I am a father of a three-year-old boy who has recently received an autism diagnosis. Our pediatrician recommended we investigate ABA services. However, when I researched ABA on the internet, I was confused by the mixed information I found. It seems that there are people who have strong opinions about ABA that conflict with what my pediatrician told me. I know it is important for my child to receive quality early intervention services. Could you provide me with some accurate information about ABA?

Answered Kate McKenna, MEd, MSEd, MS, BCBA, and Ximing Huang, BA
Association for Science in Autism Treatment

What can I expect from a quality ABA programThe time immediately following an autism diagnosis can be overwhelming for parents who are dealing with the stress of the evaluation process and struggling with the need to access educational and social support for their child. At this point, parents will be searching for interventions that will result in positive improvements for their children. Unfortunately, as many of our readers know, an internet search for autism interventions will yield a multitude of treatments, most of which have little or no basis in science and are not backed by rigorous research proving their efficacy.

It may help to first tell you more about what applied behavior analysis (ABA) is and something about its history. 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 how we help. Since behavior is shaped by the individual’s interactions with people, objects, and events in the environment, we can arrange the environment to affect the change we want to see. In your child’s case, this means creating lessons and activities that build on your child’s strengths to target increasing his social, communication, play, and pre-academic skills.

It is important to share that even though ABA is commonly associated with autism treatments, 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). These broad applications speak to the strength of ABA-based interventions in addressing so many diverse challenges. It is a common misconception that ABA itself is an autism intervention. In fact, ABA is a branch of the science of behavior that is focused on application in the attempt to find solutions to challenging situations in our society (Cooper, 2019). There are, however, many autism interventions based on the principles of ABA that have been demonstrated to successfully increase learning and decrease challenging behavior in individuals with autism. These interventions are backed by decades of rigorous scientific research carried out by hundreds of individuals that demonstrate the efficacy of interventions based on the principles of ABA (Cooper, 2019). Remember ABA is not a teaching method in and of itself. ABA is the science behind how we teach.

What you can expect from a quality-focused ABA program for your child. In the subsequent bulleted paragraphs, we describe characteristics of such a program.

