What Is Applied Behaviour Analysis (ABA)?
Autism is a complex developmental disability that is typically evident in the first three years of life. It occurs in an estimated 15 out of 10,000 births, and is more common in boys than girls. Autism occurs along a 'spectrum', and therefore displays itself in a wide variety of forms from mild to severe, occurring by itself or together with other disorders that affect child development. Children with autism may show disturbances in the rate and sequencing of development across the areas of communication, social, physical, and language skills.
The learning behaviours of children with autism are unique in that the individuals use a limited amount of the environmental information that is available to them in a learning situation. They also show a lack of motivation to explore new environments, to expand their current repertoire of interests, and to attempt alternative responses. Self-stimulatory behaviours, behaviours that have no functional relationship to the environment, such as hand flapping and body rocking are also associated with autism. Substantial scientific research and extensive clinical experience covering several decades, has shown that intensive early behavioural intervention, provides children with autism the structure that they desire, and the stimulation and success required to teach them to 'learn how to learn'.
A pioneer in the field of autism and behavioural intervention, Dr Ivar Lovaas (1987) provided the first scientific research supporting early intensive behavioural intervention. In his study, 47% of the children who received one on one behavioural treatment, reached normal functioning and completed first grade without the assistance of an aide. A follow up study showed that the children continued to function at the normal level, suggesting that behaviour treatment may produce long lasting and significant gains for children with autism, (McEachin, Smith, Lovaas, 1993). In an aim to replicate Lovaas' (1987) original behavioural treatment program, Brinbrauer and Leach (1993) reported the positive significant impact intensive early behavioural intervention can have on children with autism.
The treatment utilized was Applied Behaviour Analysis (ABA). ABA is an intensive, highly structured teaching program where skills are broken down into their simplest most manageable form, a process guided by the child's learning pattern and current level of functioning. Child specific skills are then targeted and taught using 'discrete trials'. A discrete trial is the primary teaching tool and consists of three crucial components; 'SD' (the instruction to the child), 'R' (the child's response to the instruction), and 'SR' (feedback given based on the child's response to the instruction).
As the child progresses through each program, assistance is provided and systematically reduced until the child demonstrates independence. As simple skills are acquired, the child is then taught to combine them into more complex behaviours, and to use these skills in a variety of settings.
The child's progress through the program is regularly documented. The data recording provides continuous records of the child's progress, and enables precise 'fine-tuning' of teaching procedures. The main goal of ABA is to provide children with autism the prerequisites necessary to learn naturally from the environment through, explanation, modeling, and other appropriate cues available in the situation. There is a high priority on having fun and making learning an enjoyable and rewarding process.
Lovaas, O.I (1987). Behavioural Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children. Journal of Consulting and Clinical Psychology, 55(1), 3-9
McEachin, J.J., Smith, T., and Lovaas, O.I (1993). Long Term Outcome for Children with Autism who Received Early Intensive Behavioral Treatment. American Journal on Mental Retardation, 97(4): 359-372
Brinbrauer, J.S., and Leach, D.J. (1993). The Murdoch Early Intervention Program After 2 Years. Behaviour Change, 10 (2): 63-74.
Behavioural Intervention for Young Children With Autism. A Manual for Parents and Professionals. Catherine Maurice, Gina Green & Stephen C. Luce (1996). Pro-ed: Austin, Texas.
Let Me Hear Your Voice. Catherine Maurice (1993). New York: Knopf
Behaviour analysis for lasting change. Beth Sulzer-Azaroff & G. Roy Mayer (1991). New York: Harcourt Brace Jovanovich.
Why Use It?
High Outcome Levels
Scientific research has shown that an ABA program allows a significant minority of children with autism to acquire sufficient social, emotional, academic and language skills to be independently integrated into a mainstream school. In Lovaas' 1987 study, 47% of the children who received 1:1 behavioural treatment reached normal functioning and completed first grade without the assistance of an aide. For the children who do not achieve normal functioning, sizable decreases in inappropriate behaviours and acquisition of basic language behaviours are most often achieved. These children become more active members of their family and are usually able to learn in special education classrooms or supervised regular education classrooms.
Potential Immediate Benefits
As the term early intervention suggests, the age of the child at commencement of an ABA program is a contributing factor on the overall success of the program, and the level of functioning that the child achieves.
The existing services available for children with autism typically have a long waiting period. As a diagnosis is rarely made before 18 months of age, it may occur that the child receives little or no form of early intervention well until they are 3 or 4 years of age. Even when children with autism access the services at a younger age, generally the contact hours in these programs is insufficient to enable a child to respond adequately to the techniques employed. We do not require a formal diagnosis of autism before a program can begin. An ABA home based program can begin as soon as the family is ready.
Potential Long Term Benefits
After a significant time on an ABA program, some children with autism may show an increase in independent living skills, such as dressing and undressing, personal hygiene (washing hands, toilet training etc.), packing up, and helping around the house (setting the table etc.). There may also be some gains in the areas of communication of basic desires and simple verbal behaviour. A child on an ABA program may also show an increase in the level of participation in learning situations, and a decrease in inappropriate behaviours. Overall, an ABA program provides your child with the opportunity to achieve their full potential, and to become more active participants in their school, home and community.
