“We’d like the school psychologist to evaluate Greyson during preschool and at home. He may be eligible for a special kind of therapy”, I was told one day during Early Intervention Preschool for my then two-year-old son.  “What kind of therapy?” I asked. And this was the first day “Behavior Therapy” was introduced into our world, which I now know as Applied Behavior Analysis (ABA).

“What in the heck is ABA?” I wondered. I went home and asked Google for all the info I could read. I knew what behavior meant, and I knew what therapy meant but I had zero clue of what they meant together.  So I read and I read and I read. And each new click brought on a deeper feeling of dread. It was because of words like intensive…things like- 40 hours weekly… There were groups saying it was great, and groups saying it was abusive. I didn’t know a soul I could ask for honest feedback, I didn’t want to do this therapy- But I also knew Grey needed help that I just couldn’t give him.

I was told from a school Psychologist that they were most likely going to be approved for 20 hours of ABA therapy per week. I remember getting the call a few weeks later. “Great news! Greyson is actually approved for 30 hours of ABA each week.”

The lump in my throat made it difficult to talk.

I wasn’t happy that we got approved for 30 hours of ABA a week, I was mad because I thought we would get 20, and that already felt like too much. I wasn’t happy that it was in the convenience of my own home, I was annoyed that I would have to share our living space with strangers from 8am until 5pm every day. was also frustrated that it meant I couldn’t leave the house during this time. I could no longer go for morning walks, stop at the grocery store, or even take Greyson and Parker to the park, or anywhere for that matter. I felt like we were on house arrest.

When Grey was first diagnosed, I was bombarded with suggestions on how to help him. I didn’t know which ones were legit and which ones were wacky. Now I know to look for Evidence based Practices- “Evidence-based practices” are interventions that researchers have shown to be safe and effective through scientific research. There are 27 evidence-based practices for autism and most draw directly from the science of Applied Behavior Analysis.

What is ABA? Applied Behavior Analysis is one proven method in the treatment of autism. Behavior analysis focuses on the principles that explain how learning takes place. When a behavior is followed by some sort of reward or positive reinforcement, the behavior is more likely to be repeated. Same for us typical folks- right? If we get paid, if we are told, GREAT JOB!, if we are rewarded for an action, we are more likely to repeat that action.

Applied Behavior Analysis is used to help someone learn socially appropriate, naturally integrated behaviors and reduce behaviors that interfere with learning and/or being involved in one’s community. ABA programs that are high quality prioritize the values and goals of the individual and emphasize meaningful skill development, close collaboration with the individual and their family, and the use of a variety of evidence-based approaches. The “Applied” part of ABA means we are working on socially significant skills. Let’s say a student rocks back and forth while completing math worksheets. Some institutions historically (and unfortunately – some still do now) target any behavior that “looks autistic” for change- even if it is not meaningful for the student. THIS IS NOT OK. ABA should not ever attempt to make an individual behave like a typical person. It should be used to target skills important for the student’s quality of life. Let’s say Student B hits himself if they have to leave preferred places- like a playground. This fits the criteria of “Applied”, because reducing this behavior will positively impact their quality of life.

BEHAVIOR I think traditionally we hear the word “behavior” many people automatically think “bad behavior”. In ABA, when we talk about behavior, we really mean anything a person does. Behavior includes observable actions.  Brushing teeth is a behavior. Holding hands to cross the street is a behavior. Writing is a behavior. Riding a bike is behavior.

Greyson and I working on his “Brush Teeth Program” with his therapist to ensure he could demonstrate this skill at home.

Typically developing children learn language, self help, play and social skills, from the world around them.  Many kids on the Autism Spectrum do not learn easily from their environment. They have the potential to “learn how to learn” but it often takes a structured environment where conditions are optimized for acquiring the same skills typical children learn naturally.  ABA is using environmental set ups and consequences to shape or teach any skill or appropriate behavior. It’s quite simple really, and totally complicated and fascinating and bizarre.

Sometimes learning takes place in a classroom or a cubical. But the best teachers teach everywhere, the whole wide world is a learning experience in functionality.

Often ABA is conducted in a sterile environment, or more clinical type setting. Although programming is initially occurring in this setting, the treatment should be designed in such a way that reflects the individual’s natural environment. By doing so, we help ensure the behavior generalizes across different environments outside of treatment, and that it will maintain across time. A treatment is not considered effective or successful until generality is achieved. If a student can label colors on blocks in a cubicle with a teacher, but can’t label colors on different items at the grocery store with Mom- they don’t really know their colors. If a skill is not able to generalize across people and settings- it is not yet learned.

Greyson working on receptive identification of items- fork, cup, bowl. If he can hand over a cup when asked, but can’t identify a cup sitting at the kitchen table during a meal- it is not yet generalized. 

 

 

What is the Analysis part of ABA? Being analytical means looking at the data to make data-based decisions, which means data must be collected on interventions. When looking at the data, if an intervention being used is not showing a change/ increase in the desired behavior then a change is warranted. Once the intervention is modified and data shows an increase in desired direction, then we can prove a reliable relationship between our intervention and the increase in positive behavior.

 

Therapists keep a detailed account of everything. They keep data on how many overall attempts are made, how many are successful on the first try and how many take a second try, or aren’t completed at all. They keep track of how much help- or how many “Prompts” were needed- so that these prompts can be faded until the child reaches independence in these skills. Each program- or skill being addressed is completely individualized, and constantly analyzed for progression.

 

Now my oldest son Greyson is 11, and we still do ABA. We couldn’t live without it. We use it daily in almost every aspect of our lives. It’s not scary to me anymore, like it was nine years ago. It’s fascinating, and helpful and necessary for his future. We help Greyson be more him. We work with people dedicated to helping my boys learn and navigate a world that doesn’t always understand them. We don’t work to make them look “less autistic”, we work to make them happy and productive and meaningful members of our community.

Here is a Helpful one sheet handout from The Autism Helper on What ABA is and isn’t.

Chrissy Kelly
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