Updated by Kate McKenna, MEd, MSEd, MS, BCBA
Association for Science in Autism Treatment
Description:
Applied behavior analysis (ABA) is the application of the science of behavior analysis to real-world problems with the goal of effecting lasting and positive change in socially important behavior (Baer, et al., 1968; Fennell & Dillenburger, 2014). At the heart of behavior analysis is the belief that behavior can be studied and understood, and that this understanding can guide the creation of interventions to teach skills, increase behavior that contributes to learning, independence, and happiness, and decrease behavior that interferes with the acquisition of skills, is dangerous to self or others, or limits opportunities. Since behavior is shaped by the individual’s interactions with people, objects, and events in the environment, it is possible to arrange the environment to affect change in behavior.
ABA is a branch of the science of behavior that is focused on identifying applied solutions to challenging situations in our society (Cooper, 2019). It is not a teaching method in and of itself, but the science behind how interventions are designed and implemented. ABA focuses on the reliable measurement and objective evaluation of observable behavior within relevant settings, including homes, schools, and communities. There are many interventions based on the principles of ABA that have been demonstrated to successfully increase learning and new skill acquisition and decrease interfering behavior in individuals with autism (note that some of these specific treatment summaries are listed below). These interventions are backed by decades of rigorous scientific research carried out by hundreds of individuals and demonstrate the efficacy of interventions based on the principles of ABA (Cooper, 2019).
Although ABA is commonly associated with autism treatments, interventions based on the principles of ABA have been found beneficial in the fields of addiction and substance abuse (Silverman et al., 2011), gambling (Weatherly & Flannery, 2008), eating disorders (Peterson et al, 2022), forensic analysis (Ruben, 2019), gerontology (Burgio & Burgio, 1986), and other mental health specialties (Harvey et al., 2009). This sample of broad applications speaks to the strength of ABA-based interventions in addressing many diverse challenges and to the vast body of scientific evidence that supports its use.
In the treatment of autism, many studies show that ABA is effective in increasing behaviors and teaching new skills (National Autism Center [NAC], 2015; Wong et al., 2014, 2015). In addition, numerous findings demonstrate that ABA is effective in reducing behavior that may interfere with acquiring skills and participating in the community (NAC, 2015). A number of studies also indicate that, when implemented intensively (more than 20 hours per week) and early in life (beginning prior to the age of 4 years), ABA may produce large gains in development and reductions in the need for special services (Reichow, 2012).
ABA-based interventions, of which there are dozens, are used across the lifespan to increase engagement with the environment, enhance the learning of new skills, and support the development of social interactions and communication skills needed to form social relationships and gain access to preferred items and activities. Activity schedules, for example, are a visual display of pictures or words that show a sequence of events. Visual schedules can be created for the steps of any activity such as those involved in personal hygiene, taking public transportation, completing household chores, or assignments at school. The Picture Exchange Communication System (PECS) involves exchanging individual pictures of items and activities for the desired items or activity and can help people to communicate successfully. Token economies can be used to increase behaviors as learners earn tokens for engaging in appropriate behaviors that can be redeemed at a later time for one of a variety of preferred reinforcers. Video modeling is an ABA-based intervention that is effective for teaching academic, language and communication, social and play skills, and skills of daily living by showing the individual a video of someone performing those skills. Information about a few other ABA-based interventions can be found at the links listed here. These treatment summaries provide background information on the interventions, links to resources on the topic, and reference lists to supplement your own research.
For many decades, there has been recognition of the scientific evidence supporting the use of ABA. In 1999, the Surgeon General Report, which was based on thirty years of research, took the position that sustained behavioral therapy and applied behavior analysis (ABA) early in life are effective in reducing inappropriate behavior and promoting the acquisition of language skills, communication, and social behavior. The Report 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.”
More recently, comprehensive reviews of intervention practices for individuals with autism have been conducted by the National Standards Project (2015) at the National Autism Center and the National Professional Development Center on ASD (NPDC) at the Frank Porter Graham Child Development Institute at the University of North Carolina at Chapel Hill (2020). These reviews followed a systematic process for searching published research to identify high quality studies that provide evidence that specific interventions are effective for individuals with autism. Their findings demonstrate conclusively that ABA-based interventions result in socially important, sustainable, and lasting positive change in the lives of individuals with autism.
