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Applied Behavior Analysis – A Therapeutic Intervention

Applied Behavior Analysis – A Therapeutic InterventionUpdated on March 1, 2021 | Published on February 19, 2020
Reviewed by Dr. Nereida Gonzalez-Berrios, MD, Certified Psychiatrist

7 Dimensions of Applied Behavior Analysis

In simplest terms, Applied Behavior Analysis is nothing but a stream of therapy used to modify the way a person behaves. It is an intervention to change a person’s communication skills and other social behavior. The therapy relies on scientific methods to make amends in behavior of targets. This technique can be used to improve reading and learning skills and competence at work. ABA has been used on autistic individuals as well.

Intervening to train someone’s behavior is a tedious task in terms of analysis. It is challenging as the therapist has to work with interdisciplinary teams, challenging clients, parents (when kids are treated under this therapy), and various other tasks. However, underneath all these experiences, there is a base that is followed by the ABA therapists – Behaviorism.

Applied Behavior Analysis – Definition

SUMMARY
Applied Behavior Analysis or ABA focuses on improving targeted behavior patterns by using the theories of learning and behavior modification.

The best definition till date was given by Baer, Wolf, and Risley in 1968. According to them, “Applied behavior analysis is the process of systematically applying interventions based upon the principle of learning theory to improve socially significant behaviors to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behavior.”

Another noteworthy definition of ABA was given by an organization named Autism speaks. It says, “Behavior analysis focuses on the principles that explain how learning takes place. Positive reinforcement is one such principle. When behavior is followed by some sort of reward, the behavior is most likely to be repeated. Applied behavior analysis uses techniques and principles to bring about meaningful and positive change in behavior.

What is applied behavior analysis?

SUMMARY
ABA relies on scientific techniques to shift undesirable human behavior into positive and socially acceptable ones.

The therapy uses the principles of learning to see how behavior changes and gets affected by using environmental reinforcement. The goal of this analysis is to improve socially significant behavior. ABA is based on operant conditioning, developed by B.F.Skinner and respondent or Classical conditioning theory developed by Ivan Pavlov.

In the early 1960’s Dr. Montrose Wolf, one of the pioneers in the field of ABA therapy was working with autistic children. He found that a 3 year old autistic child’s temper tantrums and aggressiveness was actually increased by the attention received from the parents. Thus Dr. Wolf followed a negative reinforcement to modify this unacceptable behavior, what he did is a time-out from parents.

Wolf created conditions where the child was deprived and denied of parent’s attention. This reduced the tantrums to a significant extent. The therapy was based on the learning principles of Operant conditioning, where reinforcing a behavior either positively or negatively increases the likelihood of occurrence of the modified behavior.

ABA rests on a process of observation and consequence. It involves the 3 main components and is known as the ABC model of behavior modification.

  1. Antecedent – Antecedents are the prompts, events, or actions that occur before the behavior. In the above example, it is the desire of the child to get the parent’s attention.
  2. Behavior – The actual manifestation of the maladaptive behavior that one wants to change. Here, it is the temper tantrums made to seek attention from the parents.
  3. Consequence – It is the impact of the reinforcement on the changed behavior and its efficacy. For example – the child was deprived of the attention. Wolf noted that by using reinforcements, behavior can be altered and made socially acceptable.

What is ABA therapy?

SUMMARY
ABA therapy is a type of therapy intervention meant for developmentally disabled children. It focuses on modifying and improving the specific behaviors that are maladaptive and goes against social norms. It helps to teach social skills, communication, reading, adaptive learning skills such as hygiene and personal grooming.

ABA therapy is a standard method of treatment for many childhood behavior conditions as well as adult psychological disorders such as:

  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Autism Spectrum Disorder (ASD)
  • Dementia
  • Substance abuse
  • Anxiety related conditions such as panic disorder, phobia, OCD, PTSD
  • Borderline Personality Disorder

Applied behavior analysis therapy can be undertaken by a trained psychotherapist who is licensed to practice functional behavior assessment (FBA). The intervention programs are tailor made to fit the individual needs of the client.

