How effective is Applied Behavior Analysis (ABA) Therapy?

Just how effective is Applied Behavior Analysis (ABA) Therapy? Several studies have been conducted on the effectiveness of this therapy since it gained popularity via the Lovaas method. The great thing about this therapy is it is so comprehensively tested most insurances cover it for children with Autism. ABA is proven to be extremely beneficial.

Here are several sources that state just how crucial ABA is for children with autism:

Current Opinion in Pediatrics, 2011; Vol 23: pp 616–620: Found that behavioral interventions are effective for cognitive abilities, language, adaptive behaviors, social skills and reduced anxiety/aggression.

American Journal on Mental Retardation, 1993; Vol. 97, No. 4: pp 359-372: Children who received ABA were tested again at an older age and were found to have benefited from long-term progress.

Journal of Consulting and Clinical Psychology, 1987; Vol. 55, No. 1: pp3-9: 9 out of 19 children attained average functioning after 40 hours a week of ABA.

Pediatrics 2012; Vol. 130; S186: Forty-eight autistic patients received ABA at the age of 2, their IQ and communication improved significantly.

Committee on Educational Interventions for Children with Autism, National Research Council: States; 40 years of testing ABA has shown that it decreases problem behaviors and teaches new skills to those with autism.

American Psychological Association website: “Since medications on their own rarely improve behavior, behavioral interventions are crucial.”

ABA is not an experimental therapy that pokes and prods at your child in hopes of finding a ‘cure’ or something that might help. ABA is a proven method that will help your child with autism reach a level of skills and functioning you may never have thought possible.

Applied Behavioral Analysis therapy (ABA) is amazing because it isn’t designed to tackle autism by itself.

Sometimes Autism isn’t the only diagnoses that a child on the spectrum is diagnosed with. A child who has autism may also be diagnosed with Attention Deficit Hyperactivity Disorder, Oppositional Defiance Disorder, Anxiety, Depression and more. There is a 30% chance your child may also have a specific phobia, and a significant number have intellectual disabilities. Autism isn’t as straightforward as some may believe which is why it’s difficult to tackle it with most conventional therapies.  

Applied Behavioral Analysis therapy (ABA) is amazing because it isn’t designed to tackle autism by itself. It is a therapy used in all areas of life, from career, to sports, to businesses and other disorders. When you put your child into an ABA programme, you’re not only providing help with life skills they lack (due to the way their brain functions), but also skills to help with a variety of issues and other disorders.

If you’re concerned your child may have issues outside of autism, such as ADHD, you can ask your DR to refer your child for further testing. Here are some symptoms and behaviors:

ADHD: Aggression, excitable, fidgeting, hyper, impulsive, irritable, no restraint, repetitive words and behaviors, absent-minded, no focus, forgetful, short attention, angry, anxious, bored, excited, mood-swings.

ODD:  Aggressive, antisocial, impulsive, irritable, screams, self-injures, vindictive, argumentative, angry, anxious, depressed, lack of attention.

Anxiety: Tired, restless, sweating, hyperventilates, irritated, racing thoughts, intrusive thoughts, excessive worry, fear, feelings of impending doom, nausea, trembling.

Depression: Apathy, discontent, guilt, hopelessness, not interested in anything, seems bored, mood-swings, tired, insomnia, agitated, cries a lot, no appetite or extreme appetite, slow movements, suicidal thoughts, no concentration, weight gain or loss, repeats thoughts, obsessive thinking.

Applied Behavioral Analysis (ABA) Therapy has techniques to help teach an Autistic child empathy

People with autism often struggle with empathy; as a parent of a child who shows little empathy, it may be pretty terrifying to wonder what might happen to your child in relationships or how their morals might develop. A child with little empathy may laugh when another is upset, or take a toy from another child and not understand why they should share, or even be violent with little remorse.  

The good news is Applied Behavioral Analysis (ABA) Therapy has techniques to help teach a child empathy and how to respond to situations appropriately. Which is a huge relief when you’re the parent or even child. The other great news is lack of empathy does NOT make someone with autism an awful person who’s choosing not to care. The issue doesn’t lie in choice (typically seen with people who have autism, it’s caused by abnormal neural connectivity), and when given the option to learn and choose to care, a child with autism absolutely can!

