By: Julie Bates, MA, BCBA, NYS LBA
Your child has a diagnosis of Autism Spectrum Disorder and is starting ABA therapy. Perhaps you are wondering what that entails? What is ABA exactly? What is the process to begin ABA therapy? What happens during an ABA therapy session? What should I expect?
What is ABA?
ABA (Applied Behavior Analysis) is considered an evidence-based best practice treatment for Autism Spectrum Disorder 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 applies our understanding of how behavior works to real situations. The goal is to increase behaviors that are helpful, such as communicating with others, and decrease behaviors that are harmful or affect learning, such as aggression.
Positive reinforcement is one of the main strategies used in ABA. When a behavior is followed by something that is valued (a reward such as verbal praise, a tangible item or activity), a person is more likely to repeat that behavior. Over time, this encourages positive behavior change. Reinforcers vary for each individual child and may change from moment to moment.
It Starts With an Assessment
A Board-Certified Behavior Analyst (BCBA®) will assess your child to determine what goals will be beneficial to them. This assessment will very likely occur in your home. You will be asked questions about what your child is able to do and what areas are difficult for them. Based on the assessment, reviewed reports, and input from parents, the BCBA® will develop a treatment plan.
There will be goals selected to increase skills that we want your child to learn and goals to decrease any behaviors that may interfere with your child learning and functioning to the best of their ability. To decrease interfering behaviors, the behavior analyst will develop a behavior intervention plan for your child. After these goals are selected, the behavior analyst will select smaller objectives within each goal to begin.
These goals will include working on increasing language and communication skills, increasing play and social skills, and reducing behaviors that may be interfering with progress, such as leaving the work area or aggressive behaviors. Alternative, more appropriate skills will be taught to replace interfering behaviors. The individual treatment plan will continually be updated with new goals as your child acquires skills.
Your treatment team will consist of a BCBA® and one or more therapists. The therapist will provide much of the direct treatment hours and the BCBA® will monitor progress across your child’s goals. The BCBA® will provide direct supervision to the therapist based on the number of hours your child is receiving direct treatment.
A Typical Day of ABA Therapy
The BCBA® and therapist’s goal is to have your child be excited and looking forward to each session. An ABA therapy session in the child’s home will look a bit different for every child as it is unique and individualized for each learner. Therapy is usually for an hour to several hours at a time depending on each individual child. The first few sessions will be about fun and play rather than working on specific goals. The therapist will be “pairing” with your child. They will begin to develop a rapport with your child and will get to know what activities your child likes, such as games, toys, high fives, hugs, and snacks.
Once your child is more comfortable with the therapist and the therapy environment, the work can really begin. The therapist will keep demands to a minimum at first and then slowly begin to increase demands. Reinforcers, or rewards, will be used to increase learning and appropriate behavior. Reinforcers may include high fives, verbal praise, tangible items, snacks, tokens, and many other possibilities. A reinforcer is dependent on what your child prefers and is motivated by.
ABA therapy is conducted through Discrete Trial Training (DTT) and Natural Environment Training (NET).
Discrete Trial Training (DTT) is a method of teaching in simplified and structured steps. Instead of teaching an entire skill at once, the skill is broken down and then “built-up” using discrete trials that teach each step one at a time. It includes presenting an antecedent, the child’s response, and the therapist providing reinforcement for a correct answer or a correction for an error. Often, DTT will be done at a desk or a table like when your child is at school. Trials may be presented in blocks of ten or twenty consecutively, allowing for learner to have more opportunities to practice the skill. This is a very effective way to teach new skills quickly.
Here is an example of a discrete trial teaching for identifying foods (apple):
- Therapist: presents a picture of apple and cookie and says “Point to apple”
- Learner: points to the apple
- Therapist: “Great pointing to apple. You did it!” (May give child a tangible reward).
Natural Environment Teaching (NET) is a method of teaching for when skills are taught or generalized within the natural environment. For example, during DDT you might teach a student to receptively and expressively label colors of items at the table. Then, during NET the student would get to practice the skill by labelling colors of crayons that you’re coloring with or asking for colors of Playdoh that you’re playing with. NET is also very useful in teaching play skills and social skills to a learner while prompting generalization of newly acquired skills.
This is an example of natural environment teaching (label colors).
- Learner: is painting a picture at an easel.
- Therapist: asks “What color?” and points to (the color) red on the paper.
- Learner: responds “Red”.
- Therapist: “Correct, that is red”.
A combination of DTT and NET will likely be used with your child during an ABA session. Each session the therapist will take data on your child’s progress for each target or goal. The BCBA® will review progress and intervene when necessary or add additional goals for your child as they master current goals. Again, ABA therapy is individualized for your child.
Caregiver Involvement
Caregiver and family involvement are a very important part of ABA therapy. Parent training is provided by the behavior analyst. This is very beneficial as it allows continuation of the treatment outside of therapy sessions and to other settings with the child’s family members. This may include parents, siblings, and other caregivers. It gives these family members the tools to maintain the child’s new skills, promote generalization in the natural setting, as well as techniques for managing behavior issues. Parents play an essential role in the child’s treatment plan because no one knows the child’s needs and personality better than the parent.
References:
Cooper, J., Heron, T., & Heward, W. (2007) Applied Behavior Analysis, Second Edition. Upper Saddle River, NJ: Pearson Prentice Hall.
Ozonoff, S., & Cathcart, K. (1998). Effectiveness of a home program Intervention for young children with autism. Journal of Autism and Developmental Disorders, (1), 25-32.
For more information about Attentive Behavior Care and how we can help your child, please contact us today.