Applied Behavioral Analysis (ABA) is utilized in home and school environments as a behavior intervention system for children with autism spectrum disorders. This article presents a brief introduction to the history of ABA and its inception. Further discussed are ways ABA is utilized in a public school setting through education strategies and roles and impacts on certain groups that include students, teachers, and administrators. Solutions for new teachers designing programs or working with autistic children are offered to help them develop the most effective programs through partnerships and collaboration.
Keywords Adaptive Behavioral Function; Autism Spectrum Disorders; Behavioral Intervention; Early Intervention; Educational Function; Intellectual Function
Overview of Autism Interventions
Autism spectrum disorders is an umbrella term for a family of neuro-developmental conditions characterized by early-onset social and communication disabilities, challenges with imagination, and restrictive behaviors that range from stereotyped movements to accumulating vast amounts of information on specific topics (Volkmar, Lord, Bailey, Schultz, & Klin, 2004). Impairments in social interaction is one of the main factors typical of autism disorders, and these disorders also cause multiple deficits in language, play, eye contact, and gestures (Kanner, 1943). According to the Individuals with Disabilities Education Act (IDEA), other characteristics of autism include “irregularities in communication, repetitive movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences” with the added restriction of the capacity for abstract thought, especially as the individual ages (Hardman, Drew, Egan, & Wolf, 1993).
Autism is a life-long impairment with multiple impacts. Early intervention is central to overcoming many of the difficulties resulting from autism. Despite evidence that autism disorders can be identified as early as 18 months, many children are not identified until much later. As of 2007, children will be screened for autism during well baby checks twice yearly. Given these advancements in early diagnosis, advancements in early intervention programs at earlier ages have also been made (Centers for Disease Control, 2007). Theoretically, many of the interventions developed and offered to autistic children remain highly questionable and untested in terms of long-term research and impact. According to Reed, Osborne & Corness (2007), "It should be noted that it is not clear to the degree to which any program has fidelity to the manual in the face of specific demands of individual children…, and [they] vary from individual-to-individual, and from day-to-day within individuals" (p. 432).
Available treatments for autism vary significantly in terms of "context (e.g., school vs. home), intensity, and theoretical underpinning." Many children receive a variety of treatments, and it should be noted that parents and professionals face difficulty in determining the most appropriate programming for children in accordance with their age, severity of impact, and philosophy (Sheinkopf & Siegel, 1998, p. 15). Before children are placed in a school environment, home programs are typically developed and are used to prepare children for school and community environments. Most behavioral treatment protocols require highly structured, time consuming, and intensive programs. Applied Behavior Analysis has been recommended as a treatment option for autism spectrum disorders (McIlvane, 2006).
Background of Applied Behavioral Analysis
Reed, Osborne and Corness (2007) explain that Applied Behavioral Analysis (ABA) is based on the behaviorist approach of altering behaviors through systematic, extrinsically reinforced behavior modification and training originating from the philosophies of B. F. Skinner, and there are a number of different ABA approaches that have been outlined in a variety of sources. In general, these approaches involve:
• The one-to-one teaching of children with autism by adult tutors;
• A discrete-trial reinforcement-based method; and
• An intensive regime (up to 40 hours a week, for 3 years, in some instances) (p. 419).
One such favored approach operating from this methodology was developed by Lovaas and was entitled the Early Intervention Program or EIP. Lovaas is considered to be the founder of the ABA approach, and his philosophies, program overview, and findings will be examined.
The Lovaas Method
The Lovaas method of ABA that is central to the UCLA Young Autism Project was first developed to maximize behavioral gains made by children during every waking minute. The complete outline for treatment was described in Lovaas' (1981) book entitled: Teaching Developmentally Disabled Children: The Me Book. For the most part, the model is based partially on the principles of operant learning. The primary teaching method is based on discrete trial discrimination learning and compliance with simple commands. Simple commands include: "sit down," "put here," and "look at me." All negative and aggressive behaviors initiated by the child are ignored or punished, and positive behaviors are reinforced. In some cases physical punishments or verbal reprimands are used to extinguish negative behaviors. These punitive reprimands can be represented as a loud "No!" or a slap on the thigh.
