Frequently Asked Questions about Applied Behaviour Analysis

Compiled from rsaffran.tripod.com and autismspeaks.org

1. What is Applied Behavior Analysis?
2. Who Can Benefit from ABA?
3. What is the Research on ABA for Autism?
4. What kind of progress can I expect?
5. I want my child to learn naturally, not behaviorally. ABA looks so unnatural.
6. I can't see my child spending all his time doing drills. Doesn't he need to go to school and play too?
7. What happens after an ABA program?
8. I've heard ABA leads to rote, "robot-like" behavior. Is this true?
9. Does ABA Work with Older Learners with Autism?
10. What Does ABA Intervention Involve?
11. What Kind of Improvements Can Be Expected From ABA?
12. Who Can Provide ABA Intervention?
13. Where can I find additional information and resources about Autism and ABA?

1. What is Applied Behavior Analysis?
Behavior analysis is a scientific approach to understanding behavior and how it is affected by the environment. "Behavior" refers to all kinds of actions and skills (not just misbehavior), and "environment" includes all sorts of physical and social events that might change or be changed by one's behavior. The science of behavior analysis focuses on principles (that is, general laws) about how behavior works, or how learning takes place. For example, one principle of behavior analysis is positive reinforcement: When a behavior is followed by something that is valued (a "reward"), that behavior is likely to be repeated. Through decades of research, the field of behavior analysis has developed many techniques for increasing useful behaviors and reducing those that may be harmful or that interfere with learning. Applied behavior analysis (ABA) is the use of those techniques and principles to address socially important problems, and to bring about meaningful behavior change.



2. Who Can Benefit from ABA?
ABA methods have been used successfully with many kinds of learners of all ages, with and without disabilities, in many different settings. In the early 1960s, behavior analysts began working with young children with autism and related disorders. Those pioneers used techniques in which adults directed most of the instruction, as well as some in which children took the lead. Since that time, a wide variety of ABA techniques have been developed for building useful skills in learners with autism of all ages. Those techniques are used in both structured situations (such as formal instruction in classrooms) and in more "natural" everyday situations (such as during play or mealtime at home), and in 1-to-1 as well as group instruction. They are used to develop basic skills like looking, listening, and imitating, as well as complex skills like reading, conversing, and taking the perspective of others.

The use of ABA principles and techniques to help persons with autism live happy and productive lives has expanded rapidly in recent years. Today, ABA is widely recognized as a safe and effective treatment for autism. It has been endorsed by a number of state and federal agencies, including the U. S. Surgeon General and the New York State Department of Health.

For general information about behavior analysis and ABA, see:
The Association for Behavior Analysis International
Behavior Analyst Certification Board
American Psychological Association Archival Description of Behavioral Psychology
Cambridge Center for Behavioral Studies



3. What is the Research on ABA for Autism?
Hundreds of published studies have shown that specific ABA techniques can help individuals with autism learn specific skills, such as how to communicate, develop relationships, play, care for themselves, learn in school, succeed at work, and participate fully and productively in family and community activities, regardless of their age. A number of peer-reviewed studies have examined the effects of combining multiple ABA techniques into comprehensive, individualized, intensive, early intervention programs for children with autism. "Comprehensive" refers to the fact that intervention addressed all kinds of skills: communication, social, self-care, play, motor, pre-academic, and so on. "Early" means that intervention began before the age of four for most children. "Intensive" means that ABA methods were used to arrange large numbers of learning opportunities for each child every day in both structured and unstructured situations, which amounted to 25-40 hours per week during which children actively learned and practiced skills. That was done so that young children with autism would have experiences like typical toddlers, who get thousands of chances every day to learn by interacting with their parents and others. These studies showed that many children with autism who received 1-3 years of this type of treatment had large improvements on tests of their cognitive, communication, and adaptive skills. Some who participated in early intensive ABA for at least 2 years acquired enough skills to participate in regular classrooms with little or no ongoing help. Other children in the studies learned many skills through intensive ABA, but not enough to function independently in regular classrooms full-time. Across studies, a small percentage of children improved relatively little. At this time, it is very difficult to predict in advance how far any individual child might go with this treatment. More research is needed to determine why some children with autism respond more favorably to early intensive ABA than others.

In some studies, intensive ABA was compared with less intensive ABA, typical early intervention or special education, and "eclectic," mixed-method interventions done both intensively and nonintensively. The children with autism who received intensive ABA treatment made larger improvements in most skill areas than children who participated in the other interventions. Parents whose children received intensive ABA reported less stress than parents whose children received other treatments.



