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Why ABA?

Interventions developed by the discipline of ABA have allowed individuals even with the most severe behavioural problems to make progress. ABA interventions for problem behaviours focus on establishing and reinforcing new skills, provide access to preferred activities and items, provide choice-making opportunities, increase appropriate communication, making complex situations more predictable and reducing maladaptive behaviours. Effective ABA techniques range from focused interventions for increasing specific functional skills and/or reducing specific problem behaviours to comprehensive programming.

 The goal of ABA is to determine the function that problem behaviour serves for an individual in a specific situation so that more socially appropriate replacement behaviours serving the same function can be facilitated. Most school-based behavioural interventions for problem behaviours are based on ABA techniques (Smith, 2001). The literature examining the effectiveness of ABA techniques with individuals with autism is substantial, and has contributed significantly to the development of a range of educational techniques.

Components of effective ABA in educational settings

In educational settings, a number of important components have been recognised toward making consistent progress through the ABA technique. These include:

  • Early intervention
  •  Parent involvement
  •  Mainstreaming children with typically developing children
  •  Intensive one-to-one teaching – Research has shown that 30-40 hours per week of one-to-one intervention for at least 2 years may be required to produce maximum effect
  •  Comprehensiveness of program
  •  Individualised programming

 

The Autism Society of America (1998) claim that properly designed and implemented ABA programs contain most if not all of the components of treatment approached found to be most successful in supporting individuals with autism. These include individualised instruction, structured learning experiences, low student-teacher ratio, early intervention and family involvement.

The beginning of ABA in educational settings

Lovaas and his colleagues have published several reviews of the UCLA early intervention program in educational settings for children with autism. Follow up data from a treatment group of 19 showed that 47% achieved normal intellectual and educational functioning with normal-range IQ scores and successful performance in public schools. Another 40% displayed mild intellectual disability and were assigned to special classes and 10% showed profound intellectual disability and were assigned to classes for children with severe disabilities. In contrast, only 2% of the control group children achieved normal intellectual functioning; 45% showed mild intellectual disability and were placed in appropriate classes and 53% displayed severe intellectual disability and were placed in other special classes (Lovaas, 1987).

Replication studies and ABA techniques

Green (1996) concluded that early intervention based on ABA can produce large, comprehensive, lasting and meaningful improvements in many important domains for a large portion of children with autism. She found early intervention to be more effective and the best results from children who began the program at 2 or 3 years of age in educational settings.

Weiss (1999) supports Lovaas’ claim of using early, intensive, behavioural intervention for children with autism. She found that children whose learning rates are slower may be helped by earlier alterations in approached and strategies to education. Such changes or additions to educational intervention may augment the degree to which these children benefit from treatment.

 Matson et al (1996) concluded that ABA has made significant contributions in demonstrating practical techniques to address the problems associated with autism. Eikseth et al (2002) provide evidence that some 4 – 7 year old children with autism may make substantial gains from ABA techniques and interventions in educational settings.

 Dillenburger et al (2004) show convincing evidence that ABA techniques offer a highly effective form of intervention for children with autistic spectrum disorder (ASD). Harris and Delmolino (2002) suggest that early intensive treatment using methods of ABA enables a significant number of children to enter the educational mainstream and achieve normal intellectual functioning. The study utilised school based models and Discrete Trial Training (DTT). Smith (2001) explored DTT as an important component of ABA treatment but concluded that it should not be the only component. This suggests that for ABA to be more effective, a multitude of techniques must be utilised.

 PECS (Picture Exchange Communication System) might have helped children to develop functional receptive language and meaningful communication skills (Bondy, 1988). The benefits of this ABA technique used in an educational setting might also have been helpful to provide children with more functional programming, focusing on the development of daily living skills and self-help skills. An earlier shift in the focus of instruction might be more beneficial.

 Pivotal Response Training (PRT) has been effectively used for peer interaction in school settings with children with autism (Pierce and Schreibman, 1995). Children with autism were seen to maintain prolonged interactions with peers, initiated play and conversations, and increased engagement in language and joint attention behaviours. In addition, teachers reported positive changes in social behaviour, with the largest increases in peer-preferred social behaviour. Further, these effects showed generality and maintenance.

 Smith, Groen and Wynn (2000) examined effects of ABA treatment for children with autism. Children received a mean of 24.5 h per week over 2 years of one-to-one ABA treatment. ABA groups in educational settings scored significantly greater than parent training groups. 27% of ABA group succeeded in regular educational classrooms.

 Eikeseth et al (2002) found ABA treatment to be produce greater outcomes that the eclectic approach. ABA treatment group scored significantly higher as compared to the eclectic treatment group on intelligence, language, adaptive functioning, and maladaptive functioning and on two of the subscales on the socio-emotional assessment (social and aggression).

 Cohen et al (2006) Compared effects of ABA treatment with special education provided at local public schools for children with autism. Six of the 21 ABA treated children were fully included into regular education without assistance, and 11 others were included with support; in contrast, only 1 comparison child was placed primarily in regular education.

 Birnbrauer and Leach (1993) showed significant improvement in autistic children using 1:1 ABA tutoring in educational settings using a pretest-posttest design. It was pertinent that parents developed ABA skills for improvement of child’s behaviour to cross over into all aspects of child’s life. 

Significant results show that ABA techniques improve child’s IQ, developmental language functioning, and developmental adaptive functioning and social skills.

Drawbacks

There are no adequate explanations why some children show dramatic improvements while others do not. Consequently, generalisations from the current research should be made with caution in many cases (Green, 1996). Also, comparisons with other competing treatments need further investigation.

 Dempsey and Foreman (2001) importantly note that while ABA has been found to be effective for some children, it is unlikely that it is effective for all children. In the future we would hope that diagnosis of autism will be sufficiently sophisticated to include specific recommendations for treatment. Some children may be prescribed sensory integration, while others are diagnosed as needing auditory integration. This can be overcome with individualised programming and low student-teacher ratios: Teachers are aware of the child’s abilities and individual program can be developed to actualise the child’s capabilities.

Some of the older procedures used by ABA tutors had let to ethical issues: e.g. hand slapping. This has been overcome through the development of ethics and would hardly be seen as an effective procedure to use as punishment.

Conclusion

It is important that we recognise that the research in ABA has not concluded that it is the cure for ASD’s. We can however see that it is a useful technique to approaching the maladaptive behaviours associated with the disorders.

From the evidence, there is a lack of research in comparison studies for ABA and other techniques. However ABA shows promise. Intervention practices have developed over time through the adherence to ABA principles and techniques continue to flourish. Effective communication instruction has drawn heavily from ABA (Ogeltree and Oren, 2001). The evidence suggests that for greatest efficacy, ABA should be implemented in all aspects of the child’s life. Evidence of ABA implementation in schools settings supports this.

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