What Is ABA Therapy?

Applied behavioral analysis (ABA) therapy is an approach to treatment that focuses on

using positive reinforcement to improve behavioral, social, communication, and learning skills.
ABA therapy utilizes behavioral principles to set goals, reinforce behaviors, and measure
outcomes.

This approach is often described as the "gold standard" in the treatment of autism. It is widely
used and has been shown to be effective for improving specific skills and decreasing problem
behaviors. It is also controversial because it has been seen as disrespectful and even
dehumanizing at times.

ABA therapy is rooted in the principles of behaviorism, particularly operant conditioning and the
use of rewards and consequences to mold behavior. During the 1950s and 1960s, mental health
professionals began utilizing principles like token economies in the treatment of conditions such
as schizophrenia and developmental disabilities.

Later, Ivar Lovaas, PhD, adapted ABA for the treatment of autism. His approach was that
behavioral and social skills could be taught while other behaviors could be extinguished by
applying rewards and consequences.1

Since then, a wide variety of techniques have emerged to treat autism and other conditions.
Many newer approaches are still rooted in the basics of ABA therapy, but also incorporate
aspects of emotional and social engagement as well.2

How Behavioral Analysis Is Used as a Treatment

Types of ABA Therapy

A number of different types of interventions can be used as part of ABA therapy.

Discrete Trial Training (DTT)

Discrete trial training (DTT) involves breaking a skill down and teaching it step-by-step. The
three components of this process include:

● The antecedent (a cue that triggers the behavior)

● The behavior (the response to the cue)
● The conclusion (what happens after the response)

When the behavior has been successfully produced, the individual will receive positive
reinforcement, but will not be rewarded if they do not successfully produce the desired response.

Early Intensive Behavioral Intervention (EIBI)

This approach may be used in young children to teach social, adaptive, communication, and
functional skills. It is usually highly individualized, intensive, and comprehensive.

Early Start Denver Model (ESDM)

This technique is based on applied behavior analysis and is often used for children with autism
between the ages of 12 and 48 months. It utilizes play activities to help foster cognitive, social,
and language skills.

Natural Environment Training

After people have acquired skills through discrete trial training, they then begin learning and
practicing those skills in more natural environments. For example, a child may learn a specific
skill and then begin practicing it at home or in school.

ABA therapy is also often delivered in two different ways. It can be used as a comprehensive
program that provides intensive intervention in many environments and situations. Or, it can be
part of a more focused program that may involve only specific behaviors or situations.

Comprehensive ABA Therapy

This approach delivers treatments that usually last for several hours each day. A therapist or
behavior technician works with the individual for at least several hours each week and often in
different contexts, such as in both home and school settings. Therapists work directly with the
individual but may also work with parents and caregivers to teach skills that can be used outside
of ABA therapy sessions.

Focused ABA Therapy

This type of treatment may focus on helping an individual in a specific situation where they are
facing difficulty. It may also focus on specific skills that an individual needs to work on. The
individual often works one-on-one with a therapist, but they may also practice these skills in
small groups or in community settings.

Techniques

ABA therapy usually involves a few different steps. Treatment plans are tailored to the needs of
the individual.3

● Assessment is the first step of ABA therapy. During this stage, the child or individual
will meet with a therapist, who asks questions about strengths, weaknesses, needs, and
goals. From this information, the professional will develop a treatment plan.
● Treatment will involve using different techniques to work toward the individual's goals.
Treatment sessions can sometimes be as short as an hour, but they often last for several
hours at a time.
 ● Caregiver training involves offering support and training to parents and other caregivers
and family members. Therapists teach parents and family members skills and strategies
that will help maintain desirable behaviors in the home, school, and community settings.

What ABA Therapy Can Help With

ABA Therapy can be used for a variety of conditions, including:

● Anxiety disorders
● Attention-deficit/hyperactivity disorder (ADHD)
● Autism spectrum disorders2
● Borderline personality disorder (BPD)
● Developmental disorders
● Obsessive-compulsive disorder (OCD)
● Post-traumatic stress disorder (PTSD)
● Sleep problems4
● Substance use disorders

Benefits of ABA Therapy

ABA therapy doesn't "treat" autism but it can be used to teach desirable behaviors and to reduce
or extinguish undesirable ones. For example, ABA may be used in autism to reduce tantrums,
teach a child to sit quietly, or use words to make requests. It can also be used to reward a child
for simple and complex skills, like brushing their teeth correctly or sharing a toy with a friend.