The most significant hallmark of the Lovaas program was the duration of time spent in program and program development. According to Lovaas (1987), the program was designed to occur over a 3-year time frame for 365 days per year with a minimum of 40-hours or more a week of initiation. The program outline mandates that for the first year, the majority of attention is focused on the reduction of self stimulatory and aggressive behaviors, increasing imitation responses, generating appropriate toy play, and extending treatment into the family. In the second year of the program, expressive and abstract language is taught as well as "appropriate" social interactions with peers. The third year of the program emphasizes the teaching of appropriate emotional expression, pre-academic tasks, such as reading, writing, and math, and observational learning of peers involved in academic tasks. The average cost of an Applied Behavioral Analysis program based on the Lovaas' model costs an estimated $60,000 per year per child ("Alternatives to Lovaas' Therapy," 1996).
After the conclusion of Lovaas' 1987 findings based on his original study and results, he wrote and published a paper outlining his findings. Initial results reported by Lovaas (1987) concerning the effectiveness of the ABA approach seemed to be miraculous in their results. According to Lovaas' research regarding his designed treatment, children who underwent this approach “made gains of up to 30 IQ points (a finding noted in some children with autism spectrum disorders undergoing special educational programs) (Gabriels et al., 2001). Just less than half of these children appeared to recover, that is, they were not noticeably different from normally developing children after 3 years of the intervention” (Reed, Osborne, & Corness, 2007, p. 419). Despite these amazing results, Lovaas' critics have noted numerous problems with the original study.
Criticism of Results
Firstly, critics allege that one significant problem with Lovaas' 1987 study revealed that Lovaas selected verbal, relatively high functioning participants who might have performed well with reasonable input (Reed, Osborne, & Corness, 2007, p. 419). Secondly, many of the questions surrounding Lovaas' study are centered around the fact that the study was clinical rather than school or community based, which raises questions about generalizability from the clinic to school and community settings (p. 419). Thirdly, all of the “significant number of critiques of Lovaas' original piece of research (i.e., Lovaas, 1987) have focused on problems both with the internal and external validity of the study (e.g., Connor, 1998; Gresham & MacMillan, 1997; Mudford et al., 2001)”(Reed, Osborne, & Corness, 2007, p. 419). These problems create confusion about the actual results of the study and whether the results justify the costs of the program.
In their recent study, Reed, Osborne, and Corness (2007) examined three different autism interventions in a community setting. The three interventions studied comparisons between the ABA model, the portage model, and a special nursery placement. Several findings resulted from this study that both support the ABA model in some instances, as well as other interventions that were less costly and time consuming, yet still offering some features of the ABA model including one-on-one tutoring and overlaps between home and educational environments. Program impacts examined results on stereotyped behaviors, communication difficulties,...
This paper focuses on how Applied Behavioral Analysis (ABA) is used to treat and manage autism spectrum disorders. Thus, the paper appraises ABA, discussing its important components and how it works. The paper also succinctly discusses about the autism spectrum disorders. Finally, the paper concludes with an analysis of how ABA is used to treat autism spectrum disorders.
Applied Behavior Analysis Treatment for Autism Spectrum Disorders.
Studies have shown that one of the most effective modes of intervention in ASD (Autism Spectrum Disorders) is Applied Behavior Analysis (ABA). ABA is also termed behavioral treatment or behavioral intervention. According to the research done by Wynn & Groen (2010), ABA produces comprehensive and long-term improvements in the most essential skill areas in children who have ASD, notwithstanding their age (p 809). Laving (2010) stated that the main objective of ABA as applied to ASD is to maximize the successes, while concurrently, reducing the failures (p763). ABA techniques make use of scientific principles, based on current behavioral learning theorems, to alter conducts in ASD patients by fostering socially-constructive repertoires and minimizing the problematical ones. ABA is a structure-based intervention that places much emphasis on the use of precise high-intensity teaching techniques to enhance language skills (such as imitation, cooperation and attention), and ensure that the affected children do obtain a collection of constructive manners (Wynn & Groen, 2010).
