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.

What kind of therapist will be a good fit for your child?

Not all therapists will have the same style of implementing common ABA therapy techniques. Some may be very gentle, others firm, where some may want to explain situations to a child who works well with logic, and others may want to make simple demands instead. Applied Behavioural Analysis (ABA) is a therapy that is implemented in a way that molds to your child's unique personality and needs.

Because of this, not all Applied Behavioral Analysis (ABA) therapist will be the right fit for your child. When you decide to terminate services, you may consider if you want somebody else. If this is the case, think about what it was about the last analyst that caused issues for you. Understanding what you disliked about the therapist style of teaching, and communicating it to the company, can help them find you a better fit. Making a concrete list of what you are looking for gives the therapist/company a way to meet your needs, and either refer you or find someone like that.

Whether it’s tone of voice, certain techniques you don’t agree with or simply the personality of your therapist, making sure all of those issues are met to your desires are important. Never be afraid to go with a different therapist until you find the right fit for your child. Every therapist practicing ABA will bring their own unique style and personality into the mix. Just like every child will bring their own personalities into the relationship.

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.