Some ways that ABA therapy can impact an individual's life include:

● Acquiring and practicing social skills

● Decreasing problem behaviors
● Developing memory and cognitive abilities
● Improving emotional connections with other people
● Improving language and communication skills
● Improving attention and focus
● Learning daily living skills
● Managing feelings of aggression and anxiety

Effectiveness
ABA therapy has become a widely used treatment approach in the treatment of autism and other
conditions. It has been linked to improvements in key areas including language, social skills, and
adaptive skills.

● One study found that long-term comprehensive ABA treatment could help autistic
children improve their daily living skills, language development, social abilities, and
intellectual functioning.5
● A 2011 review of 27 studies found that ABA interventions were effective for improving
social skills, adaptive behaviors, language abilities, and cognitive skills. These
interventions were also helpful for reducing aggression and anxiety in children and
adolescents.6
● A 2012 study suggested that children with autism spectrum disorder should have access
to a minimum of 25 hours per week of comprehensive ABA therapy, which has been
linked to improvements in play skills, behaviors, language, and social communication.7

How those results translate to long-term benefits throughout life is still being examined. It's also
important to note that ABA therapy doesn’t treat autism but rather aims to achieve specific
outcomes such as the modification of certain behaviors associated with autism.

Things to Consider

ABA is not the only approach to treatment, so it's important to listen and look at how a person is
responding in order to determine which treatment is right for their needs.

While ABA is widely used today, it's not without controversy. In the past, this type of treatment
involved hours of treatment each day, often done in rigid environments. Failures to produce
desired behaviors were often addressed with harsh punishments, which were considered both
disrespectful to those in therapy and often dehumanizing.

More recent approaches focus on either applying or withholding reinforcement and do not
involve punishments. Rather than sitting at a desk doing discrete trials for hours each day,
treatment is now often delivered in natural settings, including the home, school, and community
settings.

ABA therapy is often focused on getting people to engage in "typical" behaviors. Today, there is
a greater appreciation and value for neurodiversity.

Rather than trying to force people to fit a specific mold, newer approaches are instead focused on
helping people develop and strengthen the skills that will allow them to reach their potential and
live a fulfilling life.

How to Get Started

If you are ready to try ABA therapy for yourself or your child, there are some steps that you can
take to help find the best treatment for your needs.
 ● Get a referral. Talk to your doctor or child's pediatrician for a referral to an ABA
provider. You can also search online for local service providers.
● Check with your insurance. ABA therapy is often covered by insurance, so check with
your policy provider about coverage, and contact your therapy provider to be sure that
they take your insurance.
● Find the right therapist. Start by checking that your therapist is a board-certified
behavioral analyst (BCBA). Early ABA sessions often focus on building a rapport with
the therapist, so pay attention to whether it seems like a good match.

As with other types of therapy, it can be helpful to give it a try and keep an eye on how things
go. If you notice good outcomes over time, it may be a good idea to stick with it over the longer
term. If you or your child struggles with treatment or does not achieve good progress over time,
it may be a good idea to switch to a different treatment approach.
What are the Principles of Applied Behavior Analysis (ABA)?

ABA therapy can be applied to decrease individual behavioral concerns that could be negatively
impacting social interactions among peers, family dynamics, academics, education, and the
ability to focus.
ABA therapy can also be used to increase social and communication skills as well as teaching
life skills.
ABA principles and strategies target behavior goals and modify behaviors to be more functional
and appropriate in their natural environment, which can in turn improve daily living.
The principles of ABA applied behavior analysis target the four functions of behavior, which
include: escape or avoidance, attention seeking, access to tangibles or reinforcements, and instant
gratification (or “because it feels good”).
The four principles of behavior analysis include:
1. Behaviors are affected by their environment.
2. Behaviors can be strengthened or weakened by its consequences.
3. Behavior changes are more effective with positive instead of negative consequences.
4. Behaviors need to be reinforced or disciplined for socially significant changes.
All of the functions of behaviors can help an ABA therapist and behavior analyst create an
effective intervention plan for children with autism.

