Applied Behavior Analysis (ABA) is the leading approach to improving the developmental deficiencies associated with autism. ABA therapy is likely able to improve the quality of life of your child and help them reach their full potential. Endorsed by the U.S. Surgeon General, ABA therapy focuses on human behavior and is able to increase desirable behavior and minimize unwanted behaviors.
Listed below are some of the most frequently asked questions regarding ABA Therapy:
What Is ABA?
ABA therapy stands for Applied Behavioral Analysis and by definition is a therapy system based on behaviorism, that at its core revolves around the theory that behaviors can be learned and improved.
It is a complex therapy with many different styles, techniques, and applications that have evolved over time.
What is the History of ABA Therapy?
The origin of ABA Therapy can be traced back to Psychologist Ole Ivar Lovaas who developed ABA Therapy in the 1970s, and was influenced by BF Skinner. He created a system to treat autism based on behaviorism. His Discrete Trial Training (DTT) was extremely structured and intense, as it broke down basic skills and desired behaviors into small components for children to learn. A child would be required to complete learned activities in a specific order, and given a reward when it was completed correctly, or punishment if not completed correctly.
The initial results of this therapy proved to be a significant alternative to institutionalization. Autistic individuals who went through an intense 14-month therapy, 40 hours a week, did experience a decrease in undesirable behaviors, as well as an increase in desired behaviors.
This original application came under scrutiny primarily due to its intense nature and use of punishment, which did include shock treatment.
Today, ABA Therapy is less extreme in terms of its structure and intensity, and has shifted to a reward-based system.
When searching for an ABA therapist, it is important to verify that the therapist does not use punishment or intense repetition before hiring them.
What is ABA Therapy for Autism?
ABA therapy was specifically created to help people with Autism, with the initial goal to help autistic individuals fit better into society and act in a more neurotypical manner.
It is now understood that some behaviors, such as repetitive motions, head-banging, self-injury, meltdowns, and aggression – often are the result of medical issues that are causing pain and discomfort.
It can be more easily understood that when an autistic child is in pain, they have difficulty communicating and can become frustrated. Repetitive movements, stimming or even self-injury, are often attempts in alleviating the pain or are used as a form of communication or as a means to cope. It is a prudent course of action to explore medical needs, especially if you see an increase in negative behaviors.
The goal of an experienced ABA therapist is to build on the individual’s strengths, helping them to accomplish as much as possible. For example, early intervention greatly increases a nonverbal child’s ability to speak. It may also help them to master life-skills and self-care tasks.
Today, treatment is individualized and focuses on what is best for the individual.
What Do They Do in ABA Therapy?
ABA Therapy is no longer one-size fits-all, and has developed into a variety of methods. ABA Therapists may utilize a combination of approaches during their sessions, to address the specific needs of the autistic individual.
Here are some of the most common types of reward-based methods of ABA Therapy:
- Discrete Trial Training (DTT)
This approach is very structured, and is best described as where a task is broken down into single steps that are gradually introduced until the task can be completed in its entirety. Intense repetition is still sometimes used in DTT, while the newer approaches focus on incidental teaching vs. rigid structured repetitive learning.
- Early Start Denver Model (ESDM)
This is primarily a play-based method that aims to teach multiple skills within one exercise.
- Incidental Training
This approach teaches real-life skills that can be conducted outside of therapy and at home.
- Pivotal Response Treatment
This approach focuses on teaching pivotal social skills: sitting still, playing nicely, speaking quietly, etc. It is play-based where the child leads the session and interactions. It is based on the principles of ABA therapy, but differs in many ways, such as having a more liberal reward system that doesn’t require perfect execution of the task.
The goal of ABA is to apply positive reinforcement to encourage changes in behavior over time. When applied correctly, the child will be able to develop the needed skills and reduce undesired behaviors. It also educates parents to be more constructive in addressing everyday situations.
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What to Look for in an ABA Therapist
ABA is the most widely accepted form of therapy for Autism Spectrum Disorders (ASD). Unfortunately, it is often the only type of therapy covered by insurance companies and could possibly limit the choices that could best benefit the child.
We know that there are good providers and not so good providers. When the mental health of a child is being addressed, it is imperative to find a therapist that best suits their specific needs.
Here are a few important questions to ask when searching for an ABA therapist:
- Is Treatment Individually Tailored To Your Child?
Each child is unique, with their own unique ASD symptoms and diagnosis. It’s important to find a therapist that will assess your child’s individual needs and design plan that is based on their interests that keeps them engaged.
- Is Punishment Used?
It is imperative to verify that punishment, in any form, will not be used. Punishment can have long-term and severe consequences and have been a known cause of PTSD, and even linked to an increased risk of suicide.
- Do They Discourage Stimming?
Stimming is often a way for an autistic individuals to express their feelings. It can be a way for them to deal with stress, express joy, and more! A good therapist will recognize this type of communication and will not try to stop or change this behavior, but rather work to identify the root cause of it.
- Does it Focus on Developing New Skills and Behaviors?
The ABA therapist should focus on improving and growing skills that encourage independence and confidence. Therapists that focus on getting rid of behaviors (other than dangerous behaviors like self-harm or elopement) could have a negative impact on an autistic individual.
- How Intense / Long / Often Are The Sessions?
Therapy sessions should be enjoyable and positive. Long and tedious sessions may provide quicker results, but the child may become traumatized. A good therapist will teach a child to communicate that they need a break, that they are tired, or uncomfortable.
- Who is Conducting the Therapy Sessions?