First, the ABA therapist will likely teach your child to recognize emotions. Once they can recognize what an emotion actually is in a simple way, it will be way easier to teach them it in everyday interactions, and how to respond to those emotions. This is done through pictures of faces, the therapist demonstrating or even silent clips of facial expressions.

Apart from recognizing emotion, there are two other steps to mastering empathy. Taking someone else's point of view into account and controlling how we respond. This can be done through role-playing situations, using life skill books demonstrating situations where empathy is needed, having the child role play another's emotions through facial expressions, or even asking questions in everyday conversation when an empathetic response is needed.

The other cool thing about empathy is there are actually three types.

Emotional Sharing: Where you feel what another feels

Empathetic concern: Where you want to help others in distress

Perspective taking: Which is when you can see someone else's point of view

Knowing this as parents of autistic children can help us to understand why your child might run to help their sibling up when they’ve fallen down one second, but call them names and laugh the next.

ABA is a fantastic therapy which can help so many children with autism thrive and live a far more high-functioning life than they would have. The vast amount of things the therapists can teach and help your child with is so worth the time investment and bond you will build with both the therapist and your child.

Emotions for an ASD child

Almost all children struggle with recognizing emotions in others, but for a child with autism, this skill is even more complex. Their inability to read body language or facial expression well lends to even more complications throughout their life, which is why it’s important to teach this skill early. Learning how to recognize emotions impacts all areas of a person's life, from school, to work, to making friends and strengthening family bonds.

One great thing about teaching a child emotions is that they have to look at faces to achieve it. Something that people with autism struggle to do. An applied behavioral analysis (ABA) therapist can teach this in a variety of ways, one way is to show pictures faces that are sad, happy, worried, angry, etc. They ask the child which face is which and have the child point or tell the therapist.

Therapists can also teach this through expressing the emotions to the child and having them identify it. They express the emotion in an overt way, by grinning and clapping and asking what the child thinks the therapist feels.

The more the child practices identifying emotions in an artificial setting, the more likely they can recognize emotions in an everyday setting. Once a child can label and identify emotions, they can move on to learning how to deal with the emotions in themselves and others.

ABA is a great tool that helps children to learn a range of complex abilities that will help them with life skills across a range of areas, from school, to home to friends. Learning emotions is just one tool of many.

Researching the Therapy

As a parent new to the diagnoses of Autism or with little knowledge of Applied Behavioral Analyses (ABA) therapy, the whole process of researching the therapy and life your child could face is overwhelming. But reading about the nuts and bolts of the therapy and what kids with autism go through, in clinical dry ways, only gives us so much information.

Researching the step by steps, understanding the language, and talking to a therapist about your concerns are all legitimate ways to discover what you’re getting into—but it can’t prepare you for how it feels or even looks like living it.

There is however a book When Everybody Cares: Case Studies of ABA with People with Autism  by Bobby Newman which is a first-person account of ABA. It can show you in a very real way how this therapy affects a child’s life and what issues arise with someone on the spectrum.

The book When Everybody Cares: Case Studies of ABA with People with Autism gives a unique insight into the life of a behavioral analysis and the solutions they develop for common problems. The great thing about this book is you aren’t just reading step by step, you're reading the struggles and insights and even the raw emotions that come along with working through difficult behavioral issues: such as a child refusing to eat or learning how to follow instructions.

Like a diary, this book doesn’t tell you what ABA will be like, it shows you like a story, a biography of sorts. ABA is a beautiful journey for everyone involved, so it’s little wonder such a beautiful book has been written because of it.  If you want to really see what ABA looks like, or even feels like, then give this book a try.

Echolalia in Autistic children

A lot of children who have autism will start their speech journey with something called echolalia. Echolalia is when a child repeats what you have just said back to you. It is done for many purposes, but the main reason a child does this is because they have a hard time with fluent or creative spoken language.

Some good news about echolalia is it can be a sign your child is trying to speak and they may grow out of it. In some cases however, the child never fully overcomes echolalia.  There are some classic examples of this, as some children began with echolalic speech which slowly filters out as they speak more fluently, but rears its head again when they are under stress.

Some parents are told their child would always use echolalia and never speak but through ABA they can form fluent sentences and communicate effectively.

