ABA Therapy - An Insight

Introduction:

Applied behavioral analysis therapy or ABA therapy which is used to manage children with autism spectrum disorder aims to help children improve their communication, social skills, and behavior. The therapy is based on the child’s age and stage of development. The ABA therapy is usually a one-on-one session which can happen at the therapist’s clinic or at home. Autistic individuals have repetitive or restrictive behaviors and interests. Their ability to learn, move, or pay attention is different. Autism is more prevalent in boys and is four times more common than in girls. This condition is hereditary and children of elderly parents are at higher risk. Pregnant women who are exposed to alcohol, certain medications, health conditions, and chemicals are more prone to have autistic children.

Why Start ABA Therapy After the Diagnosis of Autism?

Early diagnosis and treatment can give better results. The reasons to start ABA therapy as early as possible are because:

• During a young age, the child goes through various stages of development and maturation. They are sensitive to certain stimuli in the environment at this stage. Capturing the condition and teaching specific behavior management techniques at this stage can give a better outlook in the future.

• Teaching certain behaviors and skills appropriate for their age can improve their learning at school and the child can be more productive.

• With the acquired skills, the child can be more efficient in academics.

• Challenging behaviors are traversed through at young age with appropriate therapy which prevents such behaviors from being a hindrance in the future. The more skills the child acquires, the more they will be equipped to socialize and learn.

The challenging behaviors can aggravate if not treated at the correct time.

What Does ABA Therapy Include?

ABA therapy differs from what is being taught. Discrete trial training (DTT) which is commonly used to teach school skills, is a type of ABA therapy that involves:

• Plan: A qualified professional who is a ‘board certified behavior analyst (BCBA), discusses with the family and the teacher and draws up a program plan that corresponds to the child’s needs.

• Goals: Large skills or goals like, ‘The child will learn shapes’ is split down into smaller skills or goals like, ‘The child will match the squares.

• Prompts: The teacher may be asked to give simple directions to the child like, ‘It is time to do an activity’ followed by an instruction like ‘match the shape’ or ‘match’.

• Offer a Helping Hand: If the child has difficulty in doing the activity, the teacher can hold the hand of the child and teach them. Once they start doing it by themselves, the teacher can slowly withdraw from helping the child. The teacher should monitor the activity of the child so that they know whether the child is learning or not.

• Reward the Child: The teacher can encourage the child after they complete the activity successfully by saying, ‘Good job matching those shapes’ or ‘You did it!’, and reward them with their favorite toy, give a star, high five, or a handshake and pat them.

• Repeat Until They Master: The activity has to be repeated till the child learns to do the activity by themselves correctly. The frequency of the rewards can be increased to encourage them. Once the child has mastered the activity, the teacher can proceed with the next difficult task.

• Generalization: The child can be appreciated and given rewards for showcasing various skills under different conditions.

How Can ABA Therapy Be Followed at Home?

ABA therapy can be followed at home in the following ways:

• Simple Instructions: The child can be asked to bring an object or a toy by pointing to that particular object or toy.

• Appreciation: If the child does the work they can be appreciated like, ‘Good job!’ or ‘Hurray you did it the first time’.

• Skill Progression: If the child performs a particular task, the parent can wait and observe what they do next. If they do it themselves, they can be appreciated and if not they can be taught by showing or asking, ‘What is next?’. The child must be given some time to do the task themselves. A final note of appreciation can encourage them.

What Are the ABCs of Behavior?

Understanding what happens before a behavior (antecedents) and knowing what happens after a behavior (consequences) are essential parts of ABA therapy. The ABCs of behavior are:

• Antecedent: Antecedent is what occurs before a behavior like giving oral commands or requests. Physical antecedents can be toys, objects, light, sound, or something in the surrounding. Antecedents can also be internal thoughts or feelings.

• Behavior: The individual’s response to the antecedent which can be verbal, through action, or something else.

• Consequence: Encouragement, appreciation, or rewards can be a consequence of desired behavior and no response can be a consequence of undesirable behavior.

These ABCs help one to understand whether the behavior can happen again after the consequence and why a behavior is happening.

What Are the Symptoms Shown by an Autistic Child?

An autistic child can display the following behaviors:

• Does repetitive movements like spinning, rocking, and flapping of hands.

• Performs activities that can cause self-harm like biting or banging the head.

• Follows certain routines and becomes upset if the routine is disturbed slightly.

• Problems with coordination and can have awkward movements like walking on toes, having weird, stiff body language, and a clumsy walk.

• Shows interest in the details of a toy or object but does not seem to understand its function or purpose.

• Appear sensitive to touch, light, or sound but undisturbed by pain or temperature.

• Deeply engrossed in an activity or object with more focus or intensity.

• Is not interested in make-believe play.

• Prefer eating only specific food types and refusing others.

What Is the Ideal Age to Start ABA Therapy?

Though it is ideal to start ABA therapy at the earliest, it is never too late to start with ABA therapy as it aids people with autism of all ages. It is advised to start ABA therapy before 3 years of age. The majority of the children who undertake ABA therapy are between 2-6 years old.

ABA therapy at two years of age can help the kid improve their communication skills and to follow simple instructions and commands. The therapy in older children focuses on education, social skills, day-to-day skills, and changing behavioral patterns. According to studies, though ABA therapy can help individuals of all ages, ABA therapy in children before the age of 2 showed significant improvements.

How Often Should a Child Undertake ABA Therapy?

Young children undertake the therapy sessions for 25 hours a week and older kids and high school children may undertake 12 to 15 hours of sessions per week. The number of hours is determined by age, cost, and stage of development.

How Does ABA Therapy Help Kids of Various Ages?

ABA therapy helps kids as they traverse through various developmental stages based on their age as follows:

• Zero to Two Years Old: Basic skills such as making eye contact, imitation, and vocalization are enforced.

• Between Two to Six Years: ABA therapy aims at language improvement, play skills, and imitation. Socialization skills needed at school and home may be taught.

• Above Six Years: Day-to-day skills such as grooming, toileting, and feeding will be taught.

What Are the Disadvantages of ABA Therapy?

A few disadvantages of ABA therapy are:

• Expensive.

• Time-consuming.

• Requires lots of skill.

How to Select an ABA Therapist?

The child’s pediatrician (child specialist) or a family physician can help with referring an ABA therapist. Usually, a Board-certified behavior analyst (BCBA) provides ABA therapy. A BCBA requires the following qualifications:

• Master’s degree or a Ph.D. in psychology or behavior analysis.

• Pass a national certification exam.

• Some states require a state license to practice.

Therapists or registered behavior technicians (RBTs) trained and supervised by the BCBA may also practice ABA therapy. They are also referred to as behavioral therapists, behavior techs, line therapists, and so on.

Conclusion:

ABA therapy is quite effective if it is started early in autistic kids. ABA therapy has passed certain scientific tests for its quality, usefulness, and effectiveness. Studies have shown that intensive and long-term ABA therapy (about 25 to 40 hours a week for one to three years) benefits a majority of autistic individuals. This therapy helps to improve intellectual and language abilities, social skills, and day-to-day skills. It reduces the chance of unhealthy or negative behaviors.