ABA therapy focuses on concrete goals such as changing or modifying the maladaptive behavior of the autistic child such as temper outbursts, anger, and self-injury. It also aims to improve functioning in deficit areas of personal growth as in communication and social interaction. The therapy also focuses on continuous evaluation of the progress made by the patient. Enough training is also given to the family members or caregiver of the child so as to reinforce the desired behavior beyond the timeline of the therapy setting.

ABA psychology

In psychology, ABA is a scientific approach based on behaviorism and learning theories to address individual behavior issues that are impacting communication, social interaction with peers, family, and the larger society. The ABA approaches target behavior that needs to be more functional in order to make it socially fit and acceptable. ABA follows the behavioristic approach in psychology. It follows a definite psychological approach to learning such as:

  • Human behavior and response patterns are determined by their environment.
  • The behavior can either be strengthened or weakened by the consequences that precedes the behavior.
  • If the consequence of a particular behavior is positive, it strengthens the behavior thus, the behavior change is effective with use of positive reinforcement. It increases the occurrence of the desired target behavior.
  • Past behavior affects the future behavior and thus needs to be changed. For example: An autistic child throwing  terrible tantrums in a shopping mall, just to receive a toy from the parent knows that displaying such an act will thereby force the parent to comply with their wish. It is because similar situations in the child’s life have brought such win.

ABA Principles

ABA principles are approaches based on learning theories. They are:

1. Natural consequence

There is a straight connection between behavior and its consequences. This is called natural consequence. For example: if you touch a burning candle, it will burn your fingers.

2. Reinforcement

Reinforcement follows a specific behavior in the form of reward or punishment and increases or decreases the likely occurrence in future. If a behavior grows and improves, then something or someone is reinforcing it in desirable ways. It can include praise, candy, extra play time and fun and play based activities. Reinforcement can be either positive or negative. A positive reinforcement is one that is given to the child after the desired behavior is achieved. A negative reinforcement is one where an uncomfortable or unpleasant stimulus is withdrawn or taken away after the desired behavior is achieved. The motive is to improve and continue the behavior.

3. Punishment

Something that follows a specific behavior and makes that behavior less likely to occur again in future. It is a type of penalty in response to a mistake or offense. For example: talkative children are punished by teachers for not obeying the rules, in the form of doing extra work during recess.

4. Shaping

Shaping is used to teach a new behavior. The child is rewarded each time the desired behavior is achieved. This shapes the behavior and increases the likelihood of its future occurrence. For example: teaching a child how to brush teeth with a step-by-step procedure and motivating them each time he/she completes the desired act.

5. Fading

It means to slow down or remove the reinforcements and prompts and continue to maintain the desired behavior or action.

Journal of Applied Behavior Analysis

The journal of Applied Behavior Analysis is an academic journal that publishes empirical research based studies and data related to the field of ABA. The acronym used for this is JABA. It was started in 1968 by Wiley-Blackwell publications on behalf of the society for the experimental analysis of behavior. It is a quarterly published journal where published research work on functional analysis and treatment of behavior disorders such as ADHD, ASD. And BPD are included. The journal is published in English and is considered as the most widely used journal in behavioral and social science.

Applied Behavior Analysis examples

ABA is considered a gold standard technique for autism treatment and behavior management. The therapy is designed to improve the deficit areas and make the young children more functional and ready to handle day to day activities. While the therapy is usually undertaken in the counselor’s office, the tricks of this intervention program can also be used at home to bring an overall well-being. Few examples of how this technique be used at home are:

  • To make the autistic child sit in one place and finish the food. This helps to teach them good discipline and table manners. Use plenty of praise when the child follows the rules well.
  • You can ask the child to look at you while you are talking to them. This improves eye contact.
  • Tell the child to match the color of the objects they can see around the room. Start with the same shades initially before trying out with many different shades. You can select one item and ask the child to match it with another same color object.
  • Encourage your child to identify emotions. You can use different types of emoji’s to teach the child how feelings vary according to situations.
  • To teach the child to identify different parts of the body, use songs and make the learning enjoyable. Your family members can sing a song with actions showing the eyes, nose, hands, legs etc. This helps to learn things simply and systematically.

