This is Part Two of my series. You can find Part One here. This article dives into the key strategies used in ABA.
In order for parents to make an informed decision about ABA, we need to understand the what’s, why’s, who’s and how’s of the intervention.
This crucial information is often omitted when the doctor recommends ABA, leaving parents to make a completely uninformed decision.
Yes, this article is longer than I’d usually write. ABA is a sensitive topic that has significant impacts.
There’s a lot to cover and I’m targeting the parents who are searching for resources so they can make a decision about enrolling their child in ABA. So I want this article to be comprehensive.
Before beginning, I want to clear up some common misconceptions:
- ABA is not a treatment for autism. As I stated in part one, autism isn’t a behavioral diagnosis. It’s a neurological and developmental diagnosis.
Autistic traits and co-occuring conditions frequently manifest as observable behaviors, but the root causes for those behaviors originate from within an autistic person’s nervous and sensory systems.
- The term “ABA therapy” is inaccurate and misleading. We should stop using that phrase altogether. ABA is an intensive intervention created with the sole purpose of conditioning behavior.
- The people working with our children are not “ABA therapists.“ In fact, they aren’t therapists at all. BCBA stands for Board Certified Behavior Analyst. RBT stands for Registered Behavioral Technician. None of those titles include the word “therapist.”
Many RBT’s have little more than a high school diploma. They’re only required to complete 40 hours of training, pass a test, and undergo 15 hours of supervision before they can work independently with our children. (That’s less than two weeks of training.)
While RBT’s technically work under the supervision of a BCBA, they hold a great deal of control over day-to-day programming and interactions – with little more than a high school diploma.
For this article, I’ll use the terms technician and analyst interchangeably in reference to the adults working with our children.
The information in this post comes strictly from resources intended for ABA providers. My own knowledge and opinions will be italicized.
The Basics of ABA
Antecedent, Behavior, Consequence (The ABC’s of ABA) – This is the cornerstone of ABA intervention. The antecedent is what happens before an “undesirable behavior” occurs. The consequence is what happens after.
If it sounds simple enough, that’s because it is. If nothing else, ABA is well-packaged. That’s a big reason for its success. While there’s plenty of data taken for bar graphs and line plots, there’s very little thought involved.
Functional Behavior Assessment (FBA) – When an “undesirable behavior” arises, the technician will complete an FBA to determine the “function” of the behavior. What is the child getting out of it?
There are only four functions of behavior analysts choose from: access, attention, avoidance (escape), or automatic (sensory). In this context, sensory means that the behavior “feels good to the child.”
After choosing one of the four functions, technicians relay their analysis to parents. They also provide extra insights to help parents understand the child’s behavior better. Parent education is essential to the success of ABA.
This is when analysts reinforce words like attention seeking, noncompliant, defiant, aggressive, and manipulative. These terms, no matter how inaccurate, are at the heart of behaviorist practices. They frame the conversation surrounding autistic behavior in our schools and in our communities.
We almost never hear words like emotional regulation, anxiety, fear, confused, unheard, and undervalued. These are the words we should bring to the forefront. The problem is these words go against behaviorist principles, and that’s bad for business.
The human condition doesn’t fit neatly into four categories. People have complex sensory systems, a wide range of emotions, and a need for communication and respectful relationships.
There are multiple ways to judge the circumstances surrounding any given behavior. Therapists and counselors go through years of school in order to make those assessments. RBTs and BCBAs don’t have the training, nor do they have the authority, to suggest anything beyond the measurable, viewable surface.
Interpreting behavior is subjective, and those judgements have significant impacts on our children and the autistic community overall. As parents, we should be mindful of those impacts.
Key Strategies Used in ABA
Preference Assessments – During the first few days of ABA, the technician learns what makes the child happy. What are his favorite activities, foods, games, and toys? Does he like high fives or stickers? Does he like big reactions, or something more subtle? What’s his comfort item?
