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ABA...The Good, The Bad, The Controversy-Part 1

For the next few posts, we will explore ABA from several different viewpoints. I will present these viewpoints in a series of posts all about ABA. A lot of people have a lot to say about this topic. Some of what they have to say is negative and some is positive. Some comes from personal experience and some comes from research or word of mouth. Before we dive into the personal stories, the controversy, and the opinions, let's learn a bit about the facts surrounding this therapeutic approach.

What is ABA?

By definition, Applied Behavioral Analysis (ABA) is a type of therapy that can improve social, communication, and learning skills through reinforcement strategies. For many, it is considered the gold standard therapy for children on the autism spectrum. It is also often used to treat several other psychological conditions, including dementia, substance abuse, borderline personality disorder and eating disorders.

What are the goals of ABA?

  • Increase communication skills and language development

  • Improve academic performance, memory, focus, and attention to a task

  • Improve social skills

  • Decrease problem behaviors

How is ABA Implemented?

ABA is geared toward changing and understanding behaviors of people on the autism spectrum, along with other psychological conditions. ABA can be provided in many different environments, including at home, at school, or in social settings. It's goals and strategies are specific to each individual's needs. A plan is created by a provider based on the specific needs of the client and it's progress is documented and assessed throughout implementation.

A major aspect of ABA therapy is the use of positive reinforcement to encourage a goal behavior.

A term called the "ABC's" is also often used in ABA therapy.

A-Antecedent: is what happens right before a goal behavior

B-Behavior: is the person’s response or lack of response to the antecedent

C-Consequence: what happens right after the behavior

Let's look at an example:

A-Mom says, "It is time to go to bed. Turn off the TV."

B- Child refuses to leave the tv room.

C- Mom takes away the remote and tv time for the next day.

ABA would seek to produce a more appropriate response from the child.

A-Mom says, "It is time to go to bed. Turn off the TV."

B- Child is guided to say, "Could I please finish this episode first?"

C- Mom says, "Sure. Finish this one and then turn it off."

Who provides ABA services?

There are many types of therapists that can provide ABA therapy to clients. A BCBA (board-certified behavior analyst) must be involved in the creation of the plan and ongoing supervision, assessments, and evaluations. BCBA's are required to earn a master's degree or PhD in psychology or behavior analysis, obtain a license to practice (in most states), and pass a national certification exam; however, BCBA's are not always the person who provides the daily therapies to clients. RBT's (registered behavior technicians), also sometimes known as line therapists, behavioral therapists, or techs) are often who implement the plan written by the BCBA. RBT's generally have far less education and training than BCBA's. Generally, the only requirements for RBT's are a high school diploma, or an equivalent, and completion of a training course.

How often are ABA services administered per week?

Many companies require clients to attend 20-40 hours a week of ABA therapy. These therapies are often completed Monday-Friday and even on weekends. The target age to begin ABA is between the ages of 1 and 3 years old, but it can be implemented from early childhood through adulthood. Some providers have adopted a more progressive approach of using less hours and less intensive methods of implementing therapy sessions.

Next week, we will look deeper into what evidence has been found to support the use of ABA therapy, as well as evidence against the use of this practice. We will also begin to dive into personal stories of those who have participated in ABA therapy and those who have chosen a different approach to therapeutic practice.

All my love and support, Anna

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