7 Dimensions of ABA – Applied Behavior Analysis

1. Generality

Generality
Generality

When a therapist approaches a client to bring a calculated behavioral change, that change should not be for a short period. The behavioral change that happened during the intervention should be able to stand the test of time. That is generality when the person displays improvised behavior not just in the clinic setting, or sterile surrounding, but in different environments.

The treatment should be able to reflect on the person’s natural characteristics and the environment. This will help to ensure that the general behavior of the individual can be maintained for a long time. Success in the treatment is not confirmed until generality is achieved in the overall process.

2. Effective

Effective
Effective

In ABA therapy, goals and objectives should be aligned with the recipient’s nature and culture of his/ her community. A therapist, to check if the intervention is “effective”, must collect on data. The sessions should be data-based, which can reveal if the therapy sessions are showing the desired outcome.

There must be consistent monitoring and regular collection of data to measure the effectiveness of the intervention. The therapist must observe how the recipient is utilizing each intervention. 

Applied Behavior Analysis - A Therapeutic Intervention
Applied Behavior Analysis – A Therapeutic Intervention

3. Technological

Technological
Technological

Technology is an essential dimension in the study of Applied Behavior Analysis. Any intervention should be written in such a way that it can describe all the components in a transparent manner. To make this task possible, the different techniques that comprise intervention needs to be checked thoroughly and explained in a detailed way.

The concise and explanatory instructions and steps about technological procedures help in replicating in multiple cases.  It is more complicated when behavioral analytic intervenes individuals. Interventions are easy to replicate, and the integrity of the treatment is high when the behavior is technological.

4. Applied

Applied
Applied

Applied refers to the implementation of ABA interventions in various parts of society and not just learners. The techniques are applied only after the processes have been tested in the laboratory.

Behavior Analysts must inevitably focus on different implementation tactics and help to implement ABA for changing various significant behaviors. The target of intervention should be not only to improve the actions of the learner, but also his siblings, parents, and friends and those who exist in his larger ecosystem.

The particular medium of treatment should decide on which goals and objectives need to be more prioritized. Every individual has their skills and characteristics, which are socially significant and are particularly unique to them and them only. These particular skills will allow any individual to react and work more efficiently and in a successful manner. 

5. Conceptually systematic

Conceptually systematic
Conceptually systematic

An intervention needs to be research-based and should represent the different principles of advanced applied science. One needs to ask oneself whether you are serious about the various aspects of applied behavioral intervention and whether you to do it or not. 

6. Analytic

Analytic
Analytic

When you are using the term “analytical”, it merely means the application of data to bring the desired change in the person undergoing therapy. The therapist can exhibit that with the intervention of a variable, and the receiver can behave in a certain way.

And when that variable is removed, the concerned person will not behave the way it is expected. The decision to apply certain variables comes after data-based analyses of the person’s behavior who has opted for therapy.   

7. Behavioral

Behavioral
Behavioral

Behavior, that is observable and measurable, is part of analysis under this approach and targeted to make amends. When we can find and perceive the behavior, we can easily measure it with the help of data, and then with the right use of methods and techniques, we can surely change it.

During therapy, all traits are monitored to ensure the effectiveness of the treatment. Behavior not only means bad, but it also stands for something good as well. It is the behavior of a person that tells us what kind of person an individual is, and that allows us to understand the characteristics of the same.

So, here are the core dimensions of ABA, which you should be well aware of. All these dimensions in psychology have a powerful and vital role to play in changing behavior. The use of measurable behavior and data-driven analysis has been successfully used in intervening in the case of Autistic individuals. 

ABA program for Autism

The ABA treatment for Autism focuses on the fact that desired behavior can be taught to the child through a system of reward and consequence. ABA behavior intervention was used in the field of autism by Dr. Ivan Lovaas, a behavioral psychologist in 1987. The first initiative of using this technique was undertaken in the psychology department at UCLA. When he started the program, he started using punishments as a method for non-compliance.

In actual setups, punishment means withholding the reward; thus making the child adopt the desirable behavior. Lovaas’s techniques of behavior modification were considered harsh by others and led to a big debate about the efficacy of using negative reinforcement in progressive treatment plans.

