Over the past decade, the science of Applied Behavior Analysis (ABA) has been increasingly correlated with the treatment of Autism Spectrum Disorder. With encouraging results (i.e. clients learn new skills and problem behavior decreases) and a growing diagnosis of Autism, this attention to ABA is not surprising. What should be noted however, is that Applied Behavior Analysis is applicable to many populations (not just individuals with Autism) in diverse environments (not just a treatment facility). Why? Everyone desires behavior change. Often, this desire is for oneself, an employee, a child, a spouse, etc. Regardless of whose behavior is changing, the environment is responsible. Specifically, behavior change occurs due to manipulations in the immediate, surrounding environment.
What is ABA?
Applied Behavior Analysis is a researched-based science in which the environment is manipulated to change behavior. ABA calls for the assessment of behavior and the environment it occurs in, prior to any treatment. Once extensive data is collected, treatment is applied to decrease problem behavior AND increase desired behavior. All treatment decisions are customized to an individual and subsequent modifications in treatment are based on continuous data (not assumption).
How is behavior defined and measured?
Behavior is any measurable and observable movement of a living organism. For example, a child may refuse to brush their teeth at bed time. How is this measured? Perhaps the refusal involves yelling out, “No!” and throwing the toothbrush on the floor. Yelling and throwing are behaviors because they can be measured (how many occurrences, how long, how intense). We would NOT say that “the child is upset” because you cannot measure being upset. ABA focuses on behavior, not moods or emotions.
What are desired behaviors?
“Desired” is a subjective term. For example, a fifteen year old male student with Autism may desire to engage in conversation with a fifteen year old female classmate, but his parents may desire for him to learn multiplication. Math and social skills are both important, yet how do we determine which target is more desirable? In an ABA program, the goal is to encourage socially significant behaviors. To determine what desired behavior is, an ABA practitioner should discuss with the client (which includes the individual receiving treatment, their family, and others involved in the client’s daily life) what their goals are AND how to achieve those goals.
Behavior and Environments
As stated earlier, ABA involves environmental manipulations in order to change behavior. Specifically, modifications are made IMMEDIATELY before and after a behavior. For example, a teacher says, “Do your math worksheet,” then her student yells, “I hate math! It’s the worst thing ever!” and subsequently the teacher sends the child to the principal. This same situation has been occurring now for over a week (i.e. the problem behavior is being supported, although unintentionally). Modifications to the environment are necessary. Before math, perhaps we can offer a choice of two subjects (math or reading), allow the student to choose, and provide access to the subject of choice. Or, instead of sending the student to the principal after he protests math, the teacher should have the student complete the task presented AND THEN allow the student to take a break from math.
When describing the environment, we call what happens before a behavior the antecedent and what happens after a behavior the consequence. By observing and taking data on antecedents and consequences that surround the behavior of interest (i.e. protesting math), we are better able to prevent problem behavior, teach alternative (more appropriate) behavior, and write a behavior intervention plan. Through consistent data collection, practitioners are given evidence that treatment is efficient and effective. If the desired behavior change is not occurring, we modify the intervention(s).
Which environmental change is most important?
The focus in any ABA program is to increase or strengthen pro-social (appropriate) behavior through reinforcement. This essential consequence is often overlooked or misused outside of our field. For example, the scenario above described a child yelling out, “I hate math!” and he was sent to the principal’s office. Notice that the problem behavior then continued for the following week. The teacher’s intention was to decrease her student’s problem behavior; however, she gave him exactly what he wanted—escape from math. Although unintentional, the teacher reinforced yelling out behavior. As ABA practitioners, we stress the importance of data collection in order to identify situations similar to the one just described. If a problem behavior (i.e. a child hitting herself on the face repeatedly or a client running out of the house when everyone is asleep) is continuing to happen (or getting worse) then the behavior is being reinforced in some way.
Keep in mind, what is reinforcing to one student is different for another. Additionally, reinforcement changes pending one’s current environment. ABA practitioners are constantly on the lookout for their client’s changing motivation in order to reinforce effectively. For example, if a child has not played outside for two days due to rain, then outside time is valuable and playing hungry hippos in the living room no longer is.
There are three easy steps to follow when it comes to using reinforcement. First, take time observing your child as they play, eat, relax, etc. and write down the items/activities they engage with most. Second, save a few of those items/activities as “special privileges” that only YOU deliver (i.e. your child cannot access those items on their own anymore). Third, when your child does something well (i.e. throws away their garbage or shares with a sibling) then give them that “special privilege” item.
Where and how does treatment begin?
Effective treatment always begins with assessment. Talking with caregivers, observing clients in their (natural) environment, and altering the environment enables an individualized treatment plan to be created. Beyond the assessment, a Board Certified Behavior Analyst (BCBA) should oversee the implementation of treatment by a highly qualified behavior therapist. This therapist is responsible for gaining rapport with their client, following behavior plan protocol, and collecting data on all targeted behaviors.
Applied Behavior Analysis is best understood through training and supervision from a BCBA. If you are reading this, Cornerstone encourages you to meet with one of our clinical team members to further discuss treatment and training opportunities.