Applied behavioral analysis (ABA) therapy often works with a child's speech. After-all, speech is used for everyday functioning. The way they go about this is by modeling the correct response. As a child can already repeat what has been said this is quite easy to implement. For example;

Therapist: Do you want a cookie?

Child: Want a cookie? (Whilst holding out their hand indicating yes)

Therapist: Yes, please.

Child: Yes, please.

Therapists: (gives the child the cookie)

Basically, this teaches the child that when they say yes to this question, they receive a cookie.

You may notice once this is put in place your child uses an echoic response first and THEN the correct response. For e.g. “Want a cookie? Yes, please.” This is wonderful news as the child is now using the echolalia to process the question before they answer it. Much the same way we do.

Have you ever been in a situation where you weren’t quite sure what somebody said and you repeated it in your head to understand it? This is the function for an echolalic response in this circumstance. It’s quite normal really, and remarkably intelligent problem solving for a child who's having trouble processing the outside world.

ABA can help in so many ways! Echolalia is just one of the many struggles a child with autism faces. ABA looks at the behavior your child uses and normalizes it, trying to both understand it and change it so they still receive the benefits they are looking for.

Techniques on how to encourage your child to stick out

The behavior of trying to escape a situation in all children is common, but especially so with autistic children who have a lot going on and little to no attention span.

In applied behavioral analyses therapy (ABA) avoidance techniques are tackled head on, to build up the child’s tolerance to accept and even enjoy certain situations—such as sitting down to read a book.

A child won’t be allowed to escape a situation (since this will re-enforce that escape is preferable to getting through to the other side) so what does the therapist do to make sure the child feels they can make it through that moment?

ABA Techniques: How to Encourage a Child to Stick it Out

A lot of now vs then techniques may be used. Sometimes autistic children have a hard time understanding that this moment won’t be forever. Timers are set up to show this will end and posters explaining now vs then.

Rewards are also great. Rewards such as music, and toys when they finish a task can help a child get excited to finish, instead of unmotivated and blah.

Replacing behaviors is another tool. Instead of your child running away and hiding, the therapist teaches them to ask for a break. If they ask too often, it is lined up with the other techniques and tolerance built up.

For older children the work you are doing together could be too hard, do they understand it or getting too frustrated by how difficult it is? Maybe everyone needs to step back and look at whether this is a reasonable ask.

For older children, help him/her discover their why, what positive thing they will get from learning or ‘surviving’ this task? Talk out the positives and help them view the task from a new light.

If the amount of time it takes is too overwhelming, a therapist may cut the work into parts, doing some now then taking a break and some later.

Our therapist uses awesome token systems, which are Velcro tokens of their favorite characters. Every time they complete one step they get a new token and they love it!

The Therapist Doesn’t Expect Perfection

The effort should get rewarded more than the outcome.

If your little one tried really hard but got the answers wrong, this won’t be penalized. For e.g. If we’re teaching a child to do the dishes, and stick it out, but they leave mess on a couple of cutlery, oh well! The point is they stuck it through and should be rewarded. Everyone makes mistakes and perfection isn’t the outcome we want here, it’s getting through the situation.

The therapist will always praise your child as they take steps through a non-preferred task, they deserve it. It is difficult to do anything when your world is full of noise and distraction, sometimes they just want to do something easy; but as we all know we can’t always do this as adults.

This is Something We All Do

Often ABA is just common sense. I bet you ask for help, know why you want things, take breaks and reward yourself for getting through boring tasks too! For instance,

“This meeting will take 20 minutes, I’ll learn some valuable things and when I go home and take a bubble bath.”

“I would like to be healthier for my family; I can ask my friends for help and have a special meal on the weekend. If I lose 10lbs I can get a new wardrobe.”

The procedures your ABA therapist uses isn’t alien, these are things even non-autistic people need to learn to optimize their days! And they set your child up to conquer the more uncomfortable aspects of later life, like boring work, meetings and chores.

Why your child is acting a certain way

Every child, anywhere, regardless of autism, acts a certain way for a reason. We don’t do things out of nowhere. Honing down those reasons are the key to helping a child overcome a behavior that won’t serve them in their adult years.

Let’s look at some common reasons people engage in certain behaviors so you notice what makes your child act the way they do!