4. What kind of progress can I expect?
The amount of progress your child will make depends on two things: his innate ability to learn, and the quality of his instructional program. How much a child can learn given the best possible program is something no one can really predict, although there are indications from research that a higher developmental age (Lovaas 1987) and a younger chronological age (Fenske 1985) at intake are predictors of greater eventual progress. More recent experience suggests that the child's progress in the first few months--a measure of his ability to learn--is related to long-term success, rather than his initial degree of disability. Above all, understand that this is a very poorly understood subject: there really are no reliable markers in a young child that predict what he will be like as an adult. (Note too that some children benefit from other interventions, such as diet or drugs, that increase their ability to learn.)

Program quality is something you can influence. The number of hours per week is one obvious measure: since your child has a lengthy curriculum to get through, it is to his benefit to do it as quickly as possible. (This is one thing that many school administrators really do not understand; they believe that they can save money by doing fewer hours of programming each week, or fewer weeks each year. Yet the research suggests exactly the opposite: an intensive program is likely to be over sooner, while a lower intensity program may go on for years and years, costing much more in the long run.) Not only do more hours mean more learning, but if your child is not yet able to initiate appropriate activity, every hour spent learning is one fewer hour spent practicing undesirable activities. In the battle for your child's future, every hour falls on one side of the ledger or the other; you want to tip the balance towards productive, quality time.

Instructional quality is just as important. As one administrator assured us, "Any idiot can do ABA." This is true, but to do it well and actually help children takes a lot of training, attention to detail, and plain hard work. Children with autism are not often the best customers for good intentions; simply sitting down and trying to teach on instinct may lead to a wide array of unwanted behaviors, but little useful learning. The principle of providing positive reinforcement seems simple, but it's rarely enough just to give a child a piece of candy every time he gives a right answer; there are many, many details and strategies which a good ABA teacher must master to really move your child through the curriculum as quickly as possible.

You can and should expect your child to learn to his maximum potential, even though there is no way to be sure exactly what that potential is. You should, however, expect that if your child is learning some skills but then fails to progress in other areas, that the program, not your child, may be at fault. Educators and parents alike are often too quick to blame the child for failing to learn. This is the great shame of the IDEA law, that any progress (or lack of it) may arbitrarily be considered "appropriate" for your child. The research proves that some children do recover completely, and most others can make very substantial progress. While no one can tell you if that is possible for your child, he does deserve the same quality of instruction and the same chance at a normal life as the many children who have recovered completely. Expect also that progress is like the stock market - you really have to play it for the long term. Three steps forward and two back is more the rule than the exception. Daily or weekly plateaus, spurts, and regression can be emotionally exhausting, but a high quality program should lead to measurable progress from month to month. Does behaviorally-based teaching provide all the answers for all children? Certainly not; many children have cognitive deficits that cannot be completely remedied by any amount of teaching and practice. While those children (and adults) may gain a great deal, they will still need help learning strategies to work around their limitations, as well as a good deal of understanding and accommodation from the rest of us!



5. I want my child to learn naturally, not behaviorally. ABA looks so unnatural.
ABA is a well-developed technology for maximizing learning. It guides the teacher in maximizing those elements of one-on-one instruction that lead to the most efficient and longest-lasting learning. While at first glance it may look very "unnatural" that's only because the student typically is so learning-disabled that certain elements which are present in all learning must be greatly exaggerated.

As an ABA program progresses, if it is successful (as it is about 90% of the time), the student's brain changes - he "learns how to learn" like his typically developing peers. The teaching process then starts to look more and more "natural."

The very saddest thing a parent or teacher can do to a child with autism is to hold on to the illusion that he can learn as his peers do, and place him in a typical environment (even with extra support), expecting him to "get it." Child development involves an astounding amount of learning in a remarkably short time. Children with autism are typically far behind their peers in a broad range of prerequisite skills, even as young as age 2. There is simply no way they will learn "naturally" if they are not prepared with the base skills they need to understand what is happening in the world around them.

For example, suppose your child is in school and the teacher is talking about caterpillars and butterflies. Typical children will learn this in one lesson and have a lasting interest in the subject that will help them enjoy the world and give them something they can share with you and their friends. But consider what they first have to know in order to learn this lesson:
    1. The categories of insects and food
    2. The idea of one thing changing into another
    3. The concepts of eating and sleeping
    4. The preposition "around" (as in "spins a cocoon around him")
    5. Sequencing (first he spins...then he opens...)
    6. Past vs. present
That's just a partial list. They also need attending skills just to pay attention to the teacher in the first place. Expecting a child who lacks even some of these prerequisites to learn "naturally" is as misguided as placing an infant in the same classroom.

