Applied Behavioral Analysis

Intensive Behavioral Intervention
Applied Behavioral Analysis (ABA)

 

 

What is Applied Behavioral Analysis (ABA)?

 

Behaviorism is the examination of behavior (behavior refers to anything observable: language, social skills, adaptive skills, self help skills…) using the principles of science: observation, reproduction, testing, and objectivity.  Applied Behavioral Analysis, then, is the application of this science of behavior to meet a certain end:  to increase or decrease a particular behavior, to improve the quality or quantity of a behavior, to extinguish an existing behavior, to generalize or transfer a new skill from one situation to another, or to teach a new one.

 

 Three decades of research by Dr. Ivar Lovaas and his colleagues at UCLA have convincingly demonstrated that intensive, early intervention has the potential to significantly improve the functioning of children with autism.  (McEachin & Leaf, 1999) Follow up studies published in 1987 and 1993 demonstrated that half of the children who participated in early, intensive behavioral intervention were able to successfully complete general education coursework, and further, were indistinguishable from their peers based on measures of IQ, adaptive skills, and emotional functioning.  Even the children who did no attain “best outcomes” made clinically significant gains in language, social, self help, and play skills.

 

The principles of ABA have existed for quite some time, grounded in the early works of Edward L. Thorndike and B.F. Skinner, and have a myriad of uses beyond the scope of teaching children with autism.  Principles of ABA are often the basis for programs and instruction addressing a broad spectrum of human behavior, from increasing productivity at work, to training our military personnel, to in fact, teaching children.  

 

Stepping Stones utilizes the seven essential components as outlined by Sulzer-Azaroff &Mayer (1991) and Baer, Wolf & Risely (1968) that must be addressed in order to expect reliable and significant behavior change through an Applied Behavioral Analysis intervention.  Our staff and families work together to:

  1.                 Select the interfering behaviors or skill deficits.  The behaviors one chooses to focus on should have some social significance.
  2.                  Identify goals and objectives.
  3.                   Establish a method of measuring target behaviors
  4.                  Evaluate the current level, frequency, intensity of behavior .
  5.                  Design and implement an intervention that will teach the new skill and/or desired behavior.  The techniques that one uses should be described completely enough to allow for duplication by another individual.  At Stepping Stones we often design parallel interventions for the families and for the students.  Parents are a key contributor to plans for themselves and for their children.
  6.                  Continually track and measure target behaviors to monitor the effectiveness of the intervention.  The program must be analytic.  There should be clear and convincing evidence through carefully collected data, that the intervention is responsible for a change in a behavior.  The ABA program at Stepping Stones relies primarily on the staff to collect data; however, any information the family can provide relevant to target behaviors or the efficacy of an intervention is always valuable input.
  7.                  Evaluate the effectiveness of the intervention, with modifications as necessary.  The program should display some generality.  A change in behavior should be seen in a wide variety of environments, or should spread to a wide variety of related or similar behaviors.   Again, at Stepping Stones, we rely heavily on parent and caregiver input as determining factors when deciding how effective an intervention is. After all, parents are the experts on their children! 

  

Extensive evidence (Jacobson, Foxx & Mulick, 2005) supports the effectiveness of the numerous instructional approaches, treatment protocols, and specialized programs rooted in Applied Behavioral Analysis.  While the most well known and widely used instructional method is Discrete Trial Teaching (DTT), there are other strategies that may support the learning of a particular child as well.  The staff at SteppingStonesLearningCenter is able to employ these strategies in conjunction with DTT as they deem appropriate.  They include: Natural Environment Strategies, Errorless Learning, Picture Exchange Communication System (PECS), Visual Schedules and Supports, Video Modeling, Social Stories, TEACCH strategies, and Positive Behavioral Support. 

 

Teaching Format

 

Discrete Trial Teaching is a specific methodology used to maximize learning.  It is a teaching process that can be used to develop most skills, including but not limited to: cognitive, communication, play, motor, Executive Functions, perspective taking, social and self-help skills.  It is a strategy that can be used for all ages and populations and is NOT only for teaching young children with autism.  DTT involves: a) breaking a skill into smaller parts; b) teaching one small sub-skill at a time until mastery; c) allowing repeated practice in a concentrated period of time; d) providing prompting and prompt fading as necessary; and e) using reinforcement procedures.

 

Stepping Stones prefers the use of Discrete Trial Teaching (although not to the exclusion of other strategies) because each teaching unit has a distinct beginning and end (“discrete”), and uses numerous trials in order to strengthen learning.  Students are assessed with each new skill to determine what amount of information is optimum to present.  Once that decision is made, the teaching process begins with the presentation of information and the seeking of a response by the student.  It is critical that the student be an active and engaged party in the learning process.  This type of teaching contrasts with more traditional methods where vast amounts of information are presented with no clearly defined target response for the student.

 

Initially teaching is conducted in an environment that will lend to early initial success.  This often entails removing distracting noise, objects, or other factors.  However, it is important that teaching is quickly extended to ordinary environments.  This serves a dual  purpose: it is more natural instruction, and it promotes the transferal of learning across settings.  Thus, Stepping Stones strongly advocates for therapy and teaching to be occurring at home, at the park, at the grocery store, at the doctor’s office and any other place in the community that the child and family frequent.  Children must be able to learn in varied environments amidst distractions such that they are more adequately prepared for learning in a typical setting such as school.

