Applied Behavior Analysis (ABA)
WHAT?
WHY?
WHO?
What is ABA?
ABA stands for Applied Behavior Analysis and is an evidence-based method of teaching that focuses on changing or improving socially significant behaviors. The goal of ABA therapy is to improve the skills and functioning level of individuals across many types of behaviors and disorders. ABA is frequently used to treat individuals diagnosed with Autism, but the principles of ABA can be used to change behaviors across many individuals and circumstances.
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ABA uses reinforcement and a child's personal preferences to shape and prompt new behaviors by breaking those skills and behaviors into small steps. The small steps are taught and linked together over time to increase more complex skills such as communication, self-help skills, and social interactions.
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ABA during young developmental ages or during early intervention is designed to be delivered in high dosages to maximize the effectiveness of treatment. We recommend a minimum of 12 hours per week of ABA therapy for individuals with Level 2 or Level 3 Autism. Treatment dosage is based on medical necessity and may vary based on your child's needs. You can discuss this need and dosage with the Behavior Analyst during the initial intake process.
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What does ABA target?
Programs begin by assessing current levels of functioning. Depending on the individual, goals can range from basic skills such as attending and sitting to more complex skills such as communication, social skills, safety awareness, and basic academic concepts (numbers, letters, shapes, colors, etc.) to adaptive skills such as toileting and feeding. Goals are integrated slowly and gradually from simple to complex.
Goals typically fit into one of 4 areas and are described below (Communication Skills, Social Skills, Adaptive Skills, and Behavior Management).
Communication Skills
ABA targets communication skills to increase functional language by focusing on verbal language, sign language, and/or picture exchange. The appropriate method is chosen based on the child's individual skills and collaboration with the family and other service providers. Verbal communication training incorporates ways to teach children to label (tact), request (mand), repeat (echo), and respond (intraverbal) in social situations.
Social Skills
ABA targets social skills to help increase an individual's ability to navigate their own social environment. Social skills are highly unique to each person and are targeted based on the individual and family's goals. Some examples of social skills that can be targeted include eye contact, conversation skills, taking turns, and making friends.
Adaptive Skills
ABA targets adaptive or self-help skills to help each individual become as independent as possible in activities of daily living. Some examples of adaptive skills include toilet training, dressing and shoe tying, bathing, toothbrushing and feeding goals. Caring for oneself is an important skill for overall quality of life and is an important aspect of development.
Behavior Management
ABA helps to reduce maladaptive or unwanted behaviors by using a person's preferences to motivate and change their behavior. These behaviors can include outbursts and tantrums that include aggression and property destruction as well as harmful self-injurious behaviors. Sometimes individuals engage in repetitive behaviors or stereotypies that cause harm or interfere with the person's functioning and may need to be addressed.
What is the Process?
Intake and Initial Assessments
All clients start the process at Will’s Way with a parent/caregiver intake or interview. This initial interview allows the family to provide valuable information about the client and for the therapists to gather information about the client's background and presenting concerns. It is also beneficial to have information regarding previous evaluations, IEPs, reports from OT/PT/SLP, and previous ABA therapy records, if applicable.
Following the initial intake, direct testing is conducted to determine the current level of functioning of the client. The time allocated to a thorough assessment will result in improved interventions and results for clients. Assessment measures used vary based on the client's need and functioning level and may include one or more of the following:
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Assessment of Basic Language and Learning Skills - Revised (ABLLS-R)
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Verbal Behavior Milestones Assessment Placement Program (VB- MAPP)
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Pervasive Developmental Disorder Behavior Inventory (PPDBI)
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PEAK Assessment
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Skills Streaming Social Skills Curriculum
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Socially Savvy
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Functional Behavior Assessment (FBA)
Assessments are re-administered typically every 6 months to measure progress and growth.
