired direction and the goals are being achieved. The expectation is that outcomes ‘generalize’ across people, situations, and settings and continue over time.

How is ABA used? Over the years, a variety of practices have evolved out of ABA. These practices are based on something called the “three-term contingency” – antecedents-behavior-consequences. In essence this means that behavior occurs in response to events or conditions in the environment (i.e., antecedents) and continues due to its results (i.e., consequences). For example, a child may whine when asked to do a lengthy or difficult chore and that whining may result in delaying its completion as the parent cajoles the child to finish.

ABA practices typically involve the following elements:

1. Managing the consequences of behavior by rewarding positive behavior, withholding positive consequences, or – in some cases - using punishment (e.g., scolding) to deter behavior

2. Re-arranging antecedents to promote positive behavior and minimize the likelihood of problem behavior (e.g., clarifying expectations, simplifying tasks, providing choices)

3. Teaching skills that allow individuals to be more successful and less reliant on problem behavior to meet their needs

Popular practices based on the principles of ABA have incorporated some or all of these features. For example, reward systems, behavioral contracts, time-out, and removing privileges are commonly used in the schools. When applied appropriately (e.g., making sure rewards are actually enticing to students), these strategies can promote positive behavior. Early intervention programs and programs for children with autism often emphasize arranging the classroom or home environments (e.g., using pictures, bins for items); these can be considered antecedent interventions. Most notable among the ABA practices is systematic instructional procedures, such as discrete trial or verbal behavior training, that incorporate effective teaching and reinforcement practices to help children with disabilities learn new skills rapidly and efficiently.

Functional behavioral assessment, which was derived from functional analysis, is a staple of ABA. It is a process by which the specific functions, or consequences, influencing a person’s behavior are identified so that interventions can be tailored to those needs. FBA involves observations and interviews to collect data that reflect consistent patterns of behavior. Interventions based on FBA are more effective than those selected arbitrarily. Functional communication training, for example, is a highly effective strategy that uses information from an FBA to teach people other ways to communicate to get exactly what they were trying to achieve through their behavior (e.g., tugging on a person’s sleeve to request attention rather than slamming objects).

Over the past several years, positive behavior support has also gained popularity, particularly in schools. The goal of PBS is to combine the principles and practices of ABA – functional behavioral assessment and comprehensive behavioral interventions that blend antecedent and consequence-based strategies - into user-friendly packages that can be readily implemented by family members and direct service providers to support children within natural routines in homes, schools, and communities. PBS practitioners are committed to transferring their knowledge and skills to produce durable, lifestyle change.

What should I expect?

Regardless of the specific practices being used, ABA services should adhere to the basic characteristics described in this article. As a family member, one should expect behavior analysts to have appropriate training and experience to implement ABA appropriately (e.g., see bacb.com for standards) and perform the following functions:

• Engage caretakers in goal setting, assessment, intervention design, plan implementation, and evaluation

• Define goals and behaviors of concern for children in observable terms

• Conduct a thorough assessment in order to identify antecedents and consequences affecting the child’s behavior

• Design individualized behavioral interventions based on the principles of applied behavior analysis that include strategies to…

i. prevent problems/prompt positive behavior

ii. Teach your child appropriate replacement skills

iii. Manage consequences (e.g., reactions) to behavior

• Provide specific written recommendations and training, allowing caretakers to apply strategies under the circumstances in which they are needed

• Evaluate the child’s progress on a regular basis using objective measures and criteria

What is right for my child? Because ABA is applied in so many different ways, using so many different labels, it can be extremely confusing for families and service providers. Often, people feel pressured to choose between different approaches, even when more than one approach may make sense for their children. Many practitioners exploit this conflict in order to ‘sell’ their particular approach.

To be informed, consumers, parents, teachers, and other service providers must understand ABA as a whole. Whereas all of the approaches described here have been derived from ABA, none are ABA in its entirety. The science of human behavior is constantly evolving, creating more effective strategies for children and families.

Functional Behavioral Assessment (FBA)

A staple of ABA is a process by which the specific functions, or consequences, influencing a person’s behavior are identified so that interventions can be tailored to those needs.

Courtesy Parenting Special Needs Magazine