Applied Behavior Analysis

What is applied behavior analysis?

Does your child have trouble interacting with other people? Have difficulty making eye contact? Issues with language development? Engage in long or intense episodes of crying or tantrums? If you’re the parent of a child with autism, you know very well how much these behaviors can affect their life. You may want to consider applied behavior analysis (ABA).

Applied behavior analysis, or ABA therapy, is a type of behavioral therapy for people with autism and other developmental disorders. It’s based on the idea that if you reward certain behaviors then children will repeat those behaviors. In other words, when you reinforce specific behaviors, those behaviors will increase. When you don’t reinforce certain behaviors, those behaviors will decrease and may eventually go away altogether. ABA may help people with autism:

• Improve social interactions.
• Learn new skills.
• Increase positive behaviors.
• Lessen challenging behavior.

Studies show that ABA significantly affects socialization, communication and expressive language. Some studies have shown that when ABA therapy was used for more than 20 hours a week during the first few years of life (before age 4), it produced large gains in development and even reduced the need for special services later in life.

What happens during ABA therapy?

When your child first starts ABA therapy, they’ll meet with a Board Certified Behavior Analyst (BCBA) who’ll assess your child’s needs and ability level. Once they’ve gotten to know your child and understand their abilities, they’ll come up with an individual treatment plan with specific intervention targets in mind.

Your child’s ABA therapist will use a variety of techniques depending on your child’s needs and the behavior they want to target.

ABA Methodologies

BCBAs may use several techniques when implementing ABA. Common strategies include prompting, reinforcement and increasing functional communication.

Discrete Trial Training (DTT)

Discrete Trial Training (DTT) is often incorrectly used interchangeably with ABA. While DTT is a method of teaching, DTT and ABA aren’t one and the same. Early ABA programs often utilized DTT alone to teach. But the method first used by Dr. O. Ivar Lovaas in the 1960s has evolved over time.

With DTT, a healthcare provider leads your child one-on-one through a series of tasks in a highly structured way, which can be effective for some learners.

In the past, providers used punishment for incorrect behaviors. This is no longer an acceptable method in DTT therapy.

Pivotal Response Treatment (PRT)

Pivotal Response Treatment (PRT) is much less structured than DTT. The therapy focuses on play and other activities that are a normal part of your child’s life. PRT uses your child’s interests and attention to guide their learning.

With PRT, a therapist follows your child’s lead. They don’t start an activity until your child engages with something. For example, let’s say your therapist wants to teach your child their letters. They put out a set of blocks with letters on them. They may introduce the idea, but they’ll let your child guide themselves to the blocks.

PRT also uses natural forms of reinforcement related to the target behavior instead of rewards like candy. For instance, if your child is working with the stack of blocks, a reward may be letting them knock down the stack if that’s what they want to do.

Early Start Denver Model (ESDM)

Early Start Denver Model (ESDM) uses play-based activities like PRT, but it also uses more traditional forms of ABA like DTT when needed.

With ESDM, there are multiple goals to reach within one activity. For example, one goal might be for your child to learn the shape of a triangle, so they’ll be asked to pick out a triangle puzzle piece. And at the same time, they might want to work on fine motor skills, so they’ll need to fit the triangle piece into a puzzle.

What are the potential benefits of applied behavior analysis?

Applied behavior analysis has many potential benefits, including:

• Widespread use: ABA can be used for a variety of health conditions, including autism.
• Personalized plan: Your child’s therapist will put together a plan tailored to your child’s needs and abilities.
• Evidenced based: Many studies have shown positive outcomes.
• Strategies that can be used at home: ABA can help you teach and measure progress at home.

What are common misconceptions about applied behavior analysis?

Applied behavior analysis has received criticism in the past. In its earliest form, ABA used punishment as a method of behavioral modification if children failed to learn skills. Although punishment is no longer used, many people still oppose the therapy for various reasons, including:

• Forced “normalization” and change: Opponents often state that ABA attempts to “normalize” the behavior of neurodivergent children and make them act like everyone else. In practice, the primary focus of ABA is to address socially significant behaviors: those that impact the safety and learning of your child.
• Compared to animal training: The methods used in ABA are sometimes used in animal training. Because ABA is based on the science of learning and behavior, positive reinforcement and prompting are used as teaching tools to address socially significant behaviors.
• Focuses on behavior problems: While ABA does aim to reduce challenging behaviors, effective ABA programs do so by teaching functional alternatives and increasing positive behaviors.
• ABA uses bribery to teach kids: Because positive reinforcement is common in ABA, those who oppose ABA suggest that children are bribed into “being good.” With positive reinforcement, your child is presented with the expectations in advance. With bribery, your child is often already engaged in a challenging behavior when a reward is offered.

How long will my child need ABA therapy?

The amount of time your child spends in ABA therapy depends on many factors. Each child is different. Once your child starts working with a therapist, they can help you determine how long your child may need. The type of therapy, how much help your child needs and how quickly they improve are all factors that your child’s therapist will consider.

A note from Cleveland Clinic

If your child has received an autism diagnosis, you may feel overwhelmed. You want to do what’s best for them, but there are a variety of treatment options available — it’s hard to know what to choose. Your child’s healthcare provider is the best person to talk to about your options, but you may want to consider applied behavior analysis. Through ABA therapy, your child will work with a therapist to help modify their behavior and potentially reduce the need for special services later in life.