Applied Behavioral Analysis (ABA) is one of the oldest and most respected autism interventions, and it has a strong track record of improving autism symptoms. However, critics claim that ABA produces trained, robotic responses and does not allow enough true self-expression. Learn about ABA and whether this treatment might benefit your child.
What Happens in ABA Treatment?
ABA involves an intensive one-on-one treatment program with a trained therapist. Therapy can take up to forty hours a week, and focuses on your child's unique learning needs. According to Autism Speaks, success of this treatment strategy relies largely on the fact that ABA is performed on a one-on-one basis, and thus a program can be tailored specifically to your child.
Assessment
Applied behavioral analysis begins with an assessment. This will show which skills your child already possesses and which skills still need to be developed. Once identified, the skills that are still lacking become a central focus of the treatment program. Goals will center on skills that further academic development, communication, and social skills and reduce restrictive of maladaptive behaviors. The therapist will create different procedures to help teach your child.
One-on-One Discreet Trial Teaching
Common techniques in ABA are discrete trial teaching (DTT) and prompting. DTT therapy operates in a strict routine that focuses on developing one skill until mastered through repetition and immediate positive reinforcement.
A therapist will work on developing behavior, communication and speech in sessions. The therapist asks questions to encourage the patient to speak and will often give a clue to an appropriate answer to develop conversations skills. He will ask one question at a time until the patient gives an appropriate answer, guiding the patient toward the correct answer. It is important to note that ABA focuses on behavioral responses rather than getting the "right" answer. The process involves a give-and-take exchange that requires the child to respond to other people.
Ongoing Support at Home
Although the therapist works one-on-one with the child, treatment also continues in the child's home environment. Parents and caregivers continue to use the same techniques and rewards to provide consistent expectations and treatment. This allows the child to grow through learning opportunities that are planned and unplanned and occur in a variety of settings and situations.
Effectiveness of Applied Behavior Analysis
Over the years, many researchers have studied the effectiveness of ABA in treating autism. In almost all major studies, ABA is shown to be very effective in most cases. However, there is some debate about whether this treatment is more effective than other approaches.
- A review article published in the journal Research in Autism Spectrum Disorders determined that early intervention using ABA practices is extremely effective.
- A 2012 study by the International Society for Autism Research found that while ABA was an effective form of early intervention, it was not more effective than alternatives like intervention programs targeting specific social and communication skills.
- A 2011 study published in the journal European Psychiatry found that ABA was effective in treating autism, but a holistic approach was at least as effective.
Pros and Cons of ABA
ABA therapy is generally widely accepted as a well established and effective treatment option. However, like any treatment, ABA does have some potential disadvantages. Before deciding whether this treatment is right for your family, it's a good idea to become aware of the pros and cons of ABA.
Advantages of ABA
You might want to consider using ABA for the following reasons:
- No other developmental or behavioral treatment has been in use longer than ABA.
- This approach works well with the need for consistency experienced by many people with autism.
- More research and support is available for ABA than for any other type of autism therapy.
- ABA therapists typically follow clear treatment guidelines and are required to keep extensive notes on therapy progress.
- Numerous studies show improved learning, social skills, cognitive function, self-help skills, and communication in autistic children treated with ABA.
Disadvantages of ABA
This therapy may have the following disadvantages:
- Guidelines require autistic children to receive 40 hours of ABA each week, which is inconvenient and extremely expensive.
- Not all schools offer ABA instruction, and those that do tend to limit therapy to regular school hours.
- Poorly trained ABA therapists may inadvertently cause robotic behavior and speech patterns in autistic children undergoing the therapy.
- ABA is behavioral, not academic. It focuses on the response of the child but not necessarily the cognitive process that elicits the response.
- Critics of ABA are concerned that this type of therapy encourages a child to suppress true emotions and self-expression, which can ultimately be harmful.
Is ABA Right for Your Child?
Deciding whether or not ABA is right for your family should involve a conversation with your child's autism specialist or psychologist. There are several things you might want to consider when making this decision.
Functioning Level
Autism spectrum disorders vary significantly in their severity. Most studies of ABA effectiveness involve children with low or moderate functioning levels; however, proponents of ABA believe it can also be effective for high-functioning autism. If you're considering ABA for mild autism, be sure to talk to the ABA therapist about how they plan to engage and challenge your child.
Child's Age
According to WebMD, ABA works best when kids begin treatment early, usually before the age of five. The treatment may help older kids and even adults, but there is less evidence to support this.
Goals
ABA is, by its nature as an evidence-based intervention, extremely goal-oriented. Before deciding on a treatment, it's important to consider the approach that best meets the goals you have for your child. ABA targets behaviors, but it does not directly work on academics or emotional relationships.
Affordability
The cost of ABA, which can be over $35,000 per year, can be a deciding factor for many families. However, it's important to remember that ABA has different levels of intensity, and you may be able to provide much of your child's treatment yourself at home. Talk to the provider before dismissing this therapy due to cost. Additionally, some insurance companies may cover this treatment.
Availability
It may be difficult to find an ABA therapist near you or to get on a waiting list for this popular treatment. For local recommendations, talk to you pediatrician, your child's school support team, other therapists, and members of your support group.
Tried and True
Applied Behavioral Analysis is a tried and true therapy for autism and has been proved effective in countless studies; however, it may not be the right choice for every child. If you decide to use this approach with your child, be sure to choose a provider who is accredited by the Association of Professional Behavior Analysts or the Behavior Analyst Certification Board.
