ABA Therapy
Applied Behavior Analysis (ABA) uses simple ideas—like rewards for good behavior—to help people learn and grow and is especially well-known for helping children with autism spectrum disorders.
Is Therapy Available In My State?What is ABA Therapy?
Applied Behavior Analysis (ABA) therapy is a therapy based on the science of learning and behavior. It involves using specific techniques to increase or decrease behaviors. ABA therapy is most commonly associated with helping children with autism spectrum disorders (ASD), but it can be used in various settings and for a variety of behaviors. ABA is one of the most evidence-based therapies due to its strong reliance on data and numerous research studies demonstrating how effective it can be.
Some examples of populations and settings where ABA is used include:
- Autism spectrum disorder (ASD)
- Developmental disabilities
- Traumatic brain injuries (TBI)
- Mental health disorders
- Substance abuse and addiction
- Elderly populations (Dementia/Alzheimer’s)
- Workplace behavior and performance
- Educational settings (for non-ASD populations)
- Sports performance and coaching
What Behaviors Does ABA Therapy Address?
ABA is based on the principle that behaviors are learned and can be modified. It involves teaching skills and behaviors in a systematic way, using reinforcement to encourage positive behaviors and sometimes using other strategies to discourage maladaptive behaviors.
Within the ASD and children with developmental disabilities populations, examples of skills that can be addressed in ABA therapy include:
- Increasing communication skills (ex., signing, one-word requests, maintaining a conversation)
- Increasing social skills (ex., greeting others, sharing, taking turns, making and keeping friends)
- Increasing daily living and adaptive skills (ex., dressing, brushing teeth, age-appropriate household responsibilities)
- Increasing play skills (ex., functionally playing with a toy, pretend/imaginative play, age-appropriate play)
- Increasing academic skills (ex., recognizing letters and numbers, following 2-step directions, reading, writing)
- Addressing feeding, toileting, and bedtime difficulties
- Decreasing verbal and physical aggression (ex., hitting, biting, yelling, cursing)
- Decreasing disruptive behaviors (ex., throwing/breaking things, running off)
- Decreasing self-injury and self-stimulatory behaviors (ex., head-banging, biting or scratching themself, verbal scripting, pacing)
Who Provides ABA Therapy?
ABA therapy is often provided by or overseen/supervised by Board-Certified Behavior Analysts (BCBAs) or Board-Certified Assistant Behavior Analysts (BCaBAs). Some states also require behavior analysts to be licensed in their state. Psychologists and social workers, who are also not a BCBA/BCaBA, may also have strong behavioral training and provide ABA therapy. It is important to confirm this level of training and expertise with the provider prior to beginning services.
More intensive ABA therapy programs (multiple hours a week) also involve therapists, or registered behavior technicians (RBTs). These therapists are trained and supervised by the BCBA or BCaBA and provide most of the direct work with the individual, practicing skills and working towards the individualized goals written by the BCBA.
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What Does ABA Therapy Look Like?
ABA can be used to teach communication, social skills, self-care, and academic skills, or to reduce challenging behaviors such as aggression or self-injury. It typically involves one-on-one sessions with a trained therapist, but it can also be adapted to work in group settings or within families.
Some common ABA therapy models include:
- Discrete trial training (DTT): A structured method that breaks down learning into small, manageable steps and tasks.
- Natural environment teaching (NET): Where learning occurs in natural settings, helping promote generalization of skills.
- Verbal behavior therapy (VBT): Focuses on teaching communication through the use of language and speech.
The frequency and intensity of these ABA therapy models varies depending on multiple factors (e.g., the individual’s needs and goals) and can range from a weekly, hourly appointment, to 40 hours of intensive therapy a week.
Steps of intensive ABA therapy (multiple hours a week) include:
- Initial assessment. A comprehensive evaluation is conducted to assess the individual’s current skills, behaviors, and areas of need. This includes caregiver interviews and direct assessments as part of a functional behavioral assessment (FBA) to understand the reasons behind the target behaviors.
- Developing a treatment plan. Based on the assessment, an individualized treatment plan is created to target specific goals (e.g., communication, social skills, self-care, behavior reduction), and measurable objectives are created to monitor progress.
- Behavioral interventions, ongoing data collection, regular reviews, and adjustments. Behavioral interventions are implemented using strategies such as discrete trial training (DTT), natural environment teaching (NET), and task analyses to teach new skills and address maladaptive behaviors. Interventions focus on the use of positive reinforcement to increase appropriate behaviors. The effectiveness of these strategies is continuously monitored and recorded through precise data collection. The data are regularly reviewed, and intervention strategies are adjusted based on the data to improve outcomes.
