13 Dec What is ABA? How can it help?
At small TALK speech therapy we are well known for using the evidence based principles of Applied Behaviour Analysis (ABA).
In this blog post we’ll share with you what ABA is and how it can help your child.
What is ABA?
Applied Behaviour Analysis (ABA) is not a therapy in itself, but a theory. ABA breaks down complex skills (or behaviours) into smaller steps, teaching through the use of clear instructions, rewards and repetition.
For example, the skill of hand washing may be taught by doing a task analysis of every single step involved in the task such as;
- turn on the tap by twisting right
- put hand under soap dispenser
- press down soap dispenser
- rub hands together 10 times
- put hands under the water
- rub hands together 10 times under the water
- turn off tap by twisting it to the left
- shake hands
- take off hand towel
- rub left hand with hand towel
- rub right hand with hand towel
- hang up hand towel
The process can be taught step by step by breaking down this skill into detailed steps. This builds success because instead of concluding that the child is not able to wash their hands we can identify where the breakdown is occurring and teach it from there.
ABA has at its base the simple behaviour principle of ABC. That is antecedent, behaviour then consequence. Everything we do, we do in order to obtain a consequence. For example we work to get paid, we eat to avoid hunger/feel good, we cry to get attention or sympathy. You can read more about the ABC principle here.
Myth #ABA is like dog training
Traditional ABA approaches have a reputation for being very rigid, structured and using food based rewards. The ABA approach was first developed by Lovaas in the 1970’s, but it’s principles date back to the infamous days of Pavlov and Skinner (19th and 20th Century). This approach has been used over many years and is backed by 50 years of research and results.
A summary of the research supporting ABA is listed below:
- “The evidence for the effectiveness of ABA with autism is extensive” (Foxx, R.M. 2008).
- “Over 1000 peer-reviewed, scientific autism articles describe ABA successes” (Foxx, R.M. 2007)
- “No other educational or treatment approach to autism meets the standards of scientific proof that are met by ABA” (Metz B, Mulick J.A, Butter E.M, 2005 & Newsom C, Hovanitz C.A. 2005).
- “An in depth review of 18 intervention types was conducted by the New York State Department of Health which indicated the strength of the scientific evidence for interventions. ABA was the only intervention recommended. Interventions reviewed and not recommended included: auditory integration therapy, facilitated communication, floor time, sensory integration therapy, touch therapy, music therapy, hormones (corticotropin [ACTH] and Secretin), vitamin therapies, and special diets” (New York State Department of Health Early Intervention Program 1999).
Myth # ABA doesn’t use play
Traditional ABA looks very structured. This is because ABA involves a large amount of repetition and frequent rewards. In more recent times the practise of ABA has evolved to be more naturalistic. It is now a conglomerate of strategies based on behaviour principles. This means that play is often used in ABA style therapy. There is always an underlying goal or skill being targeted in play using the behaviour principles of ABC (antecedent, behaviour and consequence).
How we use ABA?
As Speech Pathologists we are not university qualified Behaviour Analysts. Therefore we do not write behaviour management plans or conduct functional behaviour assessments. All of our team have trained in level 1 and 2 ABA. This means we have enough training to work as a junior ABA therapist if this was our field of practice. As Speech Pathologists we find the following ABA strategies effective for our clients and families:
ABA breaks down complex skills (or behaviours) into smaller steps and teaches them through the use of clear instructions, rewards and repetition.
When teaching a child to talk they first need to be able to:
- look towards a person
- attend to their facial expressions
- copy their actions
- imitate sounds
- say words
If we are teaching a child to follow an instruction they first need to:
- understand the language in the instruction
- understand the actions needed
- execute this without losing attention and focus
A task analysis can be done to determine the steps needed to achieve any communication goal.
Using data to collecting information about a clients goals, progress and challenges tells us what’s working and what is not. The information we collect can be in the form of percentages, number of occurrences, duration of skill, levels of prompting and length or type of expressions. There is no way to tell if therapy is working if there is no data to support its effectiveness. Taking regular data helps us identify challenges recognise goals that need adjusting.
Many teaching styles leave a lot to the imagination and are very open to interpretation. When working with children with additional and communication needs these vague instructions are often ineffective. When the instruction is not specific this leaves room for the child to respond in a way that the teacher deems as ‘incorrect.’ The child may not to respond at all as a result of confusion. Using very specific language and clear prompts allows the teacher to maximise the child’s understanding and success. For example instead of saying “you do it” an explicit instruction would be “put it here (with a point)” or “pick it up” “move it here” “put it in.”
In order to develop any new skill frequent practise is required. The same applies to communication goals. If the child is only given the opportunity to practise the skill once or twice and it is likely that minimal progress will occur. When we target a skill several times (ideally around 20 repetitions per activity) we increase the child’s ability to use the skill more independently. Increased repetition also leads to generalisation outside of their session.
Many children initially have a limited understanding of language and have trouble understanding what is expected of them. We use prompts to help a child understand what is expected of them. For example if we want the child to put in a puzzle piece we can hold their hand and direct it to pickup the piece and put it into the right hole. As a result of this assistance the child will quickly understand the task and rely less on our prompts. There are many different levels of prompting we can use to slowly increase the child’s independence in achieving the skill.
If you are trying to change habits or set a new goal, such as start going to the gym, how do you do this? Initially you might need a big motivator to get you started such as meeting a friend, working towards a weight goal, rewarding yourself with a new outfit. Similarly we need to help children develop the motivation to try new and difficult things. Because children have sufficient motivation they can develop the skills they need to communicate.
How can it help?
Clinically we find that ABA helps us understand the behaviour and skills of each of our clients. Many of the children we work with have Autism and/or behaviour challenges. Using ABA strategies ensures we maximise every learning opportunity. We can apply strategies used in ABA to a range of skills. Communication and self help skills, such as toileting and getting dressed, are examples of how ABA can be used to build skills.
At small TALK we motivate our clients, understand and respond to their behaviour, collect data and provide scaffolding to develop errorless learning.
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