Sensory

Sometimes we do things because it feels good to do them. Even though soda is bad for us, when we drink it the taste feels worth it, or the energy it gives us feels good. Sometimes we know we shouldn’t do something but we do it anyway because it makes us feel something we crave.

For an autistic child they may involve themselves in sensory stimulation, like flapping, rubbing their hands on things and spitting. This behavior is self soothing; they do it because it feels good! You may see it occur more when the child is frustrated, bored or even excited.

Escape

If you could escape from a painful situation without consequence, instead of facing it head on, would you? Most of us would!

Autistic children are known to bolt (they call it eloping now, officially) they run from situations, they hide under tables and do anything they can to escape doing something. Sometimes that something could be as simple as putting their plate in the sink. It’s not always because of doom and gloom circumstances.

A client of ours loves to use this behavior, he has several places in the house he knows is hard for adults to get to and as soon as you ask him to do something unpleasant (like chores) off he runs to hide under the bed.

There are other ways to escape situations like violence and yelling.

Children do this when they don’t want to engage in something. Maybe that something is boring, scary, annoying or too hard for them.

Attention

Yup, people do things for attention. This is a difficult one for some people to understand because it has such negative connotations wrapped around it. It shouldn’t, ‘attention seeking’ is just communicating that you want someone’s attention in the wrong way.

This is probably my middle child’s favorite reason to act out. He is a show star, he is loving, cute and by golly if he can be center of attention he will find a way! His autism (low empathy) means he often pushes children, hits them or bullies them so he can take their attention from them. It’s not about the child being a ‘bad kid’, this is just a child that doesn’t know how to say, “Hey I want a connection with you right now but I don’t know how to do it.”

Children do this when they want social interaction, or they want you to connect with them.

Tangibles

A few of our clients are obsessed with electronics. When it comes to trying to take them away the term ‘out of my cold dead hands,’ comes to mind. Sometimes children act out because they want something, plain and simple. They just don’t know how to communicate that want or they are terrified if you take it away they will never see it again.

This is the way that an ABA therapist looks at your child’s behavior, and a great thing to do for yourself as a parent. Sometimes putting meaning to situations helps us cope, and also gives us insight into how we can help our child in that moment.

Parenting Styles: Techniques can influence an autistic child in many ways

When it comes to Applied Behavioral Analyses (ABA) therapy consistency is key. This is true for all parenting styles; Autistic children are no different from every other child in the world. If they can find a way to get what they want, then they will utilize it.

For instance, if a toddler wants a lolly-pop and you say no, then they ask somebody else and they say yes, they may ask different people until they get candy because it worked before. It’s important that all parents and those raising a child (because it takes a village) are on the same page.

An ABA therapist in effect helps you to raise and teach a child who doesn’t respond as well to traditional teaching methods we as caregivers see in our own families and mainstream media. Because consistency is paramount, it’s imperative you keep constant communication with your therapist. Moreover, all parents involved are on the same page. I say this because one parent, one caregiver, or one daycare/school can undermine an entire week of ABA therapy if they aren’t clued in to how everyone is reacting to a behavior in a child.

It’s the two steps forward one step back issue. If you want ABA to run smoothly and quickly, allowing anyone to take the child a step back will make the process much longer.

If your child attends a daycare, goes to school, has separate households and more than one set of parents, every single person needs information on what techniques are used in certain situations.

ABA is a very effective but easily undermined therapy. This is why having a therapist you trust enough to implement all of their ideas, will make your ABA journey smoother. This is why communication across all platforms will ensure ABA works as well as it should.

If you ever feel that ABA isn’t getting the results you expect, you need to investigate and ensure that everyone is on the same page, and has followed through with the techniques correctly before changing them up or ending ABA all together.

How your child can wait in a structured way

It’s hard for our children on the spectrum to control impulse control and emotions related to frustration. Because of this, asking them to wait is akin to asking them to stop their world from spinning. The end result? It gets frustrating quickly; they may explode, tantrum, lash out, whine, repeatedly ask, and destroy property, or any number of things to stop the waiting period.

This is why with applied behavioral analyses (ABA) your therapist teaches your child how to wait in a structured way.  First the therapist may start by reducing the waiting period to a miniscule amount of time; usually 5 seconds.

