Applied Behavior Analysis
Applied behavior analysis (ABA) is the process of applying interventions that are based on the principles of learning derived from experimental psychology research to systematically change behavior and to demonstrate that the interventions used are responsible for the observable improvement in behavior. ABA methods are used to increase and maintain desirable adaptive behaviors, reduce interfering maladaptive behaviors or narrow the conditions under which they occur, teach new skills, and generalize behaviors to new environments or situations. ABA focuses on the reliable measurement and objective evaluation of observable behavior within relevant settings including the home, school, and community. The effectiveness of ABA-based intervention in ASDs has been well documented through 5 decades of research by using single-subject methodology and in controlled studies of comprehensive early intensive behavioral intervention programs in university and community settings. Children who receive early intensive behavioral treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.Although programs may differ in philosophy and relative emphasis on particular strategies, they share many common goals, and there is a growing consensus that important principles and components of effective early childhood intervention for children with ASDs include the following9,10,14–16:
- entry into intervention as soon as an ASD diagnosis is seriously considered rather than deferring until a definitive diagnosis is made;
- provision of intensive intervention, with active engagement of the child at least 25 hours per week, 12 months per year, in systematically planned, developmentally appropriate educational activities designed to address identified objectives;
- low student-to-teacher ratio to allow sufficient amounts of 1-on-1 time and small-group instruction to meet specific individualized goals;
- inclusion of a family component (including parent training as indicated);
- promotion of opportunities for interaction with typically developing peers to the extent that these opportunities are helpful in addressing specified educational goals;
- ongoing measurement and documentation of the individual child's progress toward educational objectives, resulting in adjustments in programming when indicated;
- incorporation of a high degree of structure through elements such as predictable routine, visual activity schedules, and clear physical boundaries to minimize distractions;
- implementation of strategies to apply learned skills to new environments and situations (generalization) and to maintain functional use of these skills; and
- use of assessment-based curricula that address:
- functional, spontaneous communication;
- social skills, including joint attention, imitation, reciprocal interaction, initiation, and self-management;
- functional adaptive skills that prepare the child for increased responsibility and independence;
- reduction of disruptive or maladaptive behavior by using empirically supported strategies, including functional assessment;
- cognitive skills, such as symbolic play and perspective taking; and
- traditional readiness skills and academic skills as developmentally indicated.
See also: Boundaries of occupational therapy realm and Relationship-based interventions lack evidence
Complete work: AMERICAN ACADEMY OF PEDIATRICS, Management of Children With Autism Spectrum Disorders BY Scott M. Myers, MD, Chris Plauché Johnson, MD, MEd, the Council on Children With Disabilities.
