ABA Therapy – Applied Behavior Analysis

Applied Behavior Analysis or “ABA” is a therapeutic modality based on certain guidelines for the treatment of behavior. Applied Behavior Analysis is a science which have predefined rules to understand behavior and hence modify it according to the needs of the concerned. It applies these rules to enhance required behavior, learning and language .It also use these rules to decrease harmful behavior which interfere with learning or cause difficulty in achieving the respective goals. It is also used to increase language and communication skills, to improve attention, focus, social skills, memory, and academics.

ABA is an evidence-based practice used for behaviour modification. (“Evidence based” means integrating clinical expertise with evidence from systemic research to produce a decision best for the patient care).

ABA is the understanding of the behavior in relation to the environment. “Behavior” means kind of actions and response which a child give to the environment.    “Environment” means all physical and social events that have an impact on one’s behavior.

All the ABA Therapy are based on 3 principles

1. Structured
2. Intensive
3. Positive reinforcement strategies

Through these principles it can help children learn or acquire new skills and inhibit disruptive behaviour. ABA therapy follows different techniques to modify the behavior. All of these techniques focus on antecedents (what happens before a behavior occurs) and on consequences (what happens after the behavior).

Few of them are listed below:

1. Positive reinforcement: It is the process of encouraging a pattern of behavior by offering reward when the behavior is shown. This technique helps to reinforce the good behavior repeatedly.
2. Discrete trial learning: It follows the principle that intensive practice is required to acquire a skill. It is a planned session which requires structure based teaching on a one-to-one basis. A child sits in front of the therapist and a structured program is followed for a particular behaviour. This intensive learning is called a “drill”. As drill is based on repetition of a task to help in learning of a behaviour or language or activity. The child is asked to repeat the same work again and again in a similar fashion so as it gets stuck to the brain. When a memory of the activity is created in the mind by repetitions then it can be reproduced at different times and hence can be generalised. The commands are given in a simple form so that the child does not get confused and distracted. The instructions are repeated a number of times and when the child reproduces it maximally, another task or goal is assigned. Children receive positive reinforcement in the form high-fives, verbal praise etc., after completing the instruction and thus forming a positive behavior and language .The rule is to repeat the instruction so as to form a better behavior. For example, a therapist takes a 1:1 session of a child, let him sit in front of him on a chair and show him a picture of an animal. He repeats the animal name and points towards it. He prompts the child to repeat the same. When the child does so he rewards the child with a positive reinforcement and appreciates the behavior.

3. Incidental teaching (or natural environment training): It creates an environment in which child feels motivated and is attracted towards it. Through this process the learning becomes fun and easily attainable. In this teaching the interactions are initiated by the child and the therapist follows the clues. To know what the child likes or dislike, the child is observed in   natural environment and his likes and dislikes are studied. Then a workplace similar to his interest is created. The objects of his like are kept just outside the reach of the child. The objects of interest should be visible to the child. The next step is to wait and let the child initiate the interaction. As soon as the child reaches for his object of interest look into the child and wait for few seconds. Ask for the object name and let the conversation begin. This can be later elaborated by different levels of prompts. Make sure the interaction is brief and does not turn into an unpleasant experience for the child. If the exchange becomes too long or unpleasant shift the child attention towards different task. As the same procedure is repeatedly done it helps to initiate and hold the dialogue for 30 sec to 1 min and hence speech and language starts elaborating. Before starting the exercise the therapist showed know how to take the maximum advantage of the natural surroundings and revise the multiple prompts he needs to make during the interaction phase.

4. Verbal behavior: It is a structured, intensive one-to-one model .It is designed to teach the student  a word through its functionality. The child is shown a scissor and also the function of the scissor i.e. to cut. He is shown the procedure and the object and its function is explained. It is a model like discrete trial training where structured and  intensive program is made to develop language .This model can be applied in incidental training where the child directs the therapist to proceed in the direction of his liking.

5. Pivotal response training (PRT): It is a naturalistic, loosely structured intervention which has been listed among the top 10 model program for autism and has been widely used to teach language, increase communication, academic skills and decrease disruptive behaviour. It works through child’s motivation, responsively to various cues, self management, and social initiation. Initial research was based on
6. Child’s choice
7. Reinforcing efforts
8. Task variation
9. Natural reinforces.

The child guides the therapist and provides clue for the further development of the plan. The reinforce  is the natural reinforce  (eg. If the child attempted to request for a particular toy that toy becomes the reinforce for them and not the candy or high five) and not the other unrelated object.

Natural language paradigm: It  allows unconditional setting of the environment  which facilitate to use language. It is based on the child’s initiative. And is followed by the therapist. It uses natural reinforces which help in the development of a particular behavior. For example, if a child is prompted to learn to say  “Bye-bye”  should be done when he is leaving the room after  the therapy session is over.