To better understand principles of applied behavior analysis, the following example situations
could be used as a learning tool for families to help them learn how a BCBA therapy uses
behavioral science to create behavior interventions which promote positive behavior:
1. Behaviors are affected by their environment. An example of this would be if a child is being
bullied at school. They may engage in negative behaviors for the function of escape or avoidance
of having to go to school.
2. Behaviors are strengthened or weakened by their consequences. An example of this would be
a child having a temper tantrum at the grocery store over the desire of wanting a candy bar. The
child has learned from past experiences that if they scream and make a scene, the parent will
most likely give in and allow access to the candy bar. This behavior serves the function of access
to tangibles or reinforcements.
3. Behavior changes are more effective with positive instead of negative consequences. Positive
consequences are also known as reinforcements. Reinforcements can be used to help increase the
target behavior that is desirable. Negative consequence is an effective treatment method to
decrease undesirable behaviors.
An example of this ABA principle would be a child misbehaving at school and the teacher using
recess as a reinforcement for good behavior. If the child follows the terms given to them by their
teacher, they will get to enjoy recess with their classmates. If the child continues to have
undesirable behavior, their consequence is having to miss recess.
The function of this behavior could fall under two different areas – escape or avoidance (not
wanting to sit and do work at school) or attention seeking (acting out to get the attention of a
teacher). In this example, the child would most likely respond to the positive reinforcement
better because they would not want to lose recess and playtime with classmates and friends.
4. Behaviors are needed to be reinforced or disciplined for socially significant changes. Learning
new behaviors or changing behaviors and habits can be a slow process sometimes. Using
reinforcement for positive behaviors increases the new behaviors that you want to see. Discipline
or negative reinforcement decreases the occurrence of negative behaviors.
An example of this could be linked with the grocery store example mentioned above. If a child
has a temper tantrum at the checkout line over a candy bar, and the parent says “No” and blocks
access to the candy bars, the child will cry louder and physically act out more aggressively with
the intent to serve the function of access to tangibles and instant gratification.
When the parent remains firm on “No”, the child eventually learns that no matter how loud they
cry or how big of a scene they make at the grocery store, they will not be receiving access to
their desired tangibles and reinforcements will not be given for negative behaviors.
What are the 7 dimensions of applied behavior analysis?
Applied behavior analysis has seven different dimensions that are supported by scientific based
research for children with ASD. The seven dimensions of applied behavior analysis to encourage
behavior change are: 1) Generality, 2) Effective, 3) Technological, 4) Applied, 5) Conceptually
Systematic, 6) Analytic, 7) Behavioral.
Below, we cover each dimension with more detail:
1. Generality. When a child receives ABA therapy in a clinic setting, this does not always carry
over to be continued at home. This is why when programs are run by behavior technicians who
implement the programs and trials designed by the BCBA therapy, the child will need to master
the skill with multiple technicians and sometimes within multiple settings to ensure he/she has
truly mastered that target.
2. Effective. The BCBA therapist will regularly study the data taken by the behavior technicians
to make sure the targets and goals are being run effectively. Adjustments and changes will be
made as often as needed to ensure the ABA therapy is continuing to be effective and that the
client is continuing to make progress.
3. Technological. ABA intervention programs written by the BCBA therapist need to be run the
same way by each technician or person to be effective at modifying behavior. Technological
refers to having all individual treatment based programs written in detail so that anyone could
run the program. This is also important for parents so that they can have continuance of modified
behavior at home.
4. Applied. This refers to teaching skills that can be carried over in real life situations. Learning
functional play skills in a clinic is very structured. Being able to apply those skills on a
playground with other children supports this dimension of applied behavior analysis.
5. Conceptually Systematic. This refers to the ABA treatment being scientifically based and
applied to improve understanding and behavior in any person receiving ABA therapy.
6. Analytic. Applied behavior analysis ABA technicians need to ensure that all data collected
during programs that were run is accurate so that the BCBA therapist can look and analyze data
to apply the principles of ABA to promote change.
7. Behavior. Behaviors need to be observed and measurable for each person so that scientific
backed ABA applied behavior analysis can be applied to improve behaviors at home and to
improve socially.

Can Parents Implement ABA themselves at home?

Parents can practice ABA themselves at home and are highly encouraged to spend time doing so
because they spend more hours with their kids than therapists can at the clinic. Parents who
understand and see value in ABA science for the autism community are an important part of the
change therapists hope to see more of through teaching and intervention.
Conclusion
ABA applied behavior analysis can be used as an intervention in order to have a better
understanding of behavior and learn science backed strategies to change or modify behaviors.
Any individual can learn more about ABA therapy through their doctor or professionals in the
autism community. The basic principles of ABA therapy are designed to help alter challenging
behaviors over time into more functional and “appropriate” behaviors.