ABA-based interventions have been used to increase behaviors across a variety of domains, including academic skills, vocational skills, social skills, play/leisure skills, and daily living skills. For example, ABA-based interventions led to increases in reading ability (Solis, et al., 2016; Joseph, et al., 2016), creative writing (Porritt, et al., 2006), interviewing skills (Stocco, et al, 2017), conversational exchanges in adults (Custer, et al., 2021) and children (Peters & Thompson, 2015), play skills (Lee, et al., 2021), and the acquisition of skills for independent living (Zawadzki, et al., 2024). Furthermore, ABA-based interventions have been used to decrease maladaptive or challenging behaviors including pica (Morris, et al., 2021), elopement in children (Boyle et al., 2023) and adolescents (Thomas, et al., 2023) as well as self-injury, aggression, and disruptive behavior (Newcomb & Hagopian, 2018).
Service Provision:
ABA services are provided by professionals who are trained in both the science of applied behavior analysis and teaching techniques/strategies based on that science (McKenna & Celiberti, 2023). The primary governing body for behavior analysis professionals is the Behavior Analyst Certification Board (BACB). The BACB oversees three levels of certification with the highest level being the board-certified behavior analyst (BCBA). BCBAs must hold a master’s degree, complete a graduate level 7-course sequence, complete 2000 hours of supervised practice, and pass a qualifying exam. BCBAs are required to complete 32 hours of professional development every two years to maintain their certification. Board certified assistant behavior analysts (BCaBAs) must also complete a course sequence, along with 1,300 hours of supervised fieldwork, and pass a certification exam. BCaBAs must be supervised closely by a BCBA. In some cases, programs designed by a BCBA are implemented by a Registered Behavior Technician (RBT). RBTs have to complete a 40-hour course and pass both a competency-based exam and a written exam. RBTs may only work under the close supervision of a BCBA or BCaBA. All clinicians certified by the BACB practice under a Code of Ethics.
Behavior analysts are mindful of social validity, the rightness of fit between an intervention and the goals, values, and resources of the individual and family members, when choosing goals in their work with clients, family members, and other stakeholders. Interventions based on the principles of ABA can focus on:
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- Teaching new skills and increasing behaviors, such as social and communication skills, that are meaningful to the client and that will result in access to new environments, greater independence, and increased self-advocacy.
- Analyzing and modifying conditions in the environment to restrict or narrow conditions under which interfering behavior occurs and self-fulfillment.
- Reducing interfering behaviors (e.g., self-injury or aggression) that can restrict an individual’s full participation in educational, social, and work settings or may require psychotropic medication.
- Where needed, supporting clients in learning procedures, such as self-monitoring when completing job-related skills, with the goal of maintaining and generalizing behaviors in work and social contexts.
- Generalizing or transferring behavior from one situation or response to another (e.g., from completing assignments in a resource room to completing similar assignments in the mainstream classroom).
- Supporting and teaching family members, other caregivers, and service providers in their important roles of shaping behavior and teaching new skills across all environments.
Summary and Recommendations:
ABA-based interventions have a 60-year history of providing rigorously researched and expertly applied solutions for many people with a variety of needs. Given their demonstrated effectiveness, ABA-based interventions are considered the gold-standard in autism treatment among many. Interventions based upon ABA have been shown to be effective for solving problems of an acute nature but are also a successful treatment for autism spectrum disorder across the lifespan. Research studies have demonstrated effectiveness with individuals of all ages, in a variety of settings (e.g., home, school, clinics, hospitals, community settings). Moreover, multiple task force reviews of treatment effectiveness have documented strong evidence for ABA-based interventions.
To ensure teaching solutions are effectively applied, we recommend contacting only those practitioners who have appropriate certifications (e.g., BCBA, certified education staff persons, communication personnel, and related services personnel). Consumers are encouraged to ask for the qualifications of providers to ascertain if they have the necessary background in behavior theory and ABA. The Behavior Analyst Certification Board (BACB) lists information on its website about the certification process and provides a listing of certified behavior analysts to help in locating a certified therapist.
Appropriately trained and certified practitioners will almost certainly introduce data systems to an individual’s care plan. These systems will help to establish patterns of behavior prior to the introduction of the intervention and provide for continuous monitoring of the treatment outcome (Gasiewski & McKenna, 2023). If the provider you are considering does not offer guidance on this important topic, please consider other providers.
