What is ABA Therapy?

ABA Therapy

ABA is the applied use of behavioral principles to everyday situations with the goal of either increasing or decreasing targeted behaviors. How this translates into practical application will depend on the specific situation. Nevertheless, all ABA programs share similar components:

Discrete trial teaching
This technical term means, quite simply, breaking a task down into smaller, more teachable components, teaching each component separately. A cue is given (SD) --> the child responds (R) --> a reinforcing consequence (SR) is given for a correct response

The cue, referred to as a discriminative stimulus (SD), is a specific environmental event or condition in response to which a child is expected to exhibit a particular behavior. What this looks like in everyday life is this:The cue, referred to an a discriminative stimulus (SD), is a specific environmental event or condition in response to which a child is expected to exhibit a particular behavior. What this looks like in everyday life is this:

  • Child 1: Hi! --> (SD)
  • Student: Hi. --> (R)
  • Child 1: [smiles] C'mon! Let's go! --> (SR)

This type situation occurs every day for typically developing children. For children with autism, frequently several skills may be lacking so that the child cannot or is not motivated to engage with the other child. Discrete trial training can address underlying skill deficits in order to increase a student's ability and motivation to respond socially to other people. In fact, the hallmark of discrete trial training is that almost any skill can be broken down into discrete parts so that weak areas can be targeted and strengthened.

Prompts may be given after an Sd to increase the likelihood that the child will demonstrate a correct response that can then be reinforced. Main types of prompts include verbal, physical, positional, gestural and model prompting.

Natural Environment Teaching - teaching for generalizations
Initially, therapy is usually conducted in a less chaotic environment, with the idea that having fewer distractions around in the learning environment will assist the child to focus and learn the task at hand. Programming for generalization takes into account the need for behaviors to occur across all environments, independently, and spontaneously. Thus criteria are set to include various setting and stimuli and a skill is not determined to be mastered unless and until the child demonstrates independent ability to perform across such environments.

Natural environment teaching is a collection of practices including environmental arrangements, interaction techniques and teaching strategies based on applied behavioral analysis. This naturalistic intervention is used in daily routines throughout the day to develop skills in the areas of communication and social development.

ABA Therapy

Reinforcement
When we think of reinforcement, we naturally think of things that we like. Behaviorally speaking, reinforcement means only that a behavior, when followed by a reinforcing stimuli, is more likely to increase over time. Thus, in an ABA program, each child's reinforcement (items and timing and activities) are likely to vary widely. All ABA programs should include a reinforcer assessment; and these assessments should be reviewed regularly over time to capture changes in the child's preferences. Reinforcers should be built on items and activities that are motivating to a child

When behaviorists talk about reinforcement with families and other lay persons, it is often in the context of presenting desired items or activities to a student. This is termed "positive" reinforcement. Another form of reinforcement is "negative" reinforcement - that is, the removal of an undesired (aversive) stimulus - which, when removed consistently over time, the target behavior is likely to increase. This concept is more easily understood in context. For example:

Child: Mommy, I want ice cream.
Mom: No, sweetie. Sd for child
Child: [tantrumming] I want it now!!!!! [screaming] Sd for Mom R for child
Mom: Okay, but just this time. And for heaven's sake, be quiet. [gives ice cream] R for Mom Sr+ for child
Child: [quiet] [takes ice cream] Sr- for Mom

In this scenario, the child's screaming was positively reinforced by the consequence of receiving a preferred item. The mother's giving the preferred item was negatively reinforced by the child stopping screaming.

In behavioral terms, the flip side of reinforcement is punishment, such that rather than increasing behaviors, punishment is measured in decrease of behaviors. Just to repeat, punishment, in behavioral terms, means only a decrease in a targeted behavior. Punishment does not mean the application of aversives, or restraints, or time outs. It means the decrease of targeted behaviors. There are a few main types of techniques used in punishment procedures: extinction (absence of Sr when a behavior occurs), time out (removal of the Sr+ from the child), response cost (removal of a token (in token economy) when targeted behavior occurs).

In addition, differential reinforcement strategies are used to help decrease unwanted behaviors. Therapists, teachers and parents all learn how to differentially reinforce alternative and other behavior, other rates of behaviors, and incompatible behaviors.

Prompting Strategies
There are several prompting strategies, but the ones you will hear about most often are most-to-least and least-to-most. A most-to-least strategy is typically used when a student is first learning a skill; the first trial is prompted with the most intrusive prompt appropriate to accomplish the skill successfully. The first trial is followed by second using a lesser intrusive prompt; this second, less-prompted successful trial is reinforced. A least-to-most- trial is typically used when a student has shown in the past an ability to accomplish successfully a task. No matter which strategy is used, it is critical to remember to fade prompts as quickly as is possible. Finally, remember to differentially reinforce those responses that require less prompting

What is a structured day?
Research supports intensive intervention, anywhere from 25 to 40 hours per week for 12 months a year, depending on the individual's needs and responsiveness to interventions. This is a lot to fit in, and children do get tired. Thus it is important to make decisions about the intensity, timing and frequency of therapy based on the child's capacity. Ideally, therapy is equally spaced throughout the week (e.g at least one session per day), and the day. Sessions are typically provided in 2-3 hours blocks, with 10-15 minute breaks every hour. Highly structured lessons typically are delivered for about half the time allotted, with the other half the time dedicated to teaching in the natural environment - systematically reinforcing and generalizing skills taught in the structured setting.

Play and social skills are more effectively taught in the natural environment. However, in order to obtain the necessary intensity of training, the family and therapists will have to contrive situations so that the targeted skill occurs with relative frequency.

For a young student, a structured teaching session of 3 hours might look something like:

  • 20 minutes structured play
  • 50 minutes discrete trial teaching (in 5-10 min. segments, broken up by short play breaks of 3-5 min.)
  • 20 minutes gross/fine motor activities/play
  • 50 minutes discrete trial teaching (in 5-10 min. segments, broken up by short breaks of 1-5 min
  • 20 minutes structured play
  • 20 minutes writing notes, updating graphs/logs, going over session with parents/therapists