Pediatric Therapeutic Services

Applied Behavioral Analysis (ABA) Therapy

Applied Behavioral Analysis (ABA) Therapy

All behaviors, not just challenging ones, stem from motivation, and all behaviors serve at least one purpose. Behaviors can help us:

  • Obtain tangible things or activities.
  • Receive attention (positive or negative often doesn’t matter).
  • Avoid or escape undesirable outcomes.
  • Get sensory stimulation.

Applied Behavior Analysis (ABA) uses an empirical understanding of the relationship between environment and behaviors to help people gain and develop skills—in students’ case, skills needed to access and successfully engage with their education.

At Pediatric Therapeutic Services (PTS), our Behavioral Health team uses several forms of  ABA therapy to help students—including but not limited to those with Autism and sensory processing disorders (SPDs)—learn behaviors that facilitate progress in school.

Depending on students’ Individualized Education Programs (IEPs), ABA Therapy can help them achieve such behavioral goals as:

  • Clearly communicating requests using words, sign language, or pictures.
  • Following directions from a teacher.
  • Raising a hand and waiting to be called upon in class.
  • Accepting “no” as an answer without responding in anger.
  • Approaching and playing with peers.
  • Correctly identifying other people’s emotional states.
  • Asking for help when needed.

ABA therapy demystifies students’ challenging behaviors and offers a proven way to replace them with more desirable ones (“targeted behaviors”). 

The “ABC” at the Core of Applied Behavior Analysis

ABA helps clarify why people act as they do by gathering and evaluating observational data according to an “ABC” assessment:

A – Antecedent

What stimuli, events, and circumstances happen just before the behavior?

B – Behavior

What is the behavior itself, in detail?

C – Consequences

What results follow the behavior?

Typically, ABA therapists must observe at least 10-15 instances of a problematic behavior before discerning a pattern of antecedents and consequences. Once they do, they can help change behaviors by introducing changes in that pattern.

Ultimately, Applied Behavioral Analysis seeks results by changing a person’s environment, not by changing the person.

Three Decades, Three Prominent Models of ABA Therapy 

As do other ABA practitioners, school-based behavioral therapists apply the field’s principles using various models. Over three decades, three prevalent, evidence-based practice models arose:

  • Discrete Trial Training (DTT)
    Developed in the 1960s, DTT was ABA therapy’s original method and remains the most highly structured. In it, therapists break desired behaviors down into discrete skills and teach the skills to the student one at a time in “teaching attempts,” giving positive reinforcement for each successful attempt. In the “chaining” model of DTT, therapists help students combine discretely learned skills into a more complex behavior.
  • Pivotal Response Training (PRT)
    PRT emerged in the 1970s as a less task-oriented, more child-driven approach than DTT. This play-based, child-initiated approach focuses on such “pivotal” developmental areas as the motivation to learn, the ability to self-regulate behavior, and the initiation of social interactions. It emphasizes natural, positive reinforcements for good attempts at targeted behaviors, not just perfectly successful attempts.
  • Early Start Denver Model (ESDM)
    The ESDM, named for its origins at the Colorado Health Sciences Center in the 1980s, is also child-led and play-based. It promotes developmental progress for young children (ages one to four) in natural environments (as opposed to sitting across a table from a therapist) and within positive relationships with parents, who receive training. ESDM can be used one-on-one or in small groups.

Some specific ABA therapy techniques which may be found in multiple practice models include, and often in conjunction:

  • Shaping
    The clinician reinforces a student’s successful approximation of a targeted behavior a certain number of times. Then the clinician withholds reinforcement and reinforces a new, closer approximation instead, repeating the process until the student reaches the desired behavior.
  • Prompting and Prompt Fading
    The clinician visually and/or verbally prompts the student to perform a targeted behavior, reinforcing successful performance. The clinician weakens these cues (“fades them out”) once students no longer need them, to avoid making students dependent on them.
  • Imitation and Video Modeling
    The clinician either demonstrates a desired behavior to the student or shows a video of it so the student has a visual model to mimic.  

Controversies Surrounding Applied Behavior Analysis

Critics of ABA therapy, especially advocates for people with Autism, question its premises and its methods.

ABA gained popularity largely because it led parents of children with Autism to hope their children could lead a “normal” life outside of institutions, as science and health writer Elizabeth DeVita-Raeburn explains for Spectrum News. But influential advocates today claim society should be and often already is more accepting of neurodiversity—the view that brain differences like Autism and ADHD are normal. 

Additionally, critics charge ABA therapy relies on burdensome and formulaic repetition and focuses too much on eliminating behaviors.  “It can be actively harmful when we teach people from a very early age that the way they act, the way they move is fundamentally wrong,” Ari Ne’eman, co-founder of the Autistic Self Advocacy Network, told Child Mind Institute.

But proponents point out DTT is no longer ABA therapy’s sole delivery model. Naturalistic, play-oriented, child-directed approaches allow students to generalize the skills they learn in their therapy sessions. They also argue ABA as currently practiced not only acknowledges neurodiversity but also equips students to live and do more in the world with their individual differences.

Discover How PTS’ Behavioral Health Team Can Help Your Program

PTS’ Behavioral Health professionals will do more than help reduce problem behaviors in your buildings. They’ll empower your teachers and staff with knowledge and tools to address behavioral issues without making unnecessary referrals. As a result, your program will help more students make educational progress.

To find out more about how Applied Behavior Analysis can benefit your program, contact us online today or give us a call at 610-941-7020. 

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