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What is ABA Therapy for Autism?

Dec
21

What is ABA Therapy for Autism?

What exactly is ABA?

These three letters strung together seem to somehow be connected to Autism. Or maybe this is the first time you’re hearing of them and wondering how you’re supposed to know all the acronyms surrounding an Autism Spectrum Disorder (ASD) diagnosis. Well, let me tell you, you are far from alone. Most families in Alberta do not know what ABA is as it is so new to the province of Alberta, however, widely seen as the gold standard for ASD therapy across the USA and the Eastern part of the globe. So, let’s start with the basics of how this form of therapy has seen such incredible results in the lives of so many for decades. 

ABA is an acronym for Applied Behaviour Analysis.

That probably doesn’t help you much considering those words sound like I’m an analyst who looks at behaviour. Well, actually, to be frank, that’s exactly what it is. ABA is a science founded in research and evidence-based practices. Ready for another acronym?  Someone who has studied ABA in a graduate program is called a Board Certified Behaviour Analyst (BCBA). A BCBA observes behaviour in the natural environment and uses these observations to make ethical decisions about the individual they are observing. I realize I said observation excessively in that last sentence, but that’s kind of the point.

ABA focuses on the things we can see, not the internal thoughts one might have. Which is great when you are working with someone who is perhaps delayed in their language or behaving in a way that is limiting how your family functions on a daily basis, yet they cannot express to you what is going on inside.  No problem!  Let me watch them in their natural environment for a while. Their behaviour will do all the talking. 

Applied behaviour analysis is a widely used teaching method, one that is recommended by many health care professionals including the U.S. Surgeon General and the National Standards Report from the National Autism Center on effective, evidence-based, treatments.

You might be thinking, my child doesn’t have any behaviours that require therapy, how could ABA help?

Well, behaviours are all around us. The behaviour of reading this blog, scrolling through Instagram, sipping your cup of coffee, deciding that today will be the day you get to bed early instead of aimlessly watching Netflix. All of these things are behaviours. We learn them through consequences of reinforcement or punishment. As much as my memory cannot recall a time when I did not sip coffee first thing in the morning, my mother can assure you I did not enter this world loving this hot black beverage.

We learn through consequences. All of us. That hot cup of coffee keeps me awake and tastes good, so I keep coming back for more. I scroll through my Instagram for more hours than I’d like to admit (thankfully my iPhone sends me these lovely reminders each Sunday), because it’s reinforcing to me. Learning how to interact with social media is a learned behaviour, taught to me through consequences. I make a post, people like it, I enjoy that attention, I post more. Reinforcement in its simplest form. Now let me pour another cup, because if history has taught me anything it’s that behaviour goes where reinforcement flows. 

ABA uses these everyday principals of behaviour and reinforcement to teach children.  It focuses on socially significant behaviours to help make the individual’s life better.  ABA does not change who a person is, their character, the things we love most about them. It works on the behaviour that might impede learning or put someone in danger. These behaviours could be appropriate play with toys, eating a variety of healthy foods, toileting, getting dressed, playing a cooperative game with their siblings or peers, writing their name, responding to their name in a social setting, speaking, using a device to communicate their needs and wants, and really anything you could want to learn how to do. These are some of the many things that a BCBA could teach a child with ASD. 

That being said, what often connects a BCBA with a family is the really hard things. The things that no one wants to talk about. Perhaps due to fear of parental failure, societal judgement, and more likely than not, utter and complete exhaustion. Running out into the street, throwing toys, pouring water anywhere and everywhere just to be able to play with it, screaming if you don’t read their favourite bedtime story three times like every other night, not being able to grocery shop, go to the library, swimming lessons, birthday parties, family dinners or restaurants, the list can seem endless and daunting. Life has changed. To some extent, it may feel like it’s stopped.