Often a provider may have an RBT conduct therapy sessions. An RBT is a Registered Behavior Technician who is a paraprofessional whose primary responsibility is to implement behavior-analytic services.
Although there may be some great RBT technicians out there, you may prefer to have your child’s therapy conducted by a licensed therapist (BCBA). If this isn’t an option, at least ensure that the RBTs are closely supervised by the BCBA.
- Are Other Therapies Incorporated?
Speech and occupational therapy can be highly effective and should be part of your child’s plan if necessary. A good therapist should also incorporate your child’s interests like music, animals, colors, etc.
- Are You Allowed to Be Present During Sessions?
It is a red flag if the therapist isn’t ok with you being present. This is especially important in the beginning when they are still building a rapport with your child.
- How Many Hours of ABA are recommended per week?
It was previously recommended that therapy could be anywhere from 30-40 hours per week. Today, however, many therapists recommend 10-20 hours a week. Work with your provider to see what would be a starting recommendation for your child.
Other things to look for is whether or not the therapist tracks the child’s progression, supervision of new therapists, and whether the program is evidence-based (proven effective in studies).
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The ABA Therapy Controversy
Even though advocates have seen and shared great improvements in their children, ABA Therapy has its share of controversy.
ABA’s goal is to help those with autism curb behaviors that make it hard for them to function better in society. This goal is often a challenge for some autistic individuals, as well as parents. After all, no one wants to feel like there is something wrong with them, and opponents have often expressed that this may be the case.
This leads opponents of ABA to often question the results of ABA therapy by asking ‘at what cost?’
Those who oppose ABA may argue that by training a child to behave in a neurotypical way, you’re teaching them that they aren’t good enough – or to suppress how they express themselves.
The founder of ABA Therapy (Lovaas) admitted later in life that most of the behavior he thought of as disobedience was merely the child attempting to communicate in the only way they know-how.
Because Autism consists of different levels of symptoms, it serves as a reminder that no therapy is going to be the right one for ALL autistic children. We also have to understand that Autism is NOT something that can be ‘fixed’, but rather it is a disability and should be treated as such. In this regard, there are therapies that are available that greatly improves the quality of life for someone diagnosed as autistic, and ABA studies have proven this.
The Challenges with ABA Therapy
All therapy methods have challenges, and ABA therapy is no different. This means that there is potential for ABA therapy to be used inappropriately and unethically, which may result in causing harm to a child.
Since ABA Therapy is the most common therapy available for Autism Spectrum Disorder (ASD), it is also a field that has experienced a significant lack of qualified and properly trained professionals that are board-certified behavioral analysts (BCBA’s). Because of this, therapy is generally conducted by registered behavior technicians (RBT) under the supervision of a BCBA. The only requirement for an RBT is a high school diploma, a background check, 40 hours of training and passing an exam.
The thing to remember is to make sure that the time spent in therapy is enjoyable for the individual, and why it is important as a parent to be actively involved by being your child’s best advocate and to find the right therapist for your child.
The Benefits of ABA Therapy
It is important for any child to learn basic social skills, self-care and communication. The right ABA therapist will help your autistic child improve in these areas that have been proven to be more difficult with standard forms of teaching.
Good therapists will work with your child to understand:
- Why certain behaviors occur
- How our child learns
- What they truly need to improve in life skills.
Therapists will provide engaging activities and reward to develop and teach these new skills.
ABA has been proven to:
- to increase language skills, with non-verbal children eventually being able to speak or communicate more effectively.
- help children with memory, focus, IQ, and academics.
- show a substantial decrease in harmful behaviors. This is especially important if your child is prone to self-harm or wandering.
Find an ABA Provider near you today (hyper link to directory)
Financing ABA Therapy
Medicaid is required to cover the cost of ABA Therapy if your doctor prescribes it. It is also the only therapy covered by insurance in many states.
Therapists often work with Parents and Guardians in obtaining coverage and assistance. They may also provide additional advice and suggestions.
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What else should I know as a parent regarding ABA Therapy?
We know that if you’re on MyABA.Today, you’re attempting to do your research so you can ask the right questions. You’re searching for the right therapist for your child, and you are trying to figure out what therapy style might work best.
Remember, however, that just because this form of therapy can be taken care of fiscally, it may not mean that it is the best solution for your child.
As you are searching for an ABA therapist, be sure to ask questions and monitor your child’s sessions. It is imperative that you are involved in the process so that you are able to take steps, if necessary, so the sessions are not causing your child any stress.
Be on the lookout for activities that may use any form of punishment or revolve around the suppression of stimming, as these are thought to be the main causes of long-term PTSD symptoms.
ABA therapy can be positive and life-changing if applied correctly. So do your best to find the right therapist, and be active throughout the process in ensuring your child is getting the best care possible.
Common Features of ABA Programs
Most ABA programs are highly structured.
Facilitated play with peers is often part of the intervention.
Targeted skills and behaviors are based on an established curriculum.
Success is measured by direct observation and data collection and analysis.
ABA programs often include support for the child in a school setting with a one-on-one aide to target the systemic transfer of skills to a typical school environment.
BUT MORE IMPORTANTLY…
Is ABA Therapy right for my child?
Absolutely! ABA works well because well because the therapy is catered specifically to your child’s needs and each child is different.
It focuses on introducing and building skills and positive behaviors, changing existing behaviors, and eliminating inappropriate behaviors.
Research has shown that ABA is more effective with early intervention, but there are no age limits.
It can be more difficult to change established patterns and behaviors in older children, but even adults can still benefit from ABA Therapy.
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Early intervention is always the best course. Don’t wait. Please find a provider today!