ABA & Autism

As the prevalence of diagnosed autism increases, Applied Behaviour Analysis (ABA) has become the treatment of choice for many parents of children with ASD. Children with autism may have difficulty with speech and communication, and with understanding social interactions. Also there may be behavioural problems related to these difficulties. ABA treatment can improve the quality of life for a person with autism – and the family – by teaching speech or communication skills, helping them to get their needs met without behaving in a way that upsets others.

Below you will find some frequently asked questions about ABA and autism. If you cannot find the answer to your question below, please feel free to Contact Us.

What is ABA?

ABA is the applied arm of the science of behaviour. It is sometimes referred to as a method but is better thought of as a scientific approach to solving problems of social significance. The treatment package that a behaviour analyst recommends for a client will most likely feature a range of evidenced-based behavioural techniques that are anchored in the philosophy of behaviourism. Behaviour analysts use the scientifically validated principles of learning to modify the environment and evaluate its impact in order to improve meaningful behaviour with a view to improving the quality of life of individuals, families and communities.

Is ABA effective?

ABA has been recommended as an effective treatment for Autism by respected organisations such as the US Surgeon General, the American Academy of Paediatrics and the New York State Department of Health. A recent report by Ireland’s National Council of Special Education found that behavioural approaches to be among the most effective for treating students with emotional and behavioural difficulties, regardless of diagnosis. In 2009, the National Standards Project conducted the largest review of published studies on the subject of Autism interventions and found that the overwhelming majority of effective treatments for autism were developed from ABA. For more information, see our section on research reports.

Effectiveness of treatment is considered very important in ABA, and a behaviour analyst should use only programmes and interventions that have been scientifically proven. There are many treatment approaches for autism but ABA is the only scientifically validated treatment approach for autism. However, ABA programmes are not conducted to satisfy long-term scientific interest, and instead the goal of an ABA programme is to produce an immediate and meaningful positive outcome for the individual or group being treated.

To ensure that ABA procedures are run properly, a qualified behaviour analyst should supervise all interventions and programmes see BCBA qualification details here or at the Behaviour Analyst Certification Board website.

What is Positive Reinforcement?

Positive Reinforcement is a cornerstone of ABA interventions and programmes. Positive reinforcement is similar to reward, but not the same. Consequences have long been arranged by all human societies to promote behaviours that are adaptive to the individual and community and to deter behaviours that are problematic. For example, hard work is rewarded with salary, prestige and respect. Anti-social behaviour is punished by prison or fines. Positive reinforcement is used in ABA to build and strengthen adaptive, positive social behaviours, but in a way that is more precise and technical than reward – and it has been shown again and again that it really works!

Also, in behaviour analysis, problem behaviours are closely examined to see what is reinforcing the behaviour, because reinforcers for behaviour are not always obvious. For example, when children are playing quietly, parents or teachers may be very happy to stay at a distance and pay little attention, but then when a child is disruptive the parent or teacher may approach the child saying “Don’t do that!” This may actually provide positive reinforcement in the form of social attention for disruptive behaviour for the particular child, even though the parent of child did not intend to do so If a consequence makes a behaviour more likely to occur (even if that’s not what you intended), then it is a form of reinforcement.

In ABA, positive reinforcement is customised to each particular situation and individual with the intent to teach desired skills or behaviours. An individualised education plan (IEP) or treatment plan is specifically designed for each individual with ABA methods that have been successfully used for over 40 years. What sets behaviour analysis apart from other forms of intervention is that all programmes rely on objective measurement (e.g., record the number of times Megan tantrumed today, number of times James spelled the word correctly, number of days Jason tied his shoelaces) rather than subjective opinion, because different people may have very different opinions about the same situation (e.g., he always does this/he does this sometimes/he never does this). Recording specific data allows one to carefully monitor each intervention programme to ensure that there is real positive change, not just an impression of improvement. ABA interventions that are not working are not allowed to continue, and instead are modified to attain successful behaviour change.

What is a Functional Behaviour Assessment?

Behaviour Analysts are frequently called into schools, hospitals, homes and residential service settings to deal with challenging behaviours such as self-injury and physical assaults. The main tool that Behaviour Analysts use to decrease challenging behaviour is the Functional Behaviour Assessment (FBA). In the United States, the Individuals with Disabilities Education Act (IDEA) specifies that an FBA be conducted before an intervention plan is developed for all school children who display problem behaviour. As of 1997, IDEA law mandates the use of FBA within US Department of Education as best practice.