The therapist will hold a toy, and when the child asks for it, they will say wait, and count to 5. If the child can wait those 5 seconds, great! They receive the toy and all is good with the world again. If this happens regularly, the time will increase from 5 seconds to 10 and so forth.

But if your child throws themselves into ‘negative’ behaviors, the therapist will stop the program until the child has calmed down, and try again. If the child continues to engage in problem behavior that’s no issue! The therapist will simply stop trying and move the situation to something else.

As long as the adults teach the child to wait, eventually this hard lesson will sink in, tolerance for this situation will be built, and you will have a child able to wait. Teaching a child how to wait has so many long term benefits. As an adult we have to wait for many things, lines in stores, for a package to arrive, for somebody to finish using what we need, etc. If an adult couldn’t wait it would severely impact their relationships and happiness later on. Which is why therapies like ABA are so important.

How to help your child with scrolling

Recently a family had trouble with their 2-year-old autistic son scrolling. Scrolling is when your child goes through several answers to a question before landing on the correct answer. This could look something like;

You hold up a picture of a cow > instead of saying cow and getting the reward your child says > duck, dog, cat, cow!

Whenever a new quirk in your child’s behavior arises you should always talk to your therapist about it so they can draw up a comprehensive plan, but there are some generic answers to this problem; which are commonly used by applied behavioral analyses (ABA) therapists.

A lot of ABA therapists seem to agree scrolling happens when the child’s error-correction isn’t performed correctly by the therapist.

What this means is, when a child is learning what a new response it is up to the therapist to prompt the child from most invasive, to least invasive.

‘A ‘most invasive’ prompt would look like “what is this shape?” And when the child doesn’t respond correctly the therapist immediately prompts them by telling them the answer to be repeated, then praises them. The least invasive method would ask the question and then wait for the child to answer it correctly the first time without prompts.’

Sometimes a child wants to give the correct answer a little too badly, and repeats a bunch of answers in hopes to land on the correct one. The scrolling could then occur when the therapist allows the child to reel off answers and praises them when they land on the right one regardless of all of those errors. Funnily enough, now the child has learnt that, cat, dog, cow, duck, is what you say to get a reward when shown a duck.

But it’s not too late to reverse the problem! Your child won’t do this forever. All the therapist has to do is clarify that spieling off ten words until they get to the answer isn’t the correct response to the question at hand.

To do this, when the child starts to scroll after a question is asked you pause, make it clear they are to wait, and then you re-introduce the question. If the child continues to scroll after three attempts, ask the question and use the most invasive prompt to illicit the correct answer, then praise.

A method like this, or something similar, is likely what your therapist will do to correct this charming, and a little bizarre quirk that a lot of children with autism develop especially as early learners. It is a simple problem to both develop and fix and should be no problem for your therapist to help your child overcome.

Verbal Behavioral Therapy Works and Just Because A Child Is Nonverbal Doesn’t Mean There Is No Hope.

Verbal Behavior (VB) therapy is a branch of Applied Behavioral Analyses therapy (ABA); it helps non-verbal children to become vocal and use words with meaning. Having a child who is non-verbal is scary, for both the child and the parents involved, but there is hope even if your child is severely delayed. Recently a study showed that children, who cannot speak by the age of four, can learn how to speak – something that was deemed unlikely. The study can be found here.

B.F. Skinner was a famous psychologist who wrote a book on verbal behavior and developed many of the theories that ABA is based on. B.F. Skinner said that language comes in types:

Mand – To ask for something, such as juice

Tact – A label of an object, such as circle, when something is round

Intraverbal – A way to answer a question, such as where do you live?

Echoic – When your child repeats what is said

Because of these different types of speech, your therapist looks at what is the most basic and works their way up. In this case, a Mand would be most basic, which is why a child will learn to ask for juice by saying ‘juice’, and not ‘I’m thirsty’ when they begin.

VB therapists today also work on play skills, self-help skills, social skills and complying with instructions. They do this using discrete trial training, natural environment teaching and manding to name a few.

Just like ABA, VB doesn’t let the child feel they got the answer wrong. Autistic children receive little positive feedback as they don’t engage in the world in the same way other children do. To achieve a positive learning environment, the child is re-directed and lavished in praise to solidify the positive re-enforcement process – that will ultimately help your child learn in the real world.

Visit our Website at WWW. BuildingBlockResolutions.Com