So what about all the odd-looking repetition, the use of edible treats, the insistence on sitting at a table, and the other "unnatural" trappings of ABA? All these are the result of very careful research on learning, an amplification of the processes that all children use to learn and develop. The teaching process may seem a little more "natural" if you compare it to the way a parent instinctively teaches his or her infant to smile. At first an infant has no idea how to respond to his parent - he may make contact or look at something more interesting. But when the parent gets even a little response - BAM! - a big smile, hugs, lots and lots of attention to the little guy. This is done over and over again until in short order he learns to give Mom and Dad a big smile and lots of eye contact.

This is pure positive reinforcement - a way all of us learn. A child with autism needs this type of intensive attention - or even more intensive attention coupled with individualized reinforcers - to learn very simple concepts like "on" and "in." But the good news is that if this is done properly then the child often will learn how to learn faster and with fewer and fewer "unnatural" interventions. There is simply no shortcut, no "natural" alternative. Just as infants cannot go to Kindergarten, so cannot children with autism "just learn" at their chronological age level. They must be led through the proper language, play, and social developmental sequence, not moving ahead until they have mastered each step.



6. I can't see my child spending all his time doing drills. Doesn't he need to go to school and play too?
An ABA program is not just discrete trial drills ("table-top work"). While drills may make up the bulk of a program at the beginning, the same principles used to instill very basic skills apply just as well in all settings, including classrooms, at home, and in the community. Remember that for typical children learning is a full-time job--it just happens without you even noticing. (If it weren't, no child would be able to attend Kindergarten without going to pre-school.) For a child with a PDD it takes careful planning by responsible adults to take advantage of as many opportunities for learning as possible. This means coordination across all settings, school included. Parent training and involvement is an essential part of almost all successful programs--remember, even if your child is in a full-time program, you probably still spend 60 hours/week with him. Yes, children with autism can and do go to school with typical children, but no, it is not a good idea to do that unless the child is ready to learn in that setting and the school is committed to working closely with the rest of the ABA program. For several reasons, it can be quite harmful to the child to pretend that it is OK to have "two programs" that don't share goals or techniques.

  • Children with developmental disorders are at risk of developing maladaptive behaviors: aggression, self-injury, self-stimulatory and perseverative habits. These unwanted behaviors often increase or decrease in direct response to the actions of parents, teachers, and other care-givers. It is essential that everyone be on the same page and respond to the child in a consistent manner designed to reduce maladaptive behaviors, and that progress (or lack of it) be periodically reviewed and adjustments made as needed. We suffered years of serious behavior problems because the adults in charge of our child were not skilled, did not teach us what to do, and when asked for an appropriate behavior management plan, they were not able to execute it.
  • Your child deserves to benefit from every possible opportunity to "catch up" to his peers. This means learning and practice, practice, practice. If he has the skills required to understand what is going on in school and to be involved in what's going on, great. If not, even though he may be quite happy, it's just not fair to put him in an environment where he's not capable of learning and not capable of participating. The school must be involved daily in your child's progress and structure the environment so he can generalize his skills. One way to do this well is to have one of the ABA therapists be a one-to-one aide in the classroom.

This was one of the hardest lessons for us to learn: our son was (and is) very happy to go to school, but he literally was learning nothing (positive), despite support from an OT and SLP in the classroom and supposedly trained teaching staff. The school administration fought tooth and nail to keep our "methods" out of his classroom, supposedly for his benefit (!). Only after we gave him the basic language, play, and attention skills to understand what was happening did he start to benefit at all from school.

The same applies to peer social interactions. There is perhaps nothing more painful for the parent of a child with autism than to watch your child "play" in a group of typical children. Teaching play skills is very much part of an ABA program, and like all other skills, it is done one baby step at a time so the child cannot fail. The development of play skills is just as important and deserves just as much attention as language development.

ABA is not "just" drills. If it were, no child would recover to normal functioning. Your child needs you, his teachers, service providers, and all the other significant people in his life to work together to maximize his chances for progress. If any one of those people is not willing to participate, they shouldn't be allowed to waste his time.