    • The importance of consent/assent. Family members should be provided with clear explanations of the strategies that will be used in the program. The content of the consent should be readily understandable to the family members and other stakeholders involved in the program. Consent is also important in the interactions during teaching sessions between the providers and your child. One key aspect of learning is genuine engagement in the activity and with the materials. The goal is for your child to be happy, relaxed, and engaged, willingly participating with no visible signs of discomfort (Hanley, 2021; Parenti & Rothman, 2023). If your child is demonstrating distress, that behavior should be seen as a withdrawal of consent. The provider may then move on to a different activity and later meet with you to discuss changes to the program. To the extent possible, the child should also be engaged in discussions about goals and strategies (i.e., assent should be solicited as is appropriate).
    • How the program will be organized. An educational program created by an appropriately qualified autism professional is highly individualized. Typically, a treatment team often consisting of a BCBA, an RBT, a speech/language pathologist/therapist (SLP), an occupational therapist (OT), and sometimes a physical therapist (PT), work together with you and your family to create a comprehensive intervention program. Goals will be chosen based on your child’s current level of skill, working towards the result of increasing their independence, their social and communication skills, as well as pre-academic skills that will help them be successful in preschool. The BCBA working with your family and the team will focus on several key areas to support your son. In addition to teaching new skills, they will help his skills generalize from one situation or environment to another. The overarching goal of the program is to teach important skills to your preschooler that will be acquired, practiced regularly in appropriate environments, maintained, and used in all settings in which their use is appropriate.
    • Teaching others to be effective intervention partners. One hallmark of ABA is that parents, family members, and caregivers are viewed as partners in the process. You can expect that team members will coach you in some of the strategies used in teaching sessions and encourage you to practice the skills with your child throughout the day.
    • Using data to make decisions. The individualized program of skills development recommended for your child should be guided by strict adherence to the use of data to make decisions regarding progress. Data should be provided to you for your review and explained to you in a manner you understand. ABA providers are often faulted for their reliance on data. ABA interventions are data driven because that is how we can verify that students are truly learning and making progress. Using data to make educational decisions ensures that you can track your child’s progress and be assured that mastery criteria have been met (Celiberti et al., 2021).
    • Response to disengagement or challenging behavior during teaching activities. The BACB Code of Ethics (BACB, 2020) mandates that reinforcement be the primary strategy used in teaching new skills and affecting change in behavior. Reinforcement is most effective when it is individualized and meaningful to the student and when they feel they have input into possible choices (Hanratty & Hanley, 2021). Preferences change over time (Butler & Graff, 2021), so team members will regularly gather information from you about your son’s preferred toys, foods, activities (Cooper, 2019), and forms of social interaction and praise, such as fist bumps or High-5s (Morris & Volmer, 2021). The professionals working with your child will strive to create lessons and activities that increase agency, communication, and engagement in learning.Any response to challenging behavior should be discussed with all team members. It is important to clarify how behavior will be assessed to ensure an understanding of the function of the behavior(s) and what strategies might be used to reduce those behaviors (see Consent above). Focus will be given to teaching replacement behaviors for any behaviors that are interfering with or limiting learning (Ghaemmaghami et al, 2021), as these may impact the acquisition of new skills or otherwise restrict an individual’s full participation in educational and social settings. It is important to note that your approval of any and all responses would be required before implementation.
    • Who can provide quality-focused programs for preschoolers with autism? ABA services are provided by professionals who are trained in the science of applied behavior analysis as well as the teaching techniques and strategies based on that science. Some of these professionals are persons with board certification in behavior analysis. The three levels of certification are overseen by the Behavior Analyst Certification Board (BACB). In addition to a master’s degree in ABA, special education, or psychology, board-certified behavior analysts (BCBAs) have completed a graduate level 7-course sequence, 2000 hours of supervised practice, and passed a qualifying exam. BCBAs are required to complete 32 hours of professional development every two years. Board-certified assistant behavior analysts (BCaBAs) must also complete the course sequence, along with 1,300 hours of supervised fieldwork, and pass a certification exam. BCaBAs are supervised closely by the BCBA working with the family. In some cases, programs designed by the BCBA are conducted by a Registered Behavior Technician (RBT) who will have completed a 40-hour course. RBTs may only work under the close supervision of a BCBA. All clinicians certified by the BACB practice under a Code of Ethics that has four core principles: benefit others, treat others with compassion, dignity, and respect, behave with integrity, and ensure competence. The emphasis on providing accountable and compassionate services, relying on the use of data implemented by qualified practitioners, is foundational to helping the family and child make important progress on crucial milestones.

We understand the frustration of finding the right services for your son. We hope we have provided you with clear information and that this has been helpful to you and your family. If you are interested in learning more about getting started, please check out this comprehensive packet for parents of newly diagnosed children. In addition, there is an annotated reading list relevant to parent of newly diagnosed children that may also be helpful to you.

References

Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior Analysis. Journal of Applied Behavior Analysis, 1, 91-97.

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. https://bacb.com/wp-content/ethics-code-for-behavior-analysts

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.

Butler, C., & Graff, R. B. (2021). Stability of preference and reinforcing efficacy of edible, leisure, and social attention stimuli. Journal of Applied Behavior Analysis, 54(2), 684 –699. https://doi-org./10.1002/jaba.807

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.

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

Ghaemmaghami, M., Hanley, G. P., & Jessel, J. (2021). Functional communication training: From efficacy to effectiveness. Journal of Applied Behavior Analysis, 54(1), 122–143. https://doi-org./10.1002/jaba.762

Hanley, G. (2021, September 9). A perspective on today’s ABA from Dr. Hanley.
https://practicalfunctionalassessment.com/2021/09/09/a-perspective-on-todays-aba-by-dr-greg-hanley/

Hanratty, L. A., & Hanley, G. P. (2021). A preference analysis of reinforcer variation and choice.Journal of Applied Behavior Analysis, 54(3), 1062–1074.

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.

Morris, S. L., & Vollmer, T. R. (2021). Evaluating the function of social interaction for children with autism. Journal of Applied Behavior Analysis, 54(4), 1456–1467.https://doi.org/10.1002/jaba.850

Parenti, K., & Rothman, H. (2023). What is the importance of engagement when working with individuals with intellectual and developmental disabilities and autism? Science in Autism Treatment, 20(01).

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

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.

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

Citation for this article

McKenna, K. & Huang, X. (2023). What can I expect from a quality ABA program? Science in Autism Treatment, 20(2).

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