Friday, March 31, 2023

According to the Center for Disease Control and Prevention (Autism Spectrum Disorders, Data and Analysis, 2013), an average of 1 in 88 children have some type of autism spectrum disorder (ASD). Individuals with an ASD typically have difficulties with social skills, communication and behavior. As a spectrum disorder, those with autism can present with a wide variety of symptoms, which can range from mild to quite severe.

At this time, there are many types of interventions available for individuals with ASDs. Applied behavior analysis (ABA) is one such intervention. As one of the only empirically tested treatments for autism, it is a scientific approach that seeks to determine which environmental factors affect behavior in a way that is socially important. Further, it uses those same factors to help change problematic behaviors.

Applied behavior analysis is not an intervention intended solely for use with autism spectrum disorders. Rather, it is an intervention strategy for any problematic behavior. Even typically developing children and their families can benefit from approaches developed from applied behavior analysis (Latham, 1994).

Behavior analytic interventions are based upon a very simple formula: A à B à C. That is, antecedent, behavior and consequence. Every behavior is preceded by some environmental occurrence (the antecedent) and is followed by a consequence. A reinforcing consequence is one that increases the likelihood that the behavior will occur again in the future. An extinguishing consequence is one that decreases the likelihood that the behavior will occur again in the future.

Typical ABA interventions are built around a theory of reinforcement and extinction. In other words, some event comes after a behavior and then causes the individual to perform more of that behavior (reinforcement). One of the key aspects of ABA is determining what items, events, and conditions are reinforcing for each individual. A reinforcer could be a particular food, activity, or even a special scent. An extinguishing intervention, then, is one in which the delivery of a reinforcer is discontinued and, as such, the likelihood of the behavior occurring in the future is decreased.

For example, Mom lets Leah go outside to play after she cleans up her room. If Leah cleans up her room more often in the future, going outside to play is a reinforcer. The procedure of letting Leah go outside to play after cleaning up her room is reinforcement. Mom isn’t reinforcing Leah. Rather, she is reinforcing Leah’s behavior of cleaning up her room.

Likewise, Yosef’s parents reinforce his behavior by hugging him whenever he cries after being told “no.” As a result, Yosef cries every time he is told “no.” After realizing they are encouraging Yosef’s behavior, his parents start to ignore his crying after being told “no.” As a result, Yosef’s crying decreases, and eventually stops. This is clearly extinction.

In order to begin an ABA intervention, one must determine what skills are to be taught. Generally, skills are chosen for their utility or in order to help reduce problem behaviors. Once a skill (or skills) is chosen, a curriculum will be devised. Each skill is taught via a teaching program. A program generally follows the Aà B à C structure mentioned above.

For example, a child with autism may be unable to answer yes/no questions intuitively. In order to teach the child to respond “yes” appropriately, a program could be devised. The antecedent might be the teacher asking, “Is this an orange?” while holding an orange in front of the child. The desired behavior is a “yes” response. The reinforcing consequence could be giving the child a small piece of orange to eat. Prompting may be required at first, but would be decreased and eventually discontinued over time. For the skill to be generalized, the child would practice responding “yes” appropriately to a variety of stimuli, eventually without prompting.

One very important aspect of ABA is that it is completely data driven. In other words, for each program, every response is recorded and graphed. This allows the teacher or therapist to know, with certainty, what skills have been mastered and when to move on to another stimulus within a particular skill, or when to move on to another skill altogether.

It should be noted that applied behavior analysis is not only the intervention commonly known as discreet trial training (Anderson & Romanczyk, 1990). Other forms of ABA include Incidental Teaching, Verbal Behavior, Pivotal Response Training and several others. While many other types of interventions exist and are widely used (such as DIR/Floortime, TEACCH, and sensory integration therapy), to date, only behavior analytic interventions have been scientifically tested and documented as to their efficacy in terms of cognitive functioning, language skills, and academic performance (Howard, Sparkman, Cohen, Green, & Stanislaw, 2005). Either alone, or as part of a comprehensive treatment plan, ABA is proven effective as a behavioral intervention.

Adapted from an article that originally appeared in Building Blocks Magazine.

Dr. Wodinsky is a social skills therapist at Teaneck Speech and Language Center. She works with individuals and groups and can be reached at a.wodinsky_teaneckspeech.com.

By Avigael (Stephanie) Saucier Wodinsky, PhD, MEd, MBA, GAC-AI, GAC-ABA

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