Autism Treatments: Applied Behavior Analysis (ABA)
Applied Behavioral Analysis (and its derivatives) is the treatment approach that is currently most widely available in the US and many other countries. It is the treatment that most often is funded by school systems and offered through many schools and by private therapists. ABA was formed by Dr. Ivar Lovaas in the 1980 (Lovass, 1987) from the branch of psychology known as Behaviorism. Behaviorism (popularized in the 1950’s by Dr. Skinner and Pavlov training animals) attempted to understand human begins by looking only at their behavior and dismissing all internal experience, that is, thoughts and feelings. This is an outdated model in modern psychology. Nonetheless, many educational techniques, including ABA, that were spawned from it still linger.
Applied Behavioral Analysis focuses on behaviors. It does not assume to know why a child has a particular behavior or to attempt to understand the child. Instead, it focuses on re-training unwanted behaviors, (through punishment or ”extinction”) and reinforcing wanted behaviors (through rewards). A detailed curriculum is designed for each child to cover areas such as expressive and receptive language skills, pre-academics and self-help skills. These skills are then broken down into component steps and ‘discrete trials’ performed (i.e. same task is repeated over and over) until the child learns each component and eventually the full sequence. Due to its intensive nature, ABA is performed one-on-one and usually continued at home.
Ivar Lovass’s original study (1987) into the efficacy of this model and the subsequent follow up (McEachin, Smith and Lovass, 1993) followed 19 children who underwent 2 years of this behavioral training. The follow-up study reported that the group gained an average of about 30 IQ points;, nearly half of them entered into mainstream education and were “indistinguishable from their peers”. However, methodology of this study has been seriously criticized. For example, the treatment group appears to be skewed in the direction of containing more initially higher-functioning children than the control group (which also contained more girls). The assessments of the children were only partially carried out by external investigators and the outcome assessments themselves have been drawn into question many times (Francis, 2005). Most importantly, no single attempt at replication (despite extensively detailed operational manuals) has been able to replicate the outcome of typical functioning (Rogers, 1998). Nonetheless, ABA is still widely employed and recommended to most parents whose children are diagnosed.
Many children with ASD who are in ABA programs do indeed learn many of the skills on which they are trained. Often, however, there is a lack of ability to generalize the skills outside of the highly structured and prompt-dependent therapy setting, and parents often report feeling as if their child is acting like a robot. This is because there is no focus on enjoyment of social interaction, merely on skill acquisition. There are now many branches of ABA and, of course, many different therapists with differing styles. More recent evolutions of the ABA approach are beginning to recognize the importance of fundamental social development, and are turning their focus to training children on what are known as “pivotal skills” such as joint attention and attending, after the work of such researchers as Dr. Robert and Lynn Koegel at UCSB. Many ABA therapists are also moving towards using more naturalistic learning environments and away from the traditional discrete-trial methods (Delpratto, 2001).
Click here to learn more about how ABA differs from The Son-Rise Program.