Article 3 - published in the Borneo Bulletin dated 6th September 2016
AUTISM AND APPLIED BEHAVIOUR ANALYSIS (ABA) – WHY IS IT IMPORTANT TO CHOOSE EVIDENCE-BASED INTERVENTION FOR CHILDREN WITH AUTISM?
By: Learning Ladders Society
Presently, there is no known cure for autism despite all the ongoing controversial claims on the discovery of miracle cure of this neurological disorder. But, this does not mean that there is nothing that can be done for people with autism. There are treatments available to people with Autism Spectrum Disorder (ASD).
Before choosing the correct treatments for your child of ASD, it is crucial to find out as much as you can about the available treatment options that you can choose from. For the child that has neurodevelopmental disorders, choosing evidenced-based interventions supported by solid foundation of scientific evidence is necessary before opting for such treatment.
Why is it important to choose evidence-based intervention?
Identifying effective medical and behavioral treatments for neurodevelopmental disorders should be based on a solid foundation of scientific evidence. The call for the use of interventions that have proven their effectiveness is particularly important for the ASD community, which has long been plagued by the use of unsupported and often controversial interventions. In fact, it has been suggested that the uncritical use of unproven “miracle” interventions has encouraged unrealistic, implausible, and unhealthy expectations about treatment results and have ultimately impeded the progress of identifying effective interventions for children and adolescents with ASD.
Recommended Treatment: Applied Behaviour Analysis (ABA)
One of the most renowned treatments that has been scientifically proven to be the most effective in showing improvements for people with ASD is Applied Behaviour Analysis (ABA). To date, ABA has been regarded by autism advocates and experts in the field as the most effective evidence-based therapy for children with autism. Extensive research has proven that intervention conducted on the principles and practices of ABA can produce highly positive improvements for children with autism.
But, what exactly is ABA?
ABA is not a technique but a system of ASD treatment based on behaviorist theories which, simply put, state that behaviors can be taught through a system of rewards and consequences. The Lovaas Institute explains the concept in this way:
ABA is the process of systematically applying interventions based on the principles of learning theory to help teach new skills, concepts and ideas in such a way that teaches the brain how to learn larger concepts. ABA literally helps kids learn to learn.
“If a child cannot learn the way we teach… We must teach the way the child can learn.”
– Dr. O. Ivar Lovaas (Dr. O. Ivar Lovaas is a world-renowned autism expert who has devoted his career to improving the lives of children with autism and their families).
ABA is not restricted to only one technique in the delivery of intervention plans for children with ASD. As a matter of fact, various techniques are employed such as Discrete Trial Teaching, Pivotal Response Training, PECS, Picture Activity Schedules and Functional Communication Training. All of which are effective techniques that utilise the principles of ABA.
The Learning Ladders Society aims to address the questions surrounding the complex choices and questions that parents of children with autism may have when looking at the ABA service. This is done in order to provide the parents with enough information for them to be able to make an educated decision about what is best for their child and what will help them the most.
The following questions illustrate common FAQs about the ABA approach to treating ASD:
1. Is ABA an easy "miracle cure?"
ABA is not easy and certainly is not a "miracle cure"; in fact there are NO known cures – be it psychological nor medical.
ABA is certainly not easy. However, when executed correctly, improvements can be expected, may not be quickly, but certainly progressively. Positive outcomes from the approach make the effort worthwhile.
Psychological treatments such as psycho-dynamic psychotherapies or holding therapy have not shown any scientifically acceptable evidence that they are effective as the theory behind them has been largely discredited. Medically, there has not been any discovery of medical treatments for autism itself.
2. How does ABA benefits those with Autism?
Presently, ABA is acknowledged as a safe and effective treatment for ASD.
According to the 2007 clinical report of the American Academy of Paediatrics, the benefit of ABA-based interventions “has been well documented” and that “children who receive early intensive ABA treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behaviour as well as some measures of social behaviour”.
ABA is currently the only autism therapy recommended for long-term benefit by the United States Surgeon General. The Surgeon General’s report on Mental Health in 1999 reported, “Thirty years of research demonstrated the efficacy of applied behavioural methods in reducing inappropriate behaviour and in increasing communication, learning, and appropriate social behavior.”
3. How does ABA work?
It is important to remember that effective ABA intervention for autism is not “one size fits all” approach and should never be regarded as a fixed set of rigid drills. On the actual fact, a qualified therapist customises the intervention to each learner’s skills, needs, interests, preferences and family situation.
4. How many hours of therapy should we do?
Research reveals that children who receive more hours of quality behavioural intervention have better results.
The recommendations typically ranging from 15 to 40 hours per week, depending on weather ABA is being applied to comprehensive educational programming in the schools or to a targeted behavioural treatment programme.5. What kind of progress can be expected with ABA?Proficiently delivered ABA intervention can help learners with autism create profound changes in many areas.