The interesting thing is, our ability to do all of these tasks appropriately or not, is all behaviour. Somewhere along the line we were taught how to play with the blocks appropriately, safely, in a manner that supports learning and peer relationships. Therefore, a child who struggles in these situations and environments needs to be taught a safe and meaningful behaviour in a specific way. Their learning might look different than a neurotypical child, who might learn through exploration and imitating their siblings and parents. The beauty of ABA is that it looks at every child as an individual. It uses decades of research to support interventions and plans. Nothing is cookie cutter. Every plan is unique. Just like the child. 

What the science of behaviour has taught me is that every child is unique and learns in unique ways. As a special education teacher, I can say that our public education system hasn’t quite figured out is how to teach each learner in the way that they learn best. So far, we’ve done a decent job of teaching the masses, but what about your child, the one who needs something different?

This is where ABA can help. This is what helped me with the students who I just couldn’t wrap my head around. The one I wrote an individualized program plan (IPP) for, but barely progressed all year. The one I had no idea how to adequately assess. The student who continues to fall through the cracks of our system. This is the child that drives me to learn more about our education system. Applied behaviour analysis saved me as an educator. It allowed me to see each child for their uniqueness and beauty, that for many years was clouded with fear and inadequate programming. It gave me hope that I could make a difference in their lives. That, above all else, I could teach them.  

Finding a BCBA in our province can be a bit tricky, since it’s just starting to develop in Canada, but trust me, they are here.  BCBA’s want nothing more than to help children with a variety of developmental needs to live their life to the fullest potential.  Because don’t we all deserve that possibility? 

Where did the negative perception of ABA therapy come from and what has changed?

The perception comes from the history of ABA, where perhaps reinforcement wasn’t used first and foremost like it is now. I was speaking to one of my clients parents the other day about this topic and I referenced how the school system 100 years ago was run by nuns and the church. Both of which were abusive to children. With awareness brought change. As well as in the psychology community. There have been many terrible things that have happened in its long and rich history. Both of these disciplines have also moved forward and are doing exceptionally better work.

With ABA, however, the stigma is often still there. The reasons why I believe that ABA has changed is because of our ethical code. There is a very strict ethical code that all BCBA’s must follow. Teachers of course have their own set of guidelines, but not to the same degree or standard. 

If someone wanted to find an ABA therapist, where should they look and what questions should they be asking?

Finding an ABA therapist can be a bit tricky in Alberta as it is such a small discipline. However, it is rapidly growing and becoming more well known and sought out. A few places that BCBA’s work in the city of Edmonton are the Centre for Autism Services (Edmonton and Calgary), Edmonton Catholic School Board, and Catalyst Behaviour Services. The other way to find a BCBA in Alberta is to check the board registry. You can type in an area and who you are searching for and directly email them.

The hierarchy of ABA service providers is: RBT (Registered Behavior Technician) – 40 hr training with certificate from the BACB- BCaBA (Board Certified Assistant Behaviour Analyst) – undergrad degree and certification with the BACB- BCBA (Board Certified Behaviour Analyst) – Masters level degree and certification with the BACB- BCBA-D (doctorate) – Doctorate degree in behaviour analysis with certification from the BACB.

Questions you should be asking your BCBA are:
• how long have they been certified for?
• what age group have they worked with?
• how are therapy sessions structured?
• what assessments will be used to determine my child’s needs?
• how will you plan for generalization?
• do you work on self-help and life skills?
• do you provide training yourself or do you have interventionists (RBT or BcABA) to provide the one-on-one support?

This guest post was written by Malorie Cardamone.
Malorie is a certified teacher in Edmonton, Alberta. She has been teaching for 12 years and is currently studying to complete her master’s to continue her work with children with an ASD diagnosis. Her passion is working with children with developmental delays and advocating for their right to an evidence-based education within our province. 

Did you have some questions pop up after reading this post? I had a few that Malorie was kind enough to answer. I’ll be sharing them soon! In the meantime, if you’ve got questions for her, comment below and we’ll get you the answers.

–Kathy

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