The Essential Guide to ABA Therapy for Autism

Applied behavioral analysis (ABA) therapy has become a widely used intervention for autism spectrum disorder and other neurodivergent conditions. But what exactly is ABA, and how does it work? This comprehensive guide will explain everything you need to know about ABA therapy, including the types, techniques, benefits, criticisms, and more.

The Essential Guide to ABA Therapy for Autism
The Essential Guide to ABA Therapy for Autism

What is ABA Therapy?

ABA stands for applied behavioral analysis. It is a therapy based on the principles of learning and behavior first developed in the 1960s and 70s. The goal of ABA is to systematically teach skills and decrease problem behaviors using positive reinforcement. 

ABA therapists break down skills into small, achievable steps. Desired behaviors are rewarded to increase their frequency. Unwanted behaviors are discouraged by removing rewards. Data collection and analysis guides which behaviors are targeted and how progress is measured.

Over time, ABA aims to build up complex behaviors by reinforcing simple skills. The highly customized therapy can address social, communication, cognitive, adaptive, motor, play, and self-care skills.

ABA is considered the “gold standard” treatment for autism spectrum disorder. Research shows it can improve language, social, behavioral, and adaptive functioning in autistic individuals. It’s also used for other neurodivergent conditions like ADHD, anxiety disorders, and intellectual disabilities.

The Origins of ABA Therapy

ABA therapy has its roots in the principles of behaviorism established in the early 20th century. Behaviorism focuses on objectively observing, measuring, and modifying behavior. 

Pioneers like B.F. Skinner developed operant conditioning, which uses rewards and punishments to change voluntary behavior. ABA applies these same principles of reinforcement and punishment to shape real-world behaviors. 

In the 1960s, psychologist Ole Ivar Lovaas began using operant conditioning to treat autism at UCLA. His 1987 study claimed nearly 50% of children who received 40 hours per week of ABA for multiple years achieved normal functioning.1

Lovaas’ early approaches were very rigid and sometimes punitive. They focused on extinguishing autistic behaviors to make children “indistinguishable from peers.”2 This “normalization” rather than acceptance remains controversial.

Over time, ABA has evolved to be more play-based, naturalistic, and respectful. But it still aims to increase socially acceptable behaviors over autistic behaviors.

The ABA Process Step-By-Step

There are several key steps in the ABA process:

Assessment

First, a BCBA (board certified behavior analyst) will assess the individual’s skills, behaviors, and goals. They’ll design a customized treatment plan targeting priority skills and behaviors.

Direct Treatment

The BCBA and/or therapists will provide direct 1:1 treatment based on the plan. They’ll use reinforcement, modeling, prompting, and other techniques to teach target skills.

Data Collection 

Detailed data will be collected on the individual’s progress and behaviors. This data guides ongoing changes to the treatment plan.

Caregiver Training

Parent and caregiver training is a crucial part of ABA. Therapists teach families to apply behavior techniques at home to encourage skill generalization.

Maintenance

After goals are met, periodic maintenance sessions help sustain long-term gains. Additional therapy may be provided if new issues arise.

ABA is intensive, with 20-40 hours per week being common. It can be costly, but is often covered by insurance. Treatment plans and intensity are tailored to each person’s unique needs

The Many Types of ABA Therapy

There are numerous behavioral techniques that fall under the umbrella of ABA therapy. Some of the most common types include:

Discrete Trial Training (DTT): Involves systematically teaching skills in simplified, structured steps with clear cues, responses, and rewards.

Early Intensive Behavioral Intervention (EIBI): Comprehensive treatment for very young children, often 25-40 hours per week. Teaches foundational cognitive, social, self-care, and language skills.

Pivotal Response Training (PRT): Uses natural motivations and contexts to target “pivotal” skills like motivation, responsivity to cues, self-management, and social initiation. 

Verbal Behavior (VB): Focuses on developing verbal communication. Breaks down language into functional units like mands (requests), tacts (labeling), and intraverbals (conversation).

Natural Environment Training (NET): Teaches skills in natural settings like homes, schools, and the community to promote generalization.

Parent-Mediated ABA: Parents are trained to deliver ABA therapy at home, encouraging consistency across environments.

There are many other variations suited to particular skill deficits or client needs. The right type depends on the individual’s specific goals.

The Potential Benefits of ABA Therapy

Decades of research support ABA as an effective intervention for autism and other conditions. Some benefits may include:

– Improved language and communication skills

– Increased social and play skills 

– Reduced disruptive or aggressive behavior

– Greater independence with self-care, school, and work skills  

– Improved attention, memory, problem solving, and academics

– Increased engagement, motivation, and compliance

– Decreased restrictive/repetitive behaviors

– Better emotional regulation and coping skills

ABA can also reduce family stress and improve parents’ ability to manage their child’s behaviors.

However, benefits depend heavily on the quality, intensity, and appropriateness of services provided. Outcomes vary greatly from person to person as well.