Treatment Plan
Following the assessment, a comprehensive assessment report is completed and an individualized treatment plan is generated to address the behavior excesses and skills deficits identified. The treatment plan will include skills targeted, methods of treatment, recommendation for number of hours of services per week in addition to parent training goals. The treatment plan developed will be continuously revised in consultation with you as your child gains skills, demonstrates different behaviors or requires different methods for learning. Skills targeted may be across multiple areas including but not limited to the following: Communication, Social, Adaptive, and, Behavior.
Treatment
Treatment services include direct client therapy as well as regular parent trainings. Duration and frequency of services per week will vary per client and is based on assessment results and client availability. ABA therapy is recommended as an intensive intervention and the earlier it begins, the more positive the outcomes. See below for more information on research and support for ABA.
Why choose ABA?
ABA therapy is the most recommended approach for the treatment of Autism Spectrum Disorders.
ABA therapy is supported by agencies such as the U.S. Surgeon General, the American Medical Association, and the American Academy of Pediatrics, the Centers for Disease Control (CDC) and The National Institutes of Health (NIH).
ABA therapy is an effective tool for increasing skills and decreasing maladaptive behaviors. There are
decades of research supporting the use of ABA and the effectiveness in improving behaviors (National Autism Center [NAC], 2015; Howard et al., 2005; McEachin et al., (1993); Sallows and Graupner 2005; Reichow, 2012; Wong et al., 2014, 2015).There is also evidence that when therapy is intense (20+ hours per week) and started before age 4, ABA may produce significant improvements in development and the reduction for special education or more intense services in the future (Reichow, 2012).
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The United States Surgeon General (1999) concluded, “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning and appropriate social behavior.” United States Surgeon General (1998). Mental health: A report of the Surgeon General. Washington, DC
Who does ABA include?
ABA therapy involves a team of individuals working together towards the same goal.
1. First and foremost is the client and their family. The family can involve parents, grandparents, siblings, or other relevant caregivers in their lives and plan an essential role in the overall success of ABA.
2. Secondly, the therapists involved in a child's therapy play an important role in the success of treatment. Therapists include Board Certified Behavior Analysts, Board Certified Assistant Behavior Analysts, Registered Behavior Technicians (see below for a more detailed description).
3. Third, collaboration with other therapists or medical personnel may occur to ensure continuity of care.
4. Finally, community members in setting such as schools, daycares, churches, or camps may be involved to aide in generalization of skills.
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Board Certified Behavior Analyst
"The Board Certified Behavior Analyst® (BCBA®) is a graduate-level certification in behavior analysis. Professionals certified at the BCBA level are independent practitioners who provide behavior-analytic services" (www.bacb.com). BCBAs can hold Master's (BCBA) or Doctorate Degrees (BCBA-D) in Applied Behavior Analysis, Psychology or a related field. BCBAs are the professionals in charge of a client's ABA programming and treatment plan. They are the therapists who will perform most parent meetings, direct treatment goals, make changes to goals, and train Registered Behavior Technicians.
Board Certified Assistant Behavior Analyst
"The Board Certified Assistant Behavior Analyst® (BCaBA®) is an undergraduate-level certification in behavior analysis. Professionals certified at the BCaBA level provide behavior-analytic services under the supervision of a Board Certified Behavior Analyst® (BCBA®)" (www.bacb.com). BCaBAs can hold Bachelor's Degrees and specialized coursework in Applied Behavior Analysis. BCaBAs can't practice independently and assist BCBAs with programming, treatment plans, parent trainings, and supervising Registered Behavior Technicians.
Registered Behavior Technician
"The Registered Behavior Technician® (RBT®) is a paraprofessional certification in behavior analysis. RBTs assist in delivering behavior analysis services and practice under the direction and close supervision of an RBT Supervisor and/or an RBT Requirements Coordinator, who are responsible for all work RBTs perform." (www.bacb.com). RBTs cannot practice independently and they work under the direct supervision of a BCBA or BCaBA. RBTs are typically the therapist providing the direct service with the client and are instrumental parts of the therapeutic process.