 

 

 

Therapy

 

There exist opponents to ABA that purport it to be a methodology that does little to develop and foster relationships, particularly between the therapist and the child.  Nothing could be farther from the truth at Stepping Stones.  It is our belief that the strongest tool we have when teaching a child is our mutual rapport.  To that end, the establishment of a trusting, reciprocal relationship built on respect, playful interactions, and supportive communication is our foundation for teaching and subsequent learning.  We deem it imperative for our therapists to create a warm, playful, reinforcing social relationship with their students.  This relationship isn’t simply important during the first few months of therapy; rather it is the basis of each interaction for the duration of our time with a student. 

 

While Stepping Stones does not prescribe generic treatment protocols and programs for students, we do recognize that therapy typically progresses through a series of phases, regardless of the starting point or functioning level of each child.

 

The Beginning Phase

  • Involves primarily establishing a rapport with the child and creating a warm, playful, reinforcing social relationship.  One way we accomplish this goal is through identification and use of reinforcers.  
  • The focus during this time is on play and noncontingent delivery of reinforcement.  Noncontingent delivery of reinforcement  means that reinforcement is available to the child at no cost to the child – meaning that the child is not asked to do something or to follow an adult directive in order to have access to the really fun bag of toys or activities! 
  • Another essential component of this early phase of therapy is Learning to Learn”.  The child learns that when she/he cooperates with requests the rewards for doing so are frequent and immediate. 
  • Other critical skills at this time include: learning how to sit and attend, remaining on task during teaching interactions, being responsive to interactions, learning how to process feedback, and understanding cause and effect (McEachin & Leaf, 1999).

 

The Middle Phase

  • Involves learning specific communication in whatever mode the child is able (verbal, sign, pictures, assistive technology), play, self-help, and social skills. 
  • Tends to be the period of time where we make the most modifications to the curriculum and programming in order to meet the individualized needs of the child and family. 
  • Complex skills and abstract concepts are broken down into a series of manageable steps (the child is the one who determines how large or how small those steps are) and taught systematically. 
  • If it is not already occurring, the staff at Stepping Stones strongly encourages children to be exposed to play dates and other social and community events during this period.  This is also a time to consider the appropriateness of beginning school.    

 

The Advanced Phase

  • Involves progressively making therapy more natural
  • Working on subtler social, play, affective, cognitive, communication, perspective taking and Executive Functioning skills is a priority at this time.

 

What sets Stepping Stones’ ABA apart from other ABA models?

Through each of these phases Stepping Stones monitors each students’ level of engagement and rapport with his/her therapists and peers, such that social and emotional development is an ongoing area of growth.  Progress is maximized when the student is actively engaged with the therapist, the learning environment, and his/her peers.  Another way we maximize progress is to encourage generalization of skills from the very first day of therapy. 

 

And finally, through each of these phases, of prime importance to the staff at Stepping Stones are the behaviors a child exhibits or doesn’t exhibit that most dramatically impact the quality of life for the family or the child.  There are a plethora of these types of behaviors and skills.  Some include:  being able to have a family photo taken, sleeping through the night, dining in a restaurant, playing with a sibling, going grocery shopping, a trip to the dentist, playing in the snow, opening a present, and getting a hair cut.  This is by no means an exhaustive list, but it does illustrate some of the areas our families and staff have identified in the past as important.  Each phase of therapy involves identifying these behaviors, creating goals and objectives around change, establishing a way to measure the behaviors, creating and implementing strategies to teach newer, more desired behaviors, and monitoring the effectiveness of the intervention.

 

Of Critical Importance to the ABA Program at Stepping Stones

  • Every child is an individual with unique strengths and challenges.  Thus, we will not project a generic treatment plan that is designed to encompass every child.  Our intervention is grounded in research yet crafted to address an individual child and family.
  • Every child must have a manner to communicate that is universally understood.
  • Behavior is a form of communication.  Our charge is to uncover what is being said by that behavior.
  • All children should laugh and smile every day, and an interaction with one of our students is not complete if that does not happen. 
  • Academics are only one small piece of a very large puzzle.  There are dozens of other skills that enhance the quality of life for a child and family.
  • The trust of a child and family is priceless.  We will do everything in our power every day to be worthy of that trust.

 

Philosophical Components of our ABA Program

  • The therapist’s rapport with the child is the basis for excellent teaching.
  • Reinforcement is the cornerstone of effective ABA
  • The child will hear positive feedback 80% of the time.
  • Understand what motivates the child and you have uncovered the secret to his/her individual learning.
  • Skills are addressed in a systematic fashion with one skill building upon another.

 

Program Goals

  • To be an effective early childhood program for children with autism spectrum disorders. The program is child specific, comprehensive, individualized and family focused.
  • To provide a highly reinforcing environment that maximizes the child’s learning potential and diminishes non-productive behaviors.
  • To be flexible and individualized.
  • To help the child transition successfully into a classroom setting.
  • To generalize skills taught in 1:1 instruction into the child’s environment.
  • To facilitate the child’s development of peer relationships.

 

  

References

 

Baer, D., Wolf, M., & Risely, R. (1968).  Some current dimensions of applied behavioral analysis.  Journal of Applied Behavioral Analysis, 1, 91-97.

 

Jacobson, Foxx, Mulick.  Controversial Therapies for Developmental Disabilities: Fads, fashion and science in professional practice, Mahwah, NJ: Lawrence Erlbaum Associates: 2005.

 

Leaf, R.. & McEachin, J. A Work in Progress.  New York: DRL Books, 1999.

 

Sulzer-Azaroff,B. &Mayer, R. (1991).  Behavior analysis for lasting change.  Reinhart & Winston, Inc.