Nevertheless, changes do not typically occur overnight. Intensive and continuous instruction that builds on their step-by-step progress are required to be undergone by each learner. It is important to remember that the rate of progress varies substantially from one person to another depending on age, level of functioning, family goals and other factors.
Some learners show improvements quickly. However, this rapid progress typically occurs in just one or two particular skill areas such as reading, while more instruction and practice is needed to acquire another skill area such as interacting with people.
5. What kind of progress can be expected with ABA? Proficiently delivered ABA intervention can help learners with autism create profound changes in many areas.
Nevertheless, changes do not typically occur overnight. Intensive and continuous instruction that builds on their step-by-step progress are required to be undergone by each learner. It is important to remember that the rate of progress varies substantially from one person to another depending on age, level of functioning, family goals and other factors.
Some learners show improvements quickly. However, this rapid progress typically occurs in just one or two particular skill areas such as reading, while more instruction and practice is needed to acquire another skill area such as interacting with people.
6. How do you explain why some recover and some do not with the use of ABA?
There are numerous factors that affect the outcome of the treatment.
Factors that can be controlled includes the age at the start of intervention, intensity of intervention and quality of intervention. Cognitive ability is recognised as another factor that is critical, but cannot be controlled in influencing the achievement of the desirable outcome. Positive outcome is based upon the combination of these factors.
7. Who Is Qualified to Provide ABA Intervention?
Always check credentials of those who claim to be qualified in behaviour analysis. ABA services should be designed and supervised by qualified professionals.
Just like any medical treatment programme which is regulated by qualified medical professionals, ABA programme for children with autism should be carried out under the supervision of licensed clinical psychologists with training in ABA. These individuals should are board certified with supervised experience in providing ABA treatment for ASD.
You would be able to identify a trained therapist that should be credentialed by Behaviour Analyst Certification Board (BACB) or the Association of Professional Behaviour Analysts. These professionals often supervise therapists under them, who will be working directly with your child. Hence, it is crucial that parents of ASD to feel assured that the licensed clinical psychologist or behaviour analyst is providing regular supervision to anyone working directly with the child.
Parents, guardians and other care givers should monitor the program by observing sessions and participating in training sessions and consultations.
AUTISM AND APPLIED BEHAVIOUR ANALYSIS (ABA) – WHY IS IT IMPORTANT TO CHOOSE EVIDENCE-BASED INTERVENTION FOR CHILDREN WITH AUTISM?
By: Learning Ladders Society
Presently, there is no known cure for autism despite all the ongoing controversial claims on the discovery of miracle cure of this neurological disorder. But, this does not mean that there is nothing that can be done for people with autism. There are treatments available to people with Autism Spectrum Disorder (ASD).
Before choosing the correct treatments for your child of ASD, it is crucial to find out as much as you can about the available treatment options that you can choose from. For the child that has neurodevelopmental disorders, choosing evidenced-based interventions supported by solid foundation of scientific evidence is necessary before opting for such treatment.
Why is it important to choose evidence-based intervention?
Identifying effective medical and behavioral treatments for neurodevelopmental disorders should be based on a solid foundation of scientific evidence. The call for the use of interventions that have proven their effectiveness is particularly important for the ASD community, which has long been plagued by the use of unsupported and often controversial interventions. In fact, it has been suggested that the uncritical use of unproven “miracle” interventions has encouraged unrealistic, implausible, and unhealthy expectations about treatment results and have ultimately impeded the progress of identifying effective interventions for children and adolescents with ASD.
Recommended Treatment: Applied Behaviour Analysis (ABA)
One of the most renowned treatments that has been scientifically proven to be the most effective in showing improvements for people with ASD is Applied Behaviour Analysis (ABA). To date, ABA has been regarded by autism advocates and experts in the field as the most effective evidence-based therapy for children with autism. Extensive research has proven that intervention conducted on the principles and practices of ABA can produce highly positive improvements for children with autism.
But, what exactly is ABA?
ABA is not a technique but a system of ASD treatment based on behaviorist theories which, simply put, state that behaviors can be taught through a system of rewards and consequences. The Lovaas Institute explains the concept in this way:
- Applied - principles applied to socially significant behavior
- Behavioral - based on scientific principles of behavior
- Analysis - progress is measured and interventions modified
ABA is the process of systematically applying interventions based on the principles of learning theory to help teach new skills, concepts and ideas in such a way that teaches the brain how to learn larger concepts. ABA literally helps kids learn to learn.
“If a child cannot learn the way we teach… We must teach the way the child can learn.”
– Dr. O. Ivar Lovaas (Dr. O. Ivar Lovaas is a world-renowned autism expert who has devoted his career to improving the lives of children with autism and their families).