Before we move on to describe the treatment plan for autism, let us take a quick look at autism signs:

15 Symptoms of Autism

Autism spectrum disorder is a developmental disability that affects the child’s communication, behavior, and socialization with others. The symptoms can start when the child is a few months old but parents may start noticing the signs sometime between 1 to 3 years. Few signs of an autistic child are as follows:

  1. Children with autism show no response when called by name by the first birthday.
  2. The child loves to be alone, thus not sharing, or talking with children of the same age group children.
  3. Usually, these children avoid eye contact and rejects physical touches such as hugging, kissing, and cuddling by parents or other elders.
  4. Autistic children never understand the emotions of themselves or others. They appear cold and socially isolated.
  5. They never stretch their arms to be picked up by adults.
  6. Shows delay in speech and language development.
  7. They suffer from echolalia (repeating the same words or sounds many times); over and over again.
  8. Most autistic children suffer from flat and robotic speech, devoid of facial expressions. The tone is usually rude and angry-prone.
  9. Individuals with autism fail to use common hand gestures.
  10. When talking to others, they have problems staying on to a single topic of conversation.
  11. They show repetitive behavior by rocking, twirling, hand-flapping and can go on doing it for a long time.
  12. Fixations occur in specific daily routines, never likes change in the immediate surroundings in everyday life.
  13. They constantly move their hands or legs; termed as ‘pacing’ behavior.
  14. Autistic children are clumsy and have short attention spans.
  15. Aggressive behavior is shown with few instances of self-harm as well.
Applied Behavior Analysis - A Therapeutic Intervention
Applied Behavior Analysis – A Therapeutic Intervention

ABA Treatment plan for Autism

ABA treatment plans for autistic children focus on improving behavior in real life situations by reducing the symptoms and facilitating new learning procedures. The therapy for autism aims at:

  • Improve language and communication skills; both verbal and non-verbal such as gestures and eye contact.
  • To improve attention and concentration, social skills, memory, facilitate academic understanding.
  • Decrease the occurrence of problem behavior as much as possible.
  • Positive rewards are used to motivate the child to repeat the same good behavior in similar life situations. For example: An autistic child is taught to arrange the toys after the play time is over. The child is rewarded with a praise or a token. This acts as a positive reinforcement and increases the likelihood of the same positive behavior in similar situations at home or in play school.
  • To teach the child appropriate self-care such as eating, wearing clothes by oneself, showering, and toilet usage.
  • The treatment focuses on developing life skills, motor skills and good eye-hand coordination.
  • The child is also trained to participate in play and leisure activities to facilitate social skills.

Customized and need-based program

A trained behavior analyst customize the ABA therapy program to meet the individual needs of the child. Therapy is never one size fits all type. It starts with a detailed assessment of each child’s skill set and ability. A thorough analysis is also done of the deficit areas that require immediate improvement to reduce behaviors that are socially unacceptable.

The deficit areas are first identified based on the age of the child. When the actual therapy session starts, the ABA therapists are trained people who break down the instruction plan into small steps on targeted short term goals.

The child is taught the appropriate behavior in a stepwise format so that the child can learn easily. For example: if the child has a verbal communication problem or a speech ailment; the therapist can break the learning steps from easier to complex learning processes. Usual therapy work consists of 40 hours a week of training and behavior interventions. It can be done in the following ways:

  1. Imitating single sounds by the use of phonic sound learning.
  2. To develop good eye contact and use of hand gestures to imitate sound.
  3. Learning of single words and double words.
  4. Use of short sentences.
  5. Complex speech activities such as carrying on a conversation

The board certified behavior analyst measures progress in each therapy session. It is evidence based and thus regular meets with family members are done to review the progress at home. Training is also given to the primary caregivers of the child at home, as taught by the ABA therapist.

10 ABA Techniques  

Over the years, ABA has emerged as a safe and reliable therapy intervention for ASD. Many different types of methods, treatment approaches, and techniques are used to modify and change the maladaptive behavior of the child. Some commonly used ABA techniques are:

1) Discrete Trial Training (DTT)

The discrete trial training uses the ABC approach of Applied Behavior Analysis in a face to face and one to one controlled setting. Here, the therapist asks the child to do something and reward the behavior after successful completion. It teaches skills like socialization with the same age group. The process is repeated many times until it gets done automatically without prompts.