7. What happens after an ABA program?
Most children with autism require some support services throughout childhood, and often into adulthood as well. The best behavioral intervention program has at most an even chance of getting a child far enough along to participate fully in regular education. And, for too many reasons to list, few children get "the best," leaving most needing some extra services for many years. While the most severely disabled may benefit from a continued one-on-one behavioral intervention program, more will participate to some degree in a regular classroom with a mix of special education services. What should those services look like? How do you transition from a 'pure' ABA program to a special education setting?

The complete answers could fill several books. There is a short answer, however. Behavior analysis can continue to play an important role even if none of the teaching follows the discrete trial format. (A not-so-secret secret: successful teachers of typical kids use behavioral principles all the time to run their classrooms, even if they don't consciously think they are doing it.)

The principles that help your child learn when he is three, four, or six years old are still valid when he is eight, eleven, fifteen. The format may be very different, but the underlying thinking is not. If he needed clear step-by-step visual instructions, chances are that is still true. If he was more able to follow a classroom routine with a reinforcement program, that will continue to be a useful tool, though the reward program may take a very different form. Just because something works well is no reason to stop doing it!

One principle you will want to keep for life is that each person is an individual, with specific strengths and weaknesses. People are most successful, and generally happiest, when they can apply their strengths and find ways to "patch" their weaknesses. A "one size fits all" education can't be perfect for anyone, and will probably be especially mismatched to your child. There are many good resources for overcoming learning disabilities and making the most of individual strengths. I haven't catalogued many yet, but one good book to start with is A Mind at a Time by Mel Levine.



8. I've heard ABA leads to rote, "robot-like" behavior. Is this true?
Have you ever learned a foreign language (let's pick French), or watched someone else learn English? When you're first learning, you do sound rote, forced, unnatural, and you also feel the strain of trying to come up with the right words and keep up with a conversation. With time and practice your speech both comes more easily and sounds more natural. When introduced to someone you struggle at first even to say "Je m'appelle -------" . Months later, it is hard to imagine that is was so difficult - but now you're having exactly the same trouble with conditionals: "Si vous... voudriez me telephoner, je...je...serais chez moi...ce soir." [Any grammatical error is my responsibility!] Or, you may learn some 'rote' phrases on what to say in a typical situation, like eating in a restaurant. You like chicken sandwiches so you learn "Je veux le sandwich poulet avec viande blanche." To an observer, you look silly ordering the same thing every time - because that's all you know and are comfortable doing. But the desire to gain access to the full menu will spur you on to master the language until you sound natural ordering a full meal, and can chat with the staff too.

Let's look at a more relevant example. My three year-old learned to identify emotions using the "developmental approach" - that is, learning from observation and practice. She made very frequent errors - "You don't want to watch TV, you're embarrassed," or "I'm fishing - be very quiet, so I don't get concerned." Because she could speak spontaneously and without any time delay, these statements sound delightful, not "robot-y." Yet the truth is, she was doing exactly what my son is doing - practicing language, making mistakes, getting corrected, and learning.

It takes time and practice for anybody, at any age, with any degree or ability or disability, to attain fluency. It is absolutely amazing that a child with such a severe disability actually can achieve fluency at language, play, and social skills. The fact that these skills may look less than completely natural at first should tell you that the child needs more practice and more opportunities for learning, not that he should be denied a proven teaching method. "Children do not fail to learn, teachers fail to teach." (Postscript: one of my son's instructional programs was to "Talk like a robot"--his peers know how to do this, but he hasn't learned it 'naturally'!)



9. Does ABA Work with Older Learners with Autism?
Yes. Research documents that many ABA techniques are effective for building skills of all kinds in children, adolescents, and adults with autism and related disorders. Additionally, ABA methods are useful for helping individuals and families manage some of the difficult behaviors that may accompany autism, without the side effects of drugs or other treatments. A number of programs have been combining many ABA techniques into comprehensive treatment programs for youths and adults with autism for many years. Many of those individuals have learned to work and live successfully in their communities thanks to ABA treatment. However, so far, there have been no studies of intensive ABA with older individuals with autism comparable to those that have been done with young children.