Parents and family members play a critical role in the treatment planning and implementation process. They must be fully involved as partners in the care of their family members (McKenna & Huang, 2023). The family’s role in the furtherance of treatment gains by extending the treatments to other settings and other persons is critically important. You can and should insist on being trained to implement all aspects of the intervention plan. In keeping with a focus on the family’s important role in the treatment of their child, there is a need for practitioners to ensure they are providing their services and recommendations with compassion (Celiberti, et al., 2021). The role of the care provider’s demeanor and willingness to provide support and instruction cannot be understated.
In summary, sixty years of rigorous research using single-subject research methods have shown the power of interventions based upon Applied Behavior Analysis. We urge families to carefully assess all recommendations for teaching new skills, and to continue to follow the evidence-based recommendations you will find in our monthly publication, Science in Autism Treatment.
Selected References
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) American Psychiatric Publishing; 2000. 2
Centers for Medicare and Medicaid for the U. S. Dept. of Health and Human Services (2010).
Johnson, C. P., & Myers, S. M. (2007). American Academy of Pediatrics, Council on Children With Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120, 1183-1215.
Mastergeorge, A. M., Rogers, S. J., Corbett, B. A., & Solomon, M. (2003). Nonmedical interventions for autism spectrum disorders. In: S. Ozonoff, S. J. Rogers, & R. L. Hendren (Eds.), Autism spectrum disorders: A research review for practitioners. (pp.133-160). American Psychiatric Publishing, Inc.
Myers, S. M., Johnson, C. P., & the Council of Children with Disabilities (2007). Management of children with autism spectrum disorders. Pediatrics, 120(5), 1162-1182. https://doi.org/10.1542/peds.2007-2362
National Standards Project. (2015). National standards project report. National Autism Center.
U.S. Department of Health and Human Service (1999) Mental Health: A report of the surgeon general.
Systematic reviews of scientific studies:
Fennell, B., & Dillenburger, K. (2014). The evidence debate for behavioural interventions for autism. International Research in Education, 2(2), 1-15. https://doi.org/10.5296/ire.v2i2.4989
Reichow, B. (2012). Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 512-520.
Wong, C., Odom, S. L., Hume, K. A., Cox, C. W., Fettig, A., Kurcharczyk, S., Brock, M. E., Plavnick, J. B., Fleury, V. P., & Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45(7), 1951-66.
Task Force Findings:
Hyman, S.L., Levy S.E., Myers, S.M., AAP COUNCIL ON CHILDREN WITH DISABILITIES, SECTION ON DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS. (2020). Identification Evaluations and Management of Children with Autism Spectrum Disorder. Pediatrics.145(1):e20193447. http://pediatrics.aappublications.org/content/early/2019/12/15/peds.2019-3447
Ministers’ Autism Spectrum Disorders Reference Group. (2007). Making a difference for students with autism spectrum disorders in Ontario schools: From evidence to action. Toronto, ON: Report to the Minister of Education and Minister of Children and Youth Services.
National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. Author.
Steinbrenner, J. R., Hume, K., Odom, S. L., Morin, K. L., Nowell, S. W., Tomaszewski, B., Szendrey, S., McIntyre, N. S., Yücesoy-Özkan, S., & Savage, M. N. (2020). Evidence-based practices for children, youth, and young adults with Autism. The University of North Carolina at Chapel Hill, Frank Porter Graham Child Development Institute, National Clearinghouse on Autism Evidence and Practice Review Team.
United States Surgeon General (1998). Mental health: A report of the Surgeon General. Washington, DC: Author.
Selected Scientific Studies:
Boyle, M. A., Monaco, B. L., & Ebeling, L. M. (2023). Treating elopement without extinction in a preschool setting. Behavioral Interventions, 38(1), 268-282.
Burgio, L. D., & Burgio, K. L. (1986). Behavioral gerontology: Application of behavioral methods to the problems of older adults. Journal of Applied Behavior Analysis, 19(4), 321-328.
Custer, T. N., Stiehl, C. M., & Lerman, D. C. (2021). Outcomes of a practical approach for improving conversation skills in adults with autism. Journal of Applied Behavior Analysis, 54(1), 309-333.
Kim, J. Y., Fienup, D. M., Oh, A. E., & Wang, Y. (2022). Systematic review and meta-analysis of token economy practices in K-5 educational settings, 2000 to 2019. Behavior Modification, 46(6), 1460-1487.