2) Modelling

It involves showing the child a video clip or listening to an audio file giving the example of the desired behavior. Then, the autistic child is supposed to learn it and adapt it in daily life. It is commonly used to teach social skills. For example – showing the child a video clipping of a group of children playing block games together. Modelling simply means to imitate the behavior of others and act accordingly.

3) Picture Exchange Communication System

This method uses pictures to teach communication and develop the vocabulary skill of the autistic child. Here, the child gives the therapist a picture of an object and in return the therapist provides the object shown in the picture. They continue this system to learn new words, phrases and it improves the interaction of the child.

4) Task Analysis

In this method, the therapist gives a task and watches how they do it. The task is broken down in small steps into manageable components so that students can easily do it. It is usually used to teach learners those skills that are complex and challenging to learn easily.

5) Pivotal response treatment

Pivotal response treatment or PRT was developed by Robert L. Koegal and Dr. Lynn Kern Koegal of Stanford University. It was earlier known as NLP (Natural Language Paradigm). It is a behavior modification training where the therapist works on pivotal areas of a child’s development rather than focusing on one broad specific area. It is a play way method to teach social skills lessons may include imitation, taking turns, peer interaction etc. It works on four fundamental areas that include motivation, correct response to multiple cues, self-management and initiating social interactions.

6) Prompting and Fading

This technique of ABA uses some kind of prompt to trigger the desired behavior. Usually, a verbal cue or a visual cue is used to tell the child what to do, such as showing a picture and asking something related to it. While prompts are used to help the autistic child learn specific skills, fading means to remove the cues once the behavior is learned. It is removed gradually as the child moves towards independence and can perform new tasks on his or her own.

7) Functional communication training

FCT or functional communication training is an effective treatment that focuses on replacing the problem behavior with better and socially acceptable alternatives. For example: If a child wants a toy placed in the therapist’s office, instead of taking it directly from the toy rack without asking, the autistic child is taught to point out using gestures that he/she wants to play with it. Thus, the socially acceptable behavior occurs in alternative ways. Thus, FCT involves icon exchanges, pointing, non-verbal gestures and sign language.

8) Speech therapy

Speech therapy is customized to meet the individual needs of the child. The goal is to improve verbal communication. The therapist uses creative tools like phonic sounds, songs, picture boards, games, to develop communication skills of the autistic child.

9) Peer mediated social skills training

The therapy is based on the idea that children learn better from their same age peers than from adults. The process involves other normal children demonstrating the desired behavior. This is also called peer modelling. Autistic children will observe these children playing with others or how they help each other while playing. This buddy system is used to develop social interaction to a significant extent.

10) Behavior Contracts

A behavior contract is a systematic plan of action that is negotiated between a client, the autistic child and the parents. It has the details of the short term and long term goals and the activity schedules created for the child. The contract also specifies what is expected of the child and the consequences that will follow after the desired behavior is done. The behavior contracts set the rules to be followed, the kind of reinforcement to be given, and the outcome to be measured.

Where Else Has ABA Been Used?

This scientific and data-driven approach has been used by board-certified behavior analysts to analyze behavioral, social, and emotional problems and helps the patients to overcome their concerns. 

ABA has emerged as a powerful tool to not just intervene in Autistic cases; it has been successfully used in changing organizational behavior management. Clinical psychology and many other fields. This branch of therapy has evolved over the years and will continue to improvise in the coming years.    

ABA can be used in the following fields:

  1. Classrooms and schools
  2. Animal behavior
  3. Behavior medicine and health psychology
  4. Mental disorders such as oppositional defiant disorder and depression
  5. Sports
  6. Gerontology
  7. Organizational behavior and marketing

Parting words from “TheMindFool”

Applied Behavior Analysis (ABA) is ideally the type of therapy that focuses on the improvement of specific behaviors, most importantly the social skills, communication, reading skills, and academics, also the different adaptive learning skills. Such skills include – motor dexterity, basic hygiene, essential grooming, various domestic capabilities, punctuality, and the ability of job competence.

ABA can be a big game-changer in a person’s life if the person is facing different problems in his life. In the field of applied behavior,  psychologists work continuously to help learners strengthen their skills and manage the ones who are looking to get rid of any issues related to them.