ABA is not restricted to only one technique in the delivery of intervention plans for children with ASD. As a matter of fact, various techniques are employed such as Discrete Trial Teaching, Pivotal Response Training, PECS, Picture Activity Schedules and Functional Communication Training. All of which are effective techniques that utilise the principles of ABA.
The Learning Ladders Society aims to address the questions surrounding the complex choices and questions that parents of children with autism may have when looking at the ABA service. This is done in order to provide the parents with enough information for them to be able to make an educated decision about what is best for their child and what will help them the most.
The following questions illustrate common FAQs about the ABA approach to treating ASD:
1. Is ABA an easy "miracle cure?"
ABA is not easy and certainly is not a "miracle cure"; in fact there are NO known cures – be it psychological nor medical.
ABA is certainly not easy. However, when executed correctly, improvements can be expected, may not be quickly, but certainly progressively. Positive outcomes from the approach make the effort worthwhile.
Psychological treatments such as psycho-dynamic psychotherapies or holding therapy have not shown any scientifically acceptable evidence that they are effective as the theory behind them has been largely discredited. Medically, there has not been any discovery of medical treatments for autism itself.
2. How does ABA benefits those with Autism?
Presently, ABA is acknowledged as a safe and effective treatment for ASD.
According to the 2007 clinical report of the American Academy of Paediatrics, the benefit of ABA-based interventions “has been well documented” and that “children who receive early intensive ABA treatment have been shown to make substantial, sustained gains in IQ, language, academic performance, and adaptive behaviour as well as some measures of social behaviour”.
ABA is currently the only autism therapy recommended for long-term benefit by the United States Surgeon General. The Surgeon General’s report on Mental Health in 1999 reported, “Thirty years of research demonstrated the efficacy of applied behavioural methods in reducing inappropriate behaviour and in increasing communication, learning, and appropriate social behavior.”
3. How does ABA work?
- The person’s individual strength and challenges are assessed.
- The person’s abilities are then used to acquire new skills.
- Each skill is broken down into manageable steps the chained with other steps until an entire skill is learned.
- Learned skills are applied to more complex situations and in new settings and environments so that skills can be mastered.
It is important to remember that effective ABA intervention for autism is not “one size fits all” approach and should never be regarded as a fixed set of rigid drills. On the actual fact, a qualified therapist customises the intervention to each learner’s skills, needs, interests, preferences and family situation.
4. How many hours of therapy should we do?
Research reveals that children who receive more hours of quality behavioural intervention have better results.
The recommendations typically ranging from 15 to 40 hours per week, depending on weather ABA is being applied to comprehensive educational programming in the schools or to a targeted behavioural treatment programme.5. What kind of progress can be expected with ABA?Proficiently delivered ABA intervention can help learners with autism create profound changes in many areas.
Nevertheless, changes do not typically occur overnight. Intensive and continuous instruction that builds on their step-by-step progress are required to be undergone by each learner. It is important to remember that the rate of progress varies substantially from one person to another depending on age, level of functioning, family goals and other factors.
Some learners show improvements quickly. However, this rapid progress typically occurs in just one or two particular skill areas such as reading, while more instruction and practice is needed to acquire another skill area such as interacting with people.
5. What kind of progress can be expected with ABA? Proficiently delivered ABA intervention can help learners with autism create profound changes in many areas.
Nevertheless, changes do not typically occur overnight. Intensive and continuous instruction that builds on their step-by-step progress are required to be undergone by each learner. It is important to remember that the rate of progress varies substantially from one person to another depending on age, level of functioning, family goals and other factors.
Some learners show improvements quickly. However, this rapid progress typically occurs in just one or two particular skill areas such as reading, while more instruction and practice is needed to acquire another skill area such as interacting with people.
6. How do you explain why some recover and some do not with the use of ABA?
There are numerous factors that affect the outcome of the treatment.
Factors that can be controlled includes the age at the start of intervention, intensity of intervention and quality of intervention. Cognitive ability is recognised as another factor that is critical, but cannot be controlled in influencing the achievement of the desirable outcome. Positive outcome is based upon the combination of these factors.
7. Who Is Qualified to Provide ABA Intervention?
Always check credentials of those who claim to be qualified in behaviour analysis. ABA services should be designed and supervised by qualified professionals.
Just like any medical treatment programme which is regulated by qualified medical professionals, ABA programme for children with autism should be carried out under the supervision of licensed clinical psychologists with training in ABA. These individuals should are board certified with supervised experience in providing ABA treatment for ASD.
You would be able to identify a trained therapist that should be credentialed by Behaviour Analyst Certification Board (BACB) or the Association of Professional Behaviour Analysts. These professionals often supervise therapists under them, who will be working directly with your child. Hence, it is crucial that parents of ASD to feel assured that the licensed clinical psychologist or behaviour analyst is providing regular supervision to anyone working directly with the child.
Parents, guardians and other care givers should monitor the program by observing sessions and participating in training sessions and consultations.