The Major Criticisms of ABA Therapy

While ABA can be helpful for many, it is not without controversy. Some common criticisms include:

Prioritizes changing the child over accommodating them: ABA focuses on molding autistic kids to fit neurotypical norms rather than accepting diversity. This can harm self-esteem.

Appears coercive or manipulative: Using rewards and punishments excessively can feel coercive. Critics argue ABA should empower kids, not control them.

Too demanding: The intensity of ABA places heavy demands on children. It may disrupt family life and limit time for play, creativity, and just being a kid. 

Neglects weaknesses: Critics argue ABA targets easily changed behaviors, not underlying skill deficits. Weaknesses like executive functioning aren’t addressed.

Poor at generalizing skills: Hyper-structured ABA drills often don’t translate well into real-world functioning. Skills may fail to generalize outside of sessions. 

Risk of abuse: Punishments like physical restraints have been abused in the name of ABA. Lack of regulation risks further mistreatment.

PTSD-like trauma: Autistic adults who had ABA as kids report traumatic memories, post-traumatic stress, and learned helplessness. Some equate it to “dog training.”3

Focuses too much on changing the child: More focus is needed on accommodating autistic behaviors and accepting neurodiversity.

These concerns have sparked a growing “neurodiversity movement” that promotes embracing neurological differences versus trying to “normalize” them.

Key Things to Consider About ABA Therapy

ABA therapy for autism and other conditions remains controversial. Because it is so customized per individual, outcomes vary immensely. Results depend on numerous factors:

  • Quality of provider: There is little regulation or standardization in ABA. Success hinges on having well-trained, ethical, compassionate providers.
  • Appropriate goals: Treatment should focus on skills that improve quality of life, not just normalize behavior for its own sake.
  • Incorporating child preferences: ABA is most effective when reinforcement motivates the child versus being imposed on them.   
  • Respecting neurodiversity: Therapists should aim to support diversity, not extinguish it. Accommodations should balance both sides.
  • Using the least-restrictive methods possible: Aversive methods, punishment, and coercion should be avoided.
  • Focusing on generalizability: ABA shouldn’t just teach rote skills. It should build abilities that translate into real social and coping skills.
  • Emphasizing family empowerment: Parents should be trained on positive behavior supports to use at home.
  • Monitoring progress: Data collection should track progress to ensure the ABA plan is working. Changes should be made if progress stalls.
  • Transitioning gradually to independence: ABA should equip kids with skills to eventually function independently without intensive therapy.

Getting Started with ABA Therapy

If considering ABA therapy, here are some tips to find reputable, ethical services:

  • Get a referral from your child’s doctor or local autism organizations. 
  • Look for a certified BCBA who is experienced working with autistic individuals.
  • Ask about their training, experience, treatment philosophy, and methods.
  • Interview several providers before choosing. Observe them interacting with your child.
  • Start with a trial period. Increase intensity gradually as needed.
  • Closely monitor progress and make adjustments as needed. 
  • Work collaboratively with the BCBA. Share your goals, priorities, and any concerns.
  • Speak up if you ever feel uncomfortable with techniques being used.
  • Seek family counseling or parent training to learn how to support progress at home.
  • Remember you can pause, switch providers, or discontinue ABA if you feel it isn’t helping.

The Bottom Line

ABA therapy can provide real benefits for many autistic individuals when designed and delivered appropriately. But like other interventions, it has both advantages and disadvantages. 

Success requires selecting high-quality, compassionate providers, setting appropriate goals, monitoring progress, and making adjustments as needed. ABA should be used thoughtfully and ethically to support neurodiversity, not extinguish it.

An individualized combination of therapies, supports, and accommodations is often best. The most “effective” approach empowers individuals and families to thrive, embrace neurodiversity, and enjoy a high quality of life.

Jade ABA Provides World-Class ABA Therapy for Maryland Families

At Jade ABA, we believe every child with autism deserves the benefits of high-quality ABA therapy. Our passionate team of Board Certified Behavior Analysts (BCBAs) and therapists are deeply committed to helping your child reach their full potential.

We take pride in providing truly individualized ABA therapy tailored to each child’s unique needs, challenges, interests and strengths. No two children are alike, so we create fully customized therapy programs using evidence-based techniques proven to work.

In addition to working directly with your child, we’ll coach you through using ABA strategies at home to promote consistency and generalization of skills. We partner with you and your child every step of the way, tracking progress and updating goals as needed.

Don’t wait to get started with in-home ABA therapy that can help your child thrive. We serve families across Maryland and are confident we can partner with you to help your child succeed. Contact us today at (410) 616-0901 or email at info@jadeaba.org to learn more!

References

1. Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of consulting and clinical psychology, 55(1), 3-9. 

2. Lovaas, O. I. (2003). Teaching individuals with developmental delays: Basic intervention techniques. ERIC.

3. Kupferstein, H. (2018). Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis. Advances in Autism, 4(1), 19-29.

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