Harvey, M. T., Luiselli, J. K., & Wong, S. E. (2009). Application of applied behavior analysis to mental health issues. Psychological Services, 6(3), 212-222.
Joseph, L. M., Alber-Morgan, S., & Neef, N. (2016). Applying behavior analytic procedures to effectively teach literacy skills in the classroom. Psychology in the Schools, 53(1), 73-88.
Lee G. T., Hu X, Liu Y, & Yang Z. (2021). Improving pretend play for children with autism through experiencing the stimulus properties of real objects. Journal of Applied Behavior Analysis, 54(4), 1369-1384.
Morris, C., Stapleton, K., Conway, A., & Peterson, S. M. (2021). A brief assessment of pica. Behavioral Interventions, 36(4), 1042-1051.
Newcomb, E. T., & Hagopian, L. P. (2018). Treatment of severe problem behaviour in children with autism spectrum disorder and intellectual disabilities. International Review of Psychiatry, 30(1), 96-109.
Peters, L. C., & Thompson, R. H. (2015). Teaching children with autism to respond to conversation partners’ interest. Journal of Applied Behavior Analysis, 48(3), 544-562.
Peterson, K. M., Phipps, L., & Ibañez, V. F. (2022). Food-related disorders and applied behavior analysis. In J. L. Matson & P. Sturmey (Eds.) Handbook of Autism and Pervasive Developmental Disorder. Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-030-88538-0_44
Porritt, M., Burt, A., & Poling, A. (2006). Increasing fiction writers’ productivity through an interest-based intervention. Journal of Applied Behavior Analysis, 39(3), 393-397.
Ruben, D. (2019). Behavioral forensics: Using applied behavior analysis in psychological court evaluations. Academic Press.
Silverman, K., Kaminski, B. J., Higgins, S. T., & Brady, J. V. (2011). Behavior analysis and treatment of drug addiction. In W. W. Fisher, C. C. Piazza, & H. S. Roane (Eds.), Handbook of applied behavior analysis (pp. 451-471). The Guilford Press.
Solis, M., El Zein, F., Vaughn, S., McCulley, L. V., & Falcomata, T. S. (2016). Reading comprehension interventions for students with autism spectrum disorders: An alternating treatments comparison. Focus on Autism and Other Developmental Disabilities, 31(4), 284-299.
Stocco, C. S., Thompson, R. H., Hart, J. M., & Soriano, H. L. (2017). Improving the interview skills of college students using behavioral skills training. Journal of Applied Behavior Analysis, 50(3), 495-510.
Thomas, B. R., Nasca, B., Cohen, J., & Strohmeier, C. W. (2023). Functional analysis and chained schedule treatment of elopement in teens with autism spectrum disorder. Developmental Neurorehabilitation, 26(4), 223-233.
Weatherly, J. N., & Flannery, K. A. (2008). Facing the challenge: The behavior analysis of gambling. The Behavior Analyst Today, 9(2), 130-142. https://doi.org/10.1037/h0100652
Zawadzki, C., Wheeler, K., Hamrick, J., Favela, A., & Heichel, K. (2024). Effects of video prompting on daily living skill acquisition in autistic adults. Education & Training in Autism & Developmental Disabilities, 59(1), 3-16.
Other References:
Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1(1), 91-97.
Celiberti, D., Wirth, K., & McKenna, K. (2021). Humanity of ABA: ABA as a humane approach. In J. A. Sadavoy, & M. L. Zube. (Eds.), Scientific framework for compassion and social justice: Lessons from applied behavior analysis (1st ed.). Routledge.
Cooper, J. O., Heron, T. E., & Heward, W. L. (2019). Applied Behavior Analysis. Pearson Publication.
Gasiewski, K., & McKenna, K. (2023). Focus on the treatment team: Applied behavior analysis. Science in Autism Treatment, 20(12).
Green, G. (2018). Consumer corner: Identifying applied behavior analysis interventions. Science in Autism Treatment, 15(2), 6.
McKenna, K., & Celiberti, D. (2023). Description of the treatment team. Science in Autism Treatment, 20(4).
McKenna, K. & Huang, X. (2023). What can I expect from a quality ABA program? Science in Autism Treatment, 20(2).
Citation for this article:
McKenna, K. (2024). A treatment summary: Applied Behavior Analysis. Science in Autism Treatment, 21(3).
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