The Applied Behavior Analysis (ABA) approach teaches social, motor, and verbal behaviors as well as reasoning skills. ABA treatment is especially useful in teaching behaviors to children with autism who may otherwise not “pick up” these behaviors on their own as other children would. The ABA approach can be used by a parent, counselor, or certified behavior analyst.

ABA uses careful behavioral observation and positive reinforcement or prompting to teach each step of a behavior. A child’s behavior is reinforced with a reward when he or she performs each of the steps correctly. Undesirable behaviors, or those that interfere with learning and social skills, are watched closely. The goal is to determine what happens to trigger a behavior, and what happens after that behavior that seems to reinforce the behavior. The idea is to remove these triggers and reinforcers from the child’s environment. New reinforcers are then used to teach the child a different behavior in response to the same trigger.

ABA treatment can include any of several established teaching tools: discrete trial training, incidental teaching, pivotal response training, fluency building, and verbal behavior (VB).

In discrete trial training, an ABA practitioner gives a clear instruction about a desired behavior (e.g., “Pick up the paper.”); if the child responds correctly, the behavior is reinforced (e.g., “Great job! Have a sticker.”). If the child doesn’t respond correctly, the practitioner gives a gentle prompt (e.g., places child’s hand over the paper). The hope is that the child will eventually learn to generalize the correct response.

Pivotal response training uses ABA techniques to target crucial skills that are important (or pivotal) for many other skills. Thus, if the child improves on one of these pivotal skills, improvements are seen in a wide variety of behaviors that were not specifically trained. The idea is that this approach can help the child generalize behaviors from a therapy setting to everyday settings.

Incidental teaching uses the same ideas as discrete trial training, except the goal is to teach behaviors and concepts throughout a child’s day-to-day experience, rather than focusing on a specific behavior.

In fluency building, the practitioner helps the child build up a complex behavior by teaching each element of that behavior until it is automatic or “fluent,” using the ABA approach of behavioral observation, reinforcement, and prompting. Then, the more complex behavior can be built from each of these fluent elements.

Finally, an ABA-related approach for teaching language and communication is called “verbal behavior” or VB for short. In VB, the practitioner analyzes the child’s language skills, then teaches and reinforces more useful and complex language skills.

What’s it like?

Through ABA training, parents and other caretakers can learn to see the natural triggers and reinforcers in the child’s environment. For example, by keeping a chart of the times and events both before and after Sammy’s tantrums, a parent might discover that Sammy always throws a tantrum right after the lights go on at night without warning. Looking deeper at the behavior, Sammy’s mother might also notice that her most natural response is to cuddle Sammy in order to get him to calm down. In effect, even though she is doing something completely natural, the cuddling is reinforcing Sammy’s tantrum. According to the ABA approach, both the trigger (lights going on at night without a warning) and the reinforcer (cuddling) must be stopped. Then a more appropriate set of behaviors (like leaving the room or dimming the lights) can be taught to Sammy, each one being reinforced or prompted as needed. Eventually, the hope is that this kind of approach will lead to a time when the lights can go on without warning and Sammy still does not throw a tantrum.

What is the theory behind it?

Many experts believe that children with autism are less likely than other children to learn from the everyday environment. The ABA approach attempts to fill this gap by providing teaching tools that focus on simplified instructional steps and consistent reinforcement. At best, the ABA approach can help children with autism lead more independent and socially active lives. Research suggests that this positive outcome is more common for children who have received early intervention. This may be due to critical brain development that occurs during the preschool years and can be affected by training.

Does it work?

ABA is considered by many researchers and clinicians to be the most effective evidence-based therapeutic approach demonstrated thus far for children with autism. The U.S. Surgeon General states that thirty years of research on the ABA approach have shown very positive outcomes when ABA is used as an early intervention tool for autism. This research includes several landmark studies showing that about 50% of children with autism who were treated with the ABA approach before the age of four had significant increases in IQ, verbal ability, and/or social functioning. Even those who did not show these dramatic improvements had significantly better improvement than matched children in the control groups. In addition, some children who received ABA therapy were eventually able to attend classes with their peers.