- Parent and caregiver training: Parents, caregivers, and other family members are provided training to help ensure the consistency and carryover of strategies outside of therapy session and to encourage their active involvement in reinforcing behaviors and implementing interventions.
- Skill generalization, fading, and transition: Once a skill has been learned within the therapy setting, it is then generalized across different settings, situations, and people (e.g., at home, school, or in the community). As these skills become more natural, new target skills can be addressed. The frequency of therapy sessions can also be reduced as the individual reaches their goals, or they can be transitioned to less intensive interventions, if appropriate, to maintain these skills.
References
Dr. Bader is a NY licensed psychologist and behavior analyst, as well as a Board-Certified Behavior Analyst (BCBA). She has over 10 years of experience working with individuals with autism spectrum disorder (ASD), developmental and intellectual disabilities, and other challenging behaviors using evidence-based behavioral interventions. Her clinical and research interests include the development of behavioral interventions and parent-training to increase adaptive behaviors (daily living skills, communication skills, social skills) and reduce maladaptive behaviors (noncompliance, tantrums, aggression) in individuals with and without a developmental disability.
Dr. Bader enjoys working with clients and their families to address unique challenging behaviors while building the parent’s skills to continue to manage behaviors that may arise both in the present and in the future. She received her PhD in Clinical Psychology from the University of Southern Mississippi in Hattiesburg, Mississippi. She then attended internship at the University of Arkansas for Medical Sciences (UAMS) and the Arkansas Children’s Hospital (ACH) in Little Rock, Arkansas and went on to complete her postdoctoral fellowship at the Kennedy Krieger Institute (KKI) and John’s Hopkins Hospital in Baltimore, Maryland.
ABA Therapy FAQ
ABA does not require a child to sit at a table. If they prefer sitting on the floor, therapy can be done from there. Your therapy goals will likely include helping them learn to sit at a table.
It can. Encouraging them to engage in more socially appropriate behaviors and increasing their communication skills and then reinforcing these with praise and reinforcers might help them learn to respond in a more appropriate and effective manner.
Yes. Therapists providing ABA therapy are trained in addressing these behaviors and often “want to” see them in session, so they can target these behaviors. If you have concerns, you should speak to your therapist about them.
Many children with ASD will develop vocalizations that can eventually be shaped into language. There are also many other means of communicating—including pictures, gestures, communication devices, and sign language –that an individual can learn. Early intervention is often key to helping them develop better communication skills and decreasing the misbehaviors that often arise when they cannot effectively communicate their needs and wants.
Yes. While some states have requirements of an ASD diagnosis to receive the intensive (multiple hours a week) therapy, there are no diagnostic requirements for the less intensive models. Psychologists and social workers with strong behavioral approaches also provide these services, and ABA principles can often help individuals not diagnosed with ASD.
Goal setting is a dynamic process between the individual (to the extent able), their parents and caregivers, and the therapist. Goals are established to improve the quality of life for the individual, and their wishes and values (as well as their family’s) are important factors in establishing these goals. The individual’s strengths, interests, and preferences are always taken into consideration and built upon to provide more meaningful and effective interventions.
ABA therapy (both less and more intensive) is covered by most state-funded and commercial insurances. To confirm whether ABA therapy is covered by your health insurance, it is always best to verify this with your insurance provider first.
LifeStance can be your resource for finding mental health professionals who are trained to provide ABA therapy.
There are many myths surrounding ABA therapy that are based on inaccurate or incomplete information. One common misconception is that ABA is a “one-size-fits-all” approach, when in fact, it is the opposite. It is highly individualized, tailored to each individual’s unique needs and goals. Another myth is that ABA only focuses on reducing “bad” behaviors, but in reality, it emphasizes the development of meaningful skills, such as communication, social interaction, and daily living skills, while also focusing on reducing harmful or disruptive behaviors. Some claim that ABA is too rigid or robotic, but modern ABA practices incorporate natural, engaging, and enjoyable activities that encourage learning in real-world settings. Additionally, some believe that ABA is solely used for children with autism spectrum disorder (ASD), but its principles are applied across a wide range of populations, including those with developmental disabilities, brain injuries, and mental health conditions. Lastly, a pervasive myth is that ABA does not involve families or caregivers, when, in fact, a key component of ABA therapy is training and involving family members to help ensure that skills are reinforced and generalized across various environments.