Due to the nature of the disability and intensity of the program, IEC place a high priority on having fun and providing a structured environment. These two elements often provide the children the prerequisites to enable them to enjoy learning.
Factors Contributing to A Successful Outcome
The earlier a child begins behavioural intervention, the more chance there is that significant gains will be made.
With or without full supervision any child on an ABA program, and the staff directly involved in the implementation, require specific teaching objectives. Without clear teaching objectives, the structure and consistency that the children require for success are lost, and this can impede on the child's progress on the program. When a new skill/behaviour is being taught, all members involved should be aware of the rationale behind the program, and why they are teaching it. If the staff have a deep understanding of the skill being taught, they will be better equipped to teach the skill and modify the teaching environment if necessary.
Children with autism on an ABA program require consistency. Consistency ensures that all staff are expecting the same response for the same target behaviour. It is also important that staff are providing appropriate levels of reinforcement at the appropriate time, and have the ability to reduce or eliminate any potentially distracting stimuli from the teaching environment. Consistency reduces frustration both for the child and teacher. A well structured environment can also help to facilitate the acquisition of skills, as the child receives exposure to the same target on a repetitious basis.
Parental involvement is a key component in the success of any educational service that your child may receive. Children on an ABA program, in the early stages of the program, learn the majority of skills in a one on one teaching situation. A child with autism may have difficulty in generalizing skills learned in one environment to another. Therefore, parents are in a perfect position to generalize the new skills to other environments. It also ensures the child utilizes the knowledge and behaviours taught during the teaching times.
IEC highly recommends at least one parent attend the regular team meeting, and encourages both parents to take part in the ICP goal setting process. IEC appreciate the fact that parents contain a source of valuable information pertaining to the child's interactions away from ABA sessions. Parents also play a vital role in the management of the ABA program. They are responsible for employing staff members, managing the team roster, ensuring that all relevant teaching materials are prepared, and that staff have access to recording sheets.
ABA is a scientific research based form of early intervention that requires the collection of data to monitor the progress and outcome of the program. The data recording provides continuous records of the child's progress, and enables precise 'fine-tuning' of teaching procedures. It will also ensure consistency and help to facilitate communication.
Number of Hours (Intensive Intervention)
Typically the more hours of intervention a child receives, the better outcome the child will achieve. Research (Lovaas, 1987) has suggested that children make greater gains with intensive Applied Behaviour Analysis varying from 30 to 40 hours a week.
To begin an intensive ABA program, you and your child will require support staff to supervise, implement, and monitor your child's progress. IEC provide a case supervisor to support families establishing an ABA program. We will also provide you with an educational program, and support for staff implementing the program. IEC provide support to families requiring instructors, however, the employment of instructors to implement the program, is the responsibility of the family or care provider.
IEC offer the services of several experienced part-time and full-time Discrete Trial Instructors available for therapy hours. Our instructors have been trained by registered psychologists in Applied Behaviour Analysis and Discrete Trial Teaching as used in Intensive Behavioural Intervention for children with developmental disabilities.
IEC's instructors are available to all current clients and have been trained to work 1:1 with children in private settings, to implement educational and behavioural programs utilising the principles of Applied Behaviour Analysis.
For further information please contact IEC's Therapist Coordinator Claire Hall.
Access To Resources
Running an ABA program requires a lot of material over a period of time. Often the material can be accessed through local toy libraries, toy shops, craft shops, and other suppliers of educational materials. Often the material can be made from equipment around the house or from magazines and photo's. As different concepts such as people, numbers and locations are introduced, families will be required to supply the appropriate material to begin the program. Access to material ensures the teaching sessions are productive.
IEC staff will inform you of material required, prior to introducing the program.
Families beginning an ABA program for their child will need to employ instructors to carry out the implementation of the program. The number of instructors employed will depend on the number of one on one ABA therapy hours that the child receives. At least two instructors should be employed for any one child. This ensures that the child does not become dependent on one instructor. We also recommend that each staff member involved in your child's program be doing at least two sessions per week. This is to ensure that each instructor has the time to develop a rapport with your child, and is up to date with the direction of each of the current programs. The family must take full responsibility for the employment of instructors to work within their home with their child. IEC has an ABA instructors list which all clients with IEC can access. All instructors on the list have completed the introductory ABA course run by IEC. Alternatively, potential instructors may be found by placing an advertisement in the local paper or at the local university facilities such as psychology, education, and disability studies.
Structuring The Child's Day
Typically the child's day is divided into 'sessions', most children have two sessions per day. During a session the instructors teach the child using the programs prepared by the case supervisor. Each of the programs is presented for approximately 2-5 minutes and is followed by a short break. Longer breaks are often included in the child's session to allow time for the child to have a snack, go outside or to have a nap. The length of the session will depend on the child's age and their length of time on an ABA program. The number of hours is re-evaluated throughout the course of treatmen.