By: Jonelle Lupero, M.Ed., BCBA, LBA (NY)
Note: The following is a fictional vignette created for the purposes of demonstrating common situations encountered by professionals in this field.
“My name is Susan and I have an eight-year-old son John who is diagnosed with Autism Spectrum Disorder. I received John’s diagnosis when he was 3 years old; at the time John’s autism seemed “mild” to me and I never sought outside help. Recently he has been displaying more severe behaviors and I’m not sure I can manage them; I think it might be time for ABA therapy but I’m still not certain. When is it time for my child to receive ABA therapy?”
Susan is a common example of many parents today who do not know if their child would benefit from ABA therapy. Let’s explore this subject further…
What is Applied Behavior Analysis (ABA)?
Applied Behavior Analysis (ABA) is a therapy based on the science of learning and behavior. Behavior analysis helps us to understand: how behavior works, how behavior is affected by the environment, and how learning takes place.
ABA therapy applies our understanding of how behavior works to real situations. The goal is to increase behaviors that are beneficial and decrease behaviors that are harmful or affect learning. ABA therapy programs can help: increase language and communication skills, improve attention, focus, social skills, memory, and decrease problem behaviors.
The methods of behavior analysis have been used and studied for decades. They have helped many kinds of learners gain different skills – from healthier lifestyles to learning a new language. Therapists have used ABA to help children with autism and related developmental disorders since the 1960s. (cited from autismspeaks.com)
Why ABA Therapy?
ABA is considered an evidence-based best practice treatment by the US Surgeon General and by the American Psychological Association.
“Evidence based” means that ABA has passed scientific tests of its usefulness, quality, and effectiveness. ABA therapy includes many different techniques. All of these techniques focus on antecedents (what happens before a behavior occurs) and on consequences (what happens after the behavior).
More than 20 studies have established that intensive and long-term therapy using ABA principles improves outcomes for many but not all children with autism. “Intensive” and “long term” refer to programs that provide 25 to 40 hours a week of therapy for 1 to 3 years. These studies show gains in intellectual functioning, language development, daily living skills and social functioning. Studies with adults, though fewer in number, show similar benefits. (cited from autismspeaks.com)
When Should Your Child Start ABA?
There is a large body of research that underscores the critical importance of early intervention services for children with autism. The right age for a child to begin working with an ABA therapist is as soon as he or she shows signs of autism or is diagnosed with a developmental disorder. According to the well-renowned source, “Autism Speaks,” in a study with toddlers, intensive behavioral intervention helped all ages, but those who started before age 2 were most likely to make dramatic gains.
This All Sounds Wonderful But…
As we know it is most beneficial to start ABA as early as possible but it doesn’t always happen like that for many reasons; to name a few, many families don’t receive an autism diagnosis right away, sometimes they will receive it later in the child’s life, 3-4 years old. Furthermore, many families are not aware of ABA therapy, and finally many families think that they have the “situation under control” and they don’t require outside support.
But Guess What …
Just like ‘Susan’ many families start to see signs and/or behaviors that indicate their child might need ABA Therapy however they are still not certain; Here is a list of some scenarios (using Susan’s son John as an example) to help parents know “It’s time for ABA therapy….”
It’s time for ABA therapy when…
- My child’s behaviors are starting to interfere with our family’s normal day to day routine. For example, John’s mother is not able to take him into the supermarket because John has a temper tantrum every time he needs to leave the car and enter a store.
- John’s Mom is noticing that he has been lining up his toys in a specific way and has a very hard time coping if the order is not the way that he prefers it to be.
- School reports; John’s family is receiving feedback from his teachers that John’s aggressive behaviors are starting to interfere with his learning and are preventing him from learning and establishing relationships with his peers.
- John isn’t able to tell his parents his wants and needs on a daily basis and as a result there has been an increase in problem behaviors including aggression and noncompliance in the home.
- John’s language is not developing as a typical child’s would; for example, he is not able to engage in a normal back and forth conversation with a peer.
- John’s Mom is seeing that John does not make eye contact with other people.
- John has been having a hard time when his parents tell him “no” and as a result is exhibiting aggressive behaviors both in the home and in the public.
- John is fixated on his routine during the day and is displaying noncompliant and aggressive behaviors if his routine is changed.
- John is having difficulty sleeping throughout the night and it is affecting his family’s routine/well-being.
- His mother notices John is not interested in making friends and prefers to be by himself; he rarely initiates any social interaction…
- John has a very hard time tolerating loud sounds and is putting his hands over his ears when he goes into a public place that is “noisy.”
This is a list of some typical scenarios, however there can be plenty more reasons why it’s time for ABA therapy.
- Cooper, J., Heron, T., & Heward, W. (2007) Applied Behavior Analysis, Second Edition. Upper Saddle River, NJ: Pearson Prentice Hall.
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.