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What is ABA Therapy?

Applied Behavior Analysis is a therapy type that keeps learning and reshaping behavior at its center through the help of positive reinforcement. Its techniques draw from the theory of behaviorism, first proposed by John B. Watson in the early 20th century. Behaviorism is a school of thought that believes an individual's behavior is affected by various external stimuli, such as environmental and social factors, and the said behavior can change after a close analysis. Operant and Classical conditioning are two primary techniques talked about in behaviorism. It stresses that the consequences of action heavily influence behavior, and rewards and punishments have an equal impact on future behavior as the environment.

Ole Ivar Lovaas first introduced this treatment approach in the 1960s. His objective was to enable autistic kids to lead normal lives (defined through socially acceptable behaviors). Before that, there was no definitive treatment for Autism Spectrum Disorder. Most professionals and institutions at the time believed that it was nearly impossible to teach children with autism to lead a self-sufficient life, which led children/patients to be often subjected to insufferable conditions due to their symptoms.

Today's ABA therapy centralizes teaching and improving behaviors. These behaviors can be as distinct as brushing teeth, simple household activities, punctuality, or as refined as academic or social skills and communication.

Lovaas' theory of this modality, which he created based on behaviorist theories, had three primary goals:

• Acquaint children with eloquent language and life skills.
• Diminish behaviors that lead to self-inflicted injuries (voluntary or involuntary) as much as possible.
• Reduce stimming actions that might be socially inappropriate, like finger-flicking or hand-flapping.

Lovaas established these goals by breaking basic life skills down into simple steps and encouraged each step with positive reinforcement. For instance, brushing their teeth might seem overwhelming for an individual with a learning disability. In that case, the most productive approach would be to break each step of the entire process and encourage the individual to approach the task one step at a time. The first step could be to acquaint a child with brushing their teeth by teaching them to squeeze out the toothpaste on their toothbrush on their own. Upon successful accomplishment, encouragement in the form of verbal reward, like, 'Good job!' can help them to move to the next step. The vital aspect of the technique is to implement regular analysis of their behavior and pay close attention to factors influencing them (both positive and negative). Gentle guidance through each step can significantly help the child to build the capability to string each step and complete the complex task of brushing their teeth.

The Different Types

ABA therapists apply various Applied-Behavior techniques to reach a specific goal, depending on the concerns and symptoms of the patients. These techniques include:

1. Discrete Trial Training (DTT)

   The very first interpretation of ABA, this technique focuses on breaking down particular skills into more simple tasks. A professional guides a child to practice every step several times until they fully grasp the task. When the child perfectly completes a task, they get a reward, like candy or a toy, or even verbal encouragement. And if they fail to respond correctly, the therapist gently prompts them to try again or use a different approach.

2. Early Intensive Behavioral Intervention (EIBI)

   EIBI functions on the theory that it is possible to teach specific skills in a systematic order, which can help children with autism to acquire new skills and behavior. Early Intensive Behavioural Intervention therapy focuses on evaluating the child's current skills and challenges and creating a personalized strategy. The strategy can have changes and advancement along the child's development journey.

3. Early Start Denver Model (ESDM)

   ESDM is one of the more recent techniques in this treatment. It focuses on teaching multiple skills incorporated as a single activity, as opposed to DDT, which focuses on a single task. The technique is usually implemented in a play set to teach a child basic skills effectively.

4. Natural Environment Training

   Natural Environment Teaching is a method that incorporates the child's surroundings into teaching, developing, and acquiring skills. The teachings are integrated into fun and playful activities that don't overwhelm the child. The therapist might use a familiar toy or games that the child enjoys, elevating the learner's inspiration.

5. Comprehensive

   Comprehensive ABA treats multiple developmental issues, such as cognitive, communicative, social, emotional, and adaptive functioning. The primary focus is eliminating dysfunctional or disruptive behaviors, such as disobedience, tantrums, etc.

6. Focused

   As the name suggests, focused therapy targets one or two problem areas. It doesn't necessarily treat the symptoms of autism but prioritizes the child's concerns. Factors like age or cognitive ability do not restrict the application of Focused ABA.

Common Techniques

ABA therapy has an individualized approach in itself. The methods and their uses are easily altered based on the child in concern. However, three major techniques form the core principle of this therapy. They include:

• Assessment: The initial step of ABA therapy comprises the child or adult meeting with the therapist. Here, the therapist might ask the patient or caregiver questions about various things, such as main concerns or any specific goals they might want to achieve from the therapy. Sometimes, the professional might observe the client's behavior and surroundings. The information collected through these analyses helps plan an effective treatment plan.
• Treatment: The next step is to implement different techniques based on the observations made regarding the client. This step is crucial in understanding the child's needs and enhancing their strengths.
• Caregiver training: The third and probably the most crucial step includes training the parents or any family member that can take the caregiver responsibility. A professional equips the caregiver with helpful strategies and techniques to help the child maintain learning.

What are the Benefits for Children with Autism?

ABA is a widely researched and effectively proven therapeutic intervention for helping children or adults with ASD. The therapy type allows patients to do things in many ways. Examples include:

• Better Social Skills: This therapy focuses on intervening with a behavioral approach. It teaches individuals to acquire the necessary social skills to easily navigate through their lives without facing any ostracization.
• Independent Living Skills/ Self-Sufficient Skills: Applied-Behavior Analysis helps track behavioral patterns' progress and responses to external stimuli. This helps the caregiver teach the child independent living skills, such as punctuality or basic hygienic requirements. Sometimes, the child becomes capable of learning these skills through positive reinforcement and gentle encouragement.
• Enables Parents and Teachers to Offer Better Support: Through a professional's help, parents and teachers learn strategies and techniques to provide the necessary assistance and support for autistic children. Positive support significantly helps increase the child's ability to accomplish desired goals. It also allows teachers and caregivers to manage any hardships, such as a meltdown.
• Positive Perspective Towards Life: The most valuable benefit any therapeutic intervention can deliver is enabling the patient and their loved ones to embrace life and pursue its happiness. Learning independence, social skills, and the capability to manage hardships empower autistic individuals to take control of their emotions and energy.

What Other Conditions Can it Help Treat?

Applied Behavioral Analysis is considered the most effective treatment for children with Autism Spectrum Disorder or other neurodevelopmental conditions. This therapeutic modality is also implemented into the treatment plans, like:

• Attention deficit hyperactivity disorder (ADHD)
• Traumatic brain injury (TBD)
• Substance Use Disorder
• Dementia
• Cognitive Impairment
• Eating disorders
• Anxiety disorder
• Panic disorder
• Obsessive-compulsive disorder (OCD)
• Phobia
• Anger issues
• Borderline personality disorder

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