ASD, also termed as PDD (Pervasive Developmental Disorder), is an intense long-term developmental disability which normally manifests itself during the early childhood period. It incorporates a cluster of developmental disorders together with their associated symptoms that have varying levels of intensity.ASD is neuro-behavioral in nature, thus, its effects are severe. Usually, ASD is diagnosed in the child before he or she is three years old. It cause the effects outlined below. Restricted repetitive patterns of behavior characterized by obsession with the sensory features of physical entities. There are impairments in social affinity, with the most common feature being inability to establish and maintain proper peer relationships. There is delayed development of cognitive functions, thus cognitive impairment occurs. Also, there is impairment in communication, both verbal and non-verbal, as evidenced by absent or delayed development of spoken language (Pearson, 2011).
It has been postulated that ASD is caused by a neuro-developmental and neuro-operational dysfunction in the brain, though its correlation with the associated behavioral manifestations are still unclear. Also, epidemiological studies have shown a strong correlation between ASD and psychiatric disorders that are genetic in origin, with the hereditary factor in ASD being greater than 90%. It affects boys more than girls with a gender disparity ratio of 4:1, though no scientific model based on genetic studies has been able to explain this discrepancy. The ASD spectrum encompasses autistic disorder, Rett’s disorder, Asperger’s disorder, Childhood Disintegrative Disorder and PDD-NOS (Pervasive Developmental Disorder-Not Otherwise Specified).
The common comorbidities associated with ASD are intellectual disabilities, lack of functional speech, behavioral disorders (such as obsessive compulsive disorder, attention deficit hyperactivity syndrome, tics and self-injurious behaviors), anxiety, depression and Bipolar disorder. Screening for ASD is done at two levels; Level I screening with involves developmental surveillance, and Level II screening which involves diagnostic evaluation and comprehensive investigations for developmental disorders (Pearson, 2011).
Treatment for ASD can be categorized into two levels. The first level is the treatment of core symptoms, and this involves addressing the developmental, educational, and behavioral requirements of the individual with ASD. The second level of management involves other forms of treatment, such as physical, speech and occupational therapies, which are indispensable in the management of autistic disorder but they do not treat other disorders, for instance, developmental delays (Pearson, 2011).
ABA is a treatment program that basically makes use of repetitive reinforcements to teach particular skills to the students, while concurrently, minimizing and/or eradicating the inappropriate behaviors (Mendelsohn, 2010).
The nine principles of ABA are outlined below. First of all, there must be an individual program for each and every student. Each program must correspond to the strengths and needs of the student. The second principle is task analysis which involves the assessment for tasks (or skills) that need to be taught. These tasks are then broken down into steps that can be easily taught. The third principle is discrete trial and prompting, which involves teaching each step individually. Fourthly, reinforcement is used to fortify each step taught. Reinforcement involves motivating the students by use of rewards. The fifth principle is repetition and prompts fading. This involves frequent practice of each step until the student masters the required skills. Skill development is the sixth principle. It involves integrating each step systematically until the student can complete the whole task autonomously. The seventh principle is data collection, and this involves frequent compilation of factual information with the aim of monitoring the progress of the student, in terms of acquisition of the required skills, and, the effectiveness of the program as a whole. The eighth principle is generalization. This involves teaching the student how to perform the whole task at different times, among different kinds of people and in different settings. The ninth principle is developmental skill building. Here the learnt skills are integrated developmentally with the aim of building a strong foundation that will serve as the basis for inspiration for self-initiated long-term learning. Thus, ABA describes how to teach (Mendelsohn, 2010).
ABA has seven characteristics or dimensions which are explained below. The applied characteristics takes into consideration the short-term behavioral change, effects of these behavioral change in the person with ASD with regards to interpersonal interactions between him or her and the family, close relatives, educators and the general public. The second dimension is behavioral change, and this behavioral change must be measured using objective parameters and not non-behavioral substitutes. The analytical dimension in the applied setting is demonstrated by behavioral control and maintenance of moral ethical standards. The technological characteristic implies that the descriptions made in ABA studies or researches are detailed, clear and precise. Hence, such studies can be replicated by a researcher. The conceptually systematic characteristic involves the utilization of procedures and interventions; and the interpretation of the obtained results within the limits of the principles of the procedures employed. The dimension of effectiveness analyses the practicability of ABA procedures in treating ASD and achieving the essential practical or social objectives. Finally, the generality dimension involves maintenance or continued gradual changes and enhancements of a particular skill after the behavioral interventions, for that specific skill, has been withdrawn for a significant period (Mendelsohn, 2010).