10. What Does ABA Intervention Involve?
Done correctly, ABA intervention for autism is not a "one size fits all" approach consisting of a "canned" set of programs or drills. On the contrary, every aspect of intervention is customized to each learner's skills, needs, interests, preferences, and family situation. For those reasons, an ABA program for one learner might look somewhat different than a program for another learner. But genuine, comprehensive ABA programs for learners with autism have certain things in common:

  • Intervention designed and overseen directly by qualified, well-trained professional behavior analysts
  • Detailed assessment of each learner's skills as well as learner and family preferences to determine initial treatment goals
  • Selection of goals that are meaningful for the learner and the family
  • Ongoing objective measurement of learner progress
  • Frequent review of progress data by the behavior analyst so that goals and procedures can be "fine tuned" as needed
  • Instruction on developmentally appropriate goals in all skill areas (e.g., communication, social, self-care, play and leisure, motor, and academic skills)
  • Skills broken down into small parts or steps that are manageable for the learner, and taught from simple (such as imitating single sounds) to complex (e.g., carrying on conversations)
  • An emphasis on skills that will enable learners to be independent and successful in both the short and the long run
  • Use of multiple behavior analytic procedures -- both adult-directed and learner-initiated -- to promote learning in a variety of ways
  • Many opportunities -- specifically planned and naturally occurring -- for each learner to acquire and practice skills every day, in structured and unstructured situations
  • Intervention provided consistently for many hours each week
  • Abundant positive reinforcement for useful skills and socially appropriate behaviors
  • An emphasis on positive social interactions, and on making learning fun
  • No reinforcement for behaviors that are harmful or prevent learning
  • Use of techniques to help trained skills carry over to various places, people, and times and to enable learners to acquire new skills in a variety of settings
  • Parent training so family members can teach and support skills during typical family activities
  • Regular meetings between family members and program

For more information about research supporting ABA as a treatment for autism, see:
The Cambridge Center for Behavioral Studies Autism Page
U.S. Surgeon General's Report on Mental Health
Clinical Practice Guideline, New York State Department of Health Early Intervention Program
Journal of Applied Behavior Analysis



11. What Kind of Improvements Can Be Expected From ABA?
Competently delivered ABA intervention can help learners with autism make meaningful changes in many areas. But most learners require a great deal of carefully planned instruction and practice on most skills, so changes do not occur quickly. As mentioned earlier, quality ABA programs address a wide range of skill areas, but the focus is always on the individual learner, so goals vary from learner to learner, depending on age, level of functioning, family needs and interests, and other factors. The rate of progress also varies from one learner to the next. Some acquire skills quickly, others more slowly. In fact, an individual learner may make rapid progress in one skill area -- such as reading -- and need much more instruction and practice to master another, such as interacting with peers.



12. Who Can Provide ABA Intervention?
Because of the huge demand for ABA intervention for autism, many individuals and programs now claim to "do ABA." Some are private practitioners or agencies that offer to provide services by periodically coming into a family's home; others operate private schools, and still others provide consultation services to public schools. Not all of them have the education and practical experience that the field of behavior analysis considers minimum requirements for practicing ABA. Family members and concerned professionals are urged to be cautious when enlisting anyone to "do ABA" with a child, youth, or adult with autism.
Whether assembling or choosing an ABA program, keep in mind the following:

  • Just as a medical treatment program should be directed by a qualified medical professional, ABA programs for learners with autism should be designed and supervised by qualified behavior analysts, preferably individuals who are Board Certified Behavior Analysts® with supervised experience providing ABA treatment for autism, or who can clearly document that they have equivalent training and experience. Always check credentials of those who claim to be qualified in behavior analysis.
  • An ABA program should have the components and features listed
  • Monitor the program by observing sessions and participating in training sessions and consultations

For more information on finding ABA practitioners, see:
Behavior Analyst Certification Board
Cambridge Center for Behavioral Studies Autism Page



13. Where can I find additional information and resources about Autism and ABA?

Autism & ABA Info Sites

asatonline.org
autism.about.com
autism-pdd.net
autismtoday.com
autismsig.org
autismsocietycanada.ca
autismcentral.ca
autism.net
autismspeaks.org
autismpro.com
autismawareness.org
bacb.com
pppsig.org
rsaffran.tripod.com

Events & Conferences

goldlearningcentre.com
autisme-montreal.com
abainternational.org

Parent Materials

The Autism Speaks 100 Day Toolkit
The Autism Speaks Video Glossary
abaresources.com
superduperinc.com
difflearn.com
greatideasforteaching.com
do2learn.org
autisminspiration.com
babybumblebee.com
vbteachingtools.com
parentbooks.ca
preschoolprintables.com
thegraycenter.org
nlconcepts.com
brighttots.com
childcareland.com
enchantedlearning.com



Information provided by:
Drs. Gina Green, Bridget Taylor, Stephen Luce, & Patricia Krantz of The Autism Advisory Group, Cambridge Center for Behavioral Studies, Richard Saffran