Using an FBA involves an examination of how the individual interacts with their environment, and aims to discover specifically when, where and why problematic behaviour arises. It’s not always easy to recognise the cause of any particular behaviour and it can be particularly difficult to identify the function of challenging behaviour in people with special needs because they may also have difficulties in communicating. The benefit of the FBA is that it helps us to learn more about the causes or functions of challenging behaviour and this knowledge can then be used to formulate an individualised effective treatment for your individual’s challenging behaviour.

There are two main types of FBA: Descriptive Assessment and Indirect Assessment. Descriptive Assessments involve the direct observation of the behaviour in a natural setting. This may involve the use of ABC sheets, scatterplots, or specially designed data collection forms. Indirect assessments get their name from the fact that the data they provide is based on recollections of the behaviour rather than direct observations. Indirect assessments are generally used in conjunction with forms of Descriptive Assessment. There are many interviews, checklists and rating scales that have been specially designed for Functional Assessments that can be carried out with parents, siblings, teachers or other significant people in the life of the individual which can be used to guide direct observations. The most precise form of functional assessment is known as a functional analysis. While very powerful, a functional analysis is the most difficult form of functional assessment to conduct properly and should only be attempted by a board certified behaviour analyst with relevant experience.

The functions of behaviour can be divided into those that are used to obtain positive reinforcement and those that are used to obtain negative reinforcement. Positive reinforcement involves obtaining something. For example, the function of a self injurious behaviour might be to obtain attention from a parent, or it might be an inappropriate way of accessing a preferred toy, activity or snack. It could also be automatically reinforced by the release of endorphins within the body which cause pleasant physical sensations. Negative reinforcement typically involves stopping, avoiding or postponing some negative condition. For instance, a child might run away to escape a barking dog, or they might scratch their skin to remove an itch.

Once a behaviour analyst has enough information about the circumstances in which the challenging behaviour occurs, he or she can form a hypothesis about its function and put in place an intervention designed to decrease its frequency. Some challenging behaviours have single functions while others may have multiple functions and any intervention will be individualised to the needs and capabilities of a particular individual. As a result every intervention will be different, however all behavioural interventions will pay particular attention to the function of a challenging behaviour and will seek to teach replacement behaviours that match its function where possible.

Does ABA ignore Biology?

ABA takes account of biological influences on behaviour, but does not focus strongly on biology or genetics. A lack of sleep or the presence of pain may be a ‘setting event’ for problem behaviour and a comprehensive functional behaviour assessment and will try to discover any such problem so that it can be treated or addressed. But as well as biological and genetic determinants, our ABA science has shown us that behaviour is very strongly influenced by the surrounding context or environment and this is where a behaviour analyst primarily focuses.

Does ABA involve using Aversive Procedures?

Behaviour Analysts adhere to the BACB, PSI and APA ethical guidelines and such try  to avoid the use of punishing, aversive or restrictive procedures and prefers to use positive reinforcement effectively. Although punishing procedures can produce faster results in comparison to positive reinforcement ( i.e. it works quickly), the long term effects of positive reinforcement are much better. That is, positive reinforcement helps to establish new and more appropriate ways of behaving, which thereby reduces the problem behaviour, In addition, punishing procedures only teach an individual what not to do and can produce unwanted effects such as lying, aggression, revenge, etc.

Therefore, behaviour analysts use positive reinforcement procedures all of the time and only use punishing procedures (i.e. time-out, loss of privileges, etc) when positive reinforcement alone is not working and the challenging behaviour is so severe that it is necessary to include more restrictive…

What Qualifications should a Behaviour Therapist have?

The internationally recognised Board Analyst Certification Board recommends that only Board Certified Behaviour Analysts (BCBAs) are sufficiently qualified and experienced to design behavioural intervention. Practicioner expertise has been found to be a crucial factor in the effectiveness of behavioural interventions

While ABA programmes have been successfully implemented by a variety of professionals and paraprofessionals including doctors, nurses, teachers, care workers, ABA tutors and special needs assistants, it is of the upmost importance that supervision from a BCBA is provided.