It seems like this time is used to bond with the child because it’s so fun, but the information is actually used in behavior modification plans as reinforcers.
Pairing – Technicians use their results from the preference assessments to “pair” themselves to the child’s favorite things. I know this seems confusing, because the technician doesn’t pair with the child. (Again, this comes straight from ABA provider resources.)
By pairing with the reinforcers, the technician becomes the gatekeeper of all-things-fun-and-good. If the child wants his favorite activity or item, he will now have to go through the technician to get them. Pairing increases the likelihood that the child will want to stay with the technician and will comply with directions.
Example: If your child’s favorite toy is a ball, the technician will keep the ball close (pairing with it), so the child can only access it when she does something to “deserve” it.
Behavior Improvement Plan (BIP) – This is also known as a behavior modification plan or program. Using results from the child’s FBA and preference assessments, the analyst creates a goal to extinguish certain behaviors using the following methods:
- Discrete Trial Training – The adult provides a prompt (demand) and reinforces the desired behavior with a reward. For instance, each time the child sits at the table, the technician gives the child a half of a gummy bear to reinforce that behavior. These rewards are referred to as tokens.
- Withholding – When the child doesn’t exhibit desired behavior, the adult withholds the reinforcer from the preference assessment. This can be as obvious as withholding a treat, favorite toy, or recess time, or as subtle as withholding a smile.
The next time someone tells you ABA isn’t like it used to be, this is what they’re talking about. Instead of squirting hot sauce into a child’s eye (yes they used to do that), they’re withholding positive reinforcements instead. While only one causes physical pain, they both are heartbreaking and hurtful.
- Planned Ignoring – This one is self-explanatory. It’s the method of extinguishing an undesirable behavior by not giving it a response.
For example: If the child is upset and unable to express why (hungry, sick, tired, overwhelmed) the technician will ignore the child until she stops communicating that discomfort.
If this strategy doesn’t bother you, I’m guessing you didn’t read the first part of this series. You might want to do that now.
Food for Thought
Best practices in early childhood aren’t complicated – not even for autistic children. At the foundation you’ll find a safe, supportive, and nurturing environment. At the core of every quality program, you’ll find child-led learning experiences, with an emphasis on play.
There are no rules about how to play or what goals the child should achieve. There are, however, guidelines for protecting children’s emotional health from even the slightest chance of harm.
There’s nothing therapeutic or developmentally appropriate about intensive behavioral conditioning, not for one hour per day and certainly not for 40 hours per week.
The practice is, in fact, compliance training– treating children like machines in order to force them to act the way their neurotypical peers act, even when it goes against their own unique neurological make-up.
(I don’t say ABA treats children like animals. Actually, most people treat their pets with more humanity than ABA strategists treat autistic children.)
Autistic people have unique developmental timelines and sensory profiles. Instead of suppressing their behaviors, we should value them and learn from them.
They aren’t wrong or disordered, they’re simply different. Pressuring our children to do things before they’re ready adds extra levels of anxiety, frustration, and shame.
As parents, we should put our energy into protecting our children from the false narratives of “disordered behavior” and “catching up.” We should create a bubble of support, acceptance, and empowerment.
Only then can we strengthen their confidence and encourage a strong self-identity so they can live their best lives.
Part Three of this series will address how parents can identify behaviorist strategies in settings we don’t expect to find them being used.
More helpful links for now:
On Hurling Myself Out Into Traffic to Get Out of ABA Therapy by Alexanderstreasureblog
I Am a Disillusioned BCBA: Autistics Are Right about ABA by Jo Ram
The Hidden Cost of Planned Ignoring by Dr. Mona Delahooke
ABA for Creating Masking Black Autistics by Cheyenne Thornton
More book recommendations for now:
- The Strategies of ABA – What Parents Should Know Before Making a Decision - May 3, 2021
- Does ABA Work? We’re Asking the Wrong Question. - April 8, 2021