Understanding ABA Therapy: How It Works and How It Can Help Your Child

Understanding ABA Therapy: How It Works and How It Can Help Your Child

Applied Behavior Analysis (ABA) therapy is the gold-standard treatment for autistic individuals. ABA uses scientifically derived principles to understand how environmental factors influence behavior, with the primary goal of promoting socially appropriate behaviors and reducing problem behaviors such as aggression, self-injurious behavior, elopement and/or disruptive behavior.

ABA therapy helps autistic children and teens by improving skills like social interaction, communication, and academics. It also teaches everyday skills such as brushing teeth, getting dressed, and playing with others.

ABA therapy is available in clinics, schools, at home, or via telehealth.

How Does ABA Therapy Work?

ABA therapy uses personalized plans tailored to each child’s specific needs and goals set by the family. The flexibility of these treatment plans allows them to be adapted as the child progresses, ensuring that treatment remains effective.

Before starting ABA therapy, a specialist will assess the child’s skills and development. This initial assessment for ABA therapy is a personalized evaluation of the child’s needs.  The specialist will use surveys and skill analyses to map out a child’s skills and deficits.  Please note: this initial assessment for ABA is separate from the diagnostic assessment for autism.

Using information from the assessment, the specialist will create a therapy plan for the child.  The therapy plan will address areas like communication, academics, play, self-care, and social skills.  To achieve the goals set for the child, skills will be broken down into smaller steps that will be easier for the child to learn.  As therapy progresses, the child will learn to combine small steps to complete their goals.

Methods Used in ABA Therapy:

• Positive Reinforcement: Good behavior is rewarded with praise, snacks, toys, or activities. For example, when a child puts away their toys independently, you can give them a high-five and positive feedback like “Great job putting away toys! I am so proud of you!”
• Shaping: Rewarding small steps toward a target behavior. For example, praising a child for picking up a toothbrush and applying toothpaste when learning to brush their teeth.
• Fading: Gradually reducing the child’s reliance on the therapist. For example, fading can be used when teaching a child to wait patiently in a line. Initially the therapist will tell the child to “Wait.” Over the time, the child will learn the expectations and will wait in line independently.
• Prompting: Giving cues to encourage the child to try a behavior. For example, a therapist may demonstrate clapping hands, encouraging the child to imitate the action.

Teaching Techniques:

Therapists repeat teaching trials until the child masters the skill. Data is collected to track progress, make necessary adjustments and help therapist measure the child’s behavior, skills and responses to interventions over time. Data that is collected during therapy sessions is kept secure and only accessible to individuals involved in the direct treatment of the child.

Decisions to stop or change goals, interventions, or teaching new skills is regularly reviewed using data analysis and discussions with parents.

Teaching Formats:  

A therapist might apply ABA teaching techniques using different formats depending on the child’s strengths, problem behaviors, and goals.

• Discrete Trial Training (DTT): One-on-one sessions guiding the child through tasks in a structured way. For example, a therapist may break down the steps of handwashing (turning on the water, wetting hands, applying soap, etc.) prompting each step and rewarding completion.
• Pivotal Response Treatment (PRT): Following the child’s interests to guide learning. For example, if a child makes a meaningful and appropriate attempt to ask for their favorite toy. The child will be rewarded with the toy.
• Early Start Denver Model (ESDM): Combining DTT and PRT to achieve multiple goals through play activities. For example, during a puzzle activity, a child can learn to identify different animals. They might be instructed to pick a specific animal, like a cow, and place it in the correct spot on the puzzle. This is reinforcing their learning through structured yet playful interaction.

Who Is Involved?

• Board-Certified Behavior Analyst (BCBA): Assesses the child’s needs and creates and modifies the treatment plan as the child progresses. Also oversees the implantation of the treatment plan by team members
• Registered Behavior Technician (RBT): Works closely with the child, implementing the treatment plan and tracking progress. RBTs may implement therapy in an ABA clinic, at school or via telehealth.

How Long Will a Child Need ABA Therapy?

The duration of therapy varies for each child. The BCBA will determine how much therapy is needed and how long it may take based on the child’s progress. It can range from 25-40 hours per week for 1-3 years.

Common Misconceptions About ABA Therapy

There are many myths about ABA therapy, such as it being too rigid or only suitable for severe cases. However, ABA is highly flexible and can be tailored to meet the needs of any child, regardless of the severity.

Additionally, ABA focuses on reducing harmful behaviors and promoting positive skills. It does not target harmless self-stimulatory (stimming) behaviors that do not pose a risk.

How to Find a Qualified ABA Therapist

Finding a qualified therapist is crucial. Look for certified professionals, such as a BCBA, and ask about their experience and approach. Recommendations from other parents or your child’s doctor can also be helpful.

You can also use the Directory on the Autism Toolkit website to see what ABA clinics are in your areas or use the Autism Toolkit’s Early Intervention Phonebook to see which ABA providers serve which counties.

Involvement of Parents in ABA Therapy

Parents involvement is essential for the success of ABA therapy. By learning the techniques and strategies used by the therapist, you can reinforce the same practices at home, providing consistency and support for your child.

Cost and Insurance Coverage

ABA therapy can be expensive, but many insurance plans cover it. Check with your insurance provider to understand your coverage and explore options for financial assistance if needed.

Setting Realistic Expectations

Progress with ABA therapy can be gradual. It’s important to set realistic goals and celebrate small achievements along the way. Patience and persistence are key.

Article by: Jessica Charm Watkins and The Autism ToolKit

Sources:

https://www.sciencedirect.com/science/article/pii/S1056499308000412

https://www.autismspeaks.org/applied-behavior-analysis

https://my.clevelandclinic.org/health/treatments/25197-applied-behavior-analysis