How should I structure a Home Programme?

Every programme will be designed to meet the needs of a child. In Ireland, a home programme is typically supervised by a BCBA who designs relevant behavioural interventions which are run by a tutor. Regular meetings are conducted amoung the parents of the child, the child’s supervisor, the child’s tutor and other members of the multi-disciplinary team.

Supervisors of ABA home programmes must have a postgraduate qualification in the area of Applied Behaviour Analysis (ABA) and must be a Board Certified Behaviour Analyst (BCBA) as recognised by the Behaviour Analysis Certification Board (BACB). They should have extensive experience in: conducting assessments of need; writing Individualised Education Plans (IEPs); and designing and implementing behaviour support plans, functional analyses, and functional assessments. Supervisors can also be directly involved in programmes. They conduct supervision meetings on a regular basis (usually bi-weekly, or more often on request) and liaise closely with the family and other members of the multi-disciplinary team. Supervisors also write educational reports based on their behavioural assessment of a child and these may be used in schools for children with special needs.

The tutor is the person who implements the home programme with the child directly for an amount of hours per week as decided by the parents and agreed with a supervisor. If a programme is funded by the Department of Education, tutors must meet the criteria for home tuition, as specified by that body. Tutors must have a recognised teaching qualification or a “qualification in autism” or “a qualification in an applied approach to teaching children with autism” or a degree in psychology. The most common educational backgrounds of ABA tutors include: graduates of psychology; someone who is currently enrolled on a postgraduate training course in Applied Behaviour Analysis (ABA); or someone possessing a teaching qualification. It is extremely important that the tutor has been appropriately trained to use the principles of ABA.

Before a tutor can begin work with a child, the supervisor must conduct an assessment of the child’s current skill level, meet with the child’s parents to produce an individualised education plan and compile a folder of programmes for the tutor to use.

The supervisor carries out an assessment of skills. Such assessments include the Assessment of Basic Language and Learning Skills (ABLLS), and the VB-MAPP. This initial assessment gives an overall description of the child’s skill level in various areas such as: communication; academic skills; self-management; gross and fine motor skills; and play. This assessment crucially highlights the child’s competencies and deficits, and thus gives an indication of goals to focus on in the home programme.

An IEP is drawn up following an in-depth meeting between the supervisor and the child’s parents. This allows the supervisor to hear what goals the parents would like incorporated into the programme. For example, they may discuss where they would like to see their child in six months or a year’s time and they may highlight specific skills they feel would be of immediate importance to their child and the current context. This meeting also gives the parents the opportunity to discuss at length what they see as the behavioural difficulties of their child. This session is referred to as an IEP meeting because it generates the basis of the IEP. The supervisor compiles all of the information from the assessment and from the IEP meeting and draws up a Programme List.

Within the folder, programmes are taken from a range of skill areas selected from those examined during the initial assessment. Examples include: academic literacy (reading, writing, spelling and numeracy); communication (e.g. speaker and listener skills); self-management; play; and gross/fine motor skills. The degree to which each of these areas will be focussed on varies from child to child and depends on factors such as age and individual needs.

Once the numbers of hours have been agreed between parents and tutor(s), the implementation of the programme can begin. The tutor will come to the child’s house and implement the programme (teaching skills in each of the required areas), using the principles of ABA. Data is collected by the tutor during each programme and is graphed on a daily basis. Tutors monitor the child’s progress within each programme, making amendments as necessary. They should notify the supervisor immediately if issues arise within a programme. Otherwise, progress is reported at the scheduled supervision sessions (see below).

Supervision sessions take place on average every two weeks, or more frequently if requested by the parents. The programme supervisor attends a tutoring session to monitor the progress of the programme and to ensure it is being implemented as it was designed. These sessions also give an opportunity to discuss any issues that have arisen and any amendments that need to be made to the programme. Concerns of parents can also be discussed during this time. However, in situations where parents have concerns or anxieties about programmes or their child’s behaviour, they should contact the supervisor who will arrange an immediate meeting.

A re-assessment of the child’s skills and deficits will occur on average every six months. Children on intensive home programmes can make a lot of progress within this time and it is necessary (and exciting) to keep track of the behavioural changes in each of the skill areas. This also ensures that the home programme is continues to meet the specific needs of each child.