ABA treatment of ASD involves the three step procedure explained below. First of all, there is the antecedent which involves the use of tact, mand, intraverbals, autoclitics; or physical/verbal stimulus, for instance, a request or command. Secondly, there is the response to the stimulus, such as a specific resultant behavioral response to a specific stimulus or lack of response to that particular stimulus. Finally, there is the consequence, which is either the establishment of a positive reinforcement, or lack of response for an inappropriate behavior. The behavior is measured using the following parameters: repeatability, temporal extent, temporal locus and derivative measures (Wynn & Groen, 2010).
The skills in ABA are divided into small discrete tasks which are subsequently taught using prompts that gradually fade out as the required skills are grasped. Positive reinforcement is done using verbal praise or any tangible object that the student considers rewarding. Punishments are normally discouraged, but non-injurious methods of punishment such as a light spray of water on the face, may be used as a mode of intervention in a child who is engaging in activities that may cause self-injury (Wynn & Groen, 2010).
Individual programming has two main components: the curriculum and the ABA teaching methods. The curriculum for students with ASD mostly caters for the areas that need attention. These areas include communication, difficult behaviors, language development, independent functioning, life skills, leisure and play skills; and, social interaction and emotional development. Hence, the ABA teaching methods encompasses the following strategies: prompt, fading, task analysis, discrete trail training, shaping and chaining, pivotal response training, modeling, social scripting or script fading, video instruction, priming, incidental teaching, and structured peer-play interactions (Mendelsohn, 2010).
Reinforcement in ABA is a systematic consequence aimed at increasing the frequency of desirable behavior, not just using rewards to motivate the student. Thus, reinforcement must be linked directly to the values of the student, and needs to be planned and monitored closely. The procedure for reinforcement is as follows. Initially, the behavior that needs to be modified is selected. Next, the most potent reinforces that will alter this behavior are selected. The reinforcements are then made immediately when the behavior under consideration is manifested. The reinforcement is more effective when the reinforcer follows the behavior closely. Lastly, data on that specific behavior is collected prior to, for the duration of and subsequent to the teaching strategy or intervention that had been put in place for monitoring the progress of the student (Mendelsohn, 2010).
The data collection tools of ABA are more useful than the common assessment methods. The assessment methods used in the teaching strategy include the following: data collection and graphing, benchmarks, checklists, rubrics, running records, anecdotal records and video recording. The following measurements are used during data collection: frequency of demonstration of the required skills, the number of times these skills were done appropriately, duration of time of the execution of these skills, measurement of how much prompting is utilized in skill development, and the ration of correct to incorrect responses. Data is collected during three occasions; prior to, during and subsequent to teaching. Prior to teaching data collection is used to establish the baseline for skill development. Data that is collected during teaching is used to assess the effectiveness of the materials and teaching strategies used, and the progress of the acquisition of the required skills. Data collection subsequent to teaching is used to assess skill acquisition and the maintenance of the acquired skills, for example, can the student demonstrate the skills several months after it was taught? The collected data is then recorded (Mendelsohn, 2010).
The recorded data is used for troubleshooting and decision-making processes. Troubleshooting involves searching for patterns in various aspects of school programming and in the school environment that slow down the standard rate of progress, and initiating the necessary systematic changes (Mendelsohn, 2010).
In generalization, the educators must frequently change the materials in order for the student to develop a broader concept of the skill being taught. The standard rule in generalization is that a skill must be demonstrated or performed in at least three different settings, with three different individuals and at three different times using various teaching materials and teaching aids. Also, the skill is considered to be mastered or leant effectively when the student can demonstrate the skill correctly and independently in 9 out of every 10 attempts (Mendelsohn, 2010).
An effective ABA teaching strategy must put into consideration plans for transitions. Examples of transition in an individual with ASD includes transition into a new school setting, between grade levels, between different activities in different settings, transition from high school life into adulthood and life transitions in general. An effective plan encompasses the following two features; identification of the transition challenges for the student and setting up of clear goals and a teaching stratagem for managing and addressing these challenges(Wynn & Groen, 2010).