The Fundamentals of Applied Behavior Analysis (ABA) MARK STAFFORD, MA, BCBA, LPA, LBA STAFFORD BEHAVIORAL CONSULTING, PLLC

ABA AND AUTISM Applied Behavior Analysis (ABA): The scientific study of behavior. Applied Behavior Analysis (ABA) is the application of the principles of learning and motivation from Behavior Analysis, and the procedures and technology derived from those principles, to the solution of problems of social significance. (Center for Autism and Relate Disorders (CARD) http://www.centerforautism.com/aba-therapy.aspx) ABA can also be described as increasing behaviors of social significance and decreasing behaviors that have a negative social impact.

ABA AND AUTISM Diagnosis of Autism: Deficits in social communication and social interaction Restricted, repetitive patterns of behavior, interests, or activities. (This may have a negative social impact.) Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. ABA from it’s origin was well suited to treat the symptoms of autism.

How ABA Works ABA methods are used to support persons with autism in at least five ways: to increase behaviors (eg reinforcement procedures increase on-task behavior, or social interactions); to teach new skills (eg, systematic instruction and reinforcement procedures teach functional life skills, communication skills, or social skills); to maintain behaviors (eg, teaching self control and self-monitoring procedures to maintain and generalize job-related social skills); to generalize or to transfer behavior from one situation or response to another (eg, from completing assignments in the resource room to performing as well in the mainstream classroom); to restrict or narrow conditions under which interfering behaviors occur (eg, modifying the learning environment); and to reduce interfering behaviors (eg, self injury or stereotypy). (Center for Autism and Relate Disorders (CARD) http://www.centerforautism.com/aba-therapy.aspx)

What is Behavior? Behavior is anything a person does. “If a dead man can’t do it, it’s behavior.” Walking, eating, doing math computations, talking, and even thinking are all considered “behavior” in ABA. In treating individuals with autism we are most concerned with: Communicative behaviors (verbal behavior) Social behaviors Repetitive behaviors Other problem behaviors (e.g. tantrums)

Why do behaviors occur? Behaviors occur due to motivation and stimuli that occur before and after the behavior. We call factors that affect motivation, Motivating Operations (MO). Some increase motivation and some decrease motivation. A stimulus (plural stimuli) is anything that can be perceived by one of the sensory systems (sight, touch, hearing, taste, smell). Antecedents is the term used to describe stimuli that occur before behavior occur We use the term Consequences for stimuli that occur after a behavior. A single instance of a behavior is called a response.

Antecedents Antecedents consist of MOs and stimuli that occur just before a response. Stimuli that indicate that a response is likely to result in a positive outcome (reinforcement) are called Discriminative Stimuli (SD). When that stimulus is present one can discriminate that a good outcome will result from a behavior. Other antecedents include the biological state of the individual. Someone who feels good is likely to behave better than someone who is ill, has a headache or stomach ache. The individual’s recent history is also important.

Consequences There are three basic kinds of consequences which follow behaviors: Reinforcers: A stimulus which immediately follows a response and increases the frequency of that response in the future. We also say it increases the rate of the response in the future. The process of providing reinforcers and increasing the rate of a response is called reinforcement. (SR) Punishers: A stimulus which immediately follows a response and decreases the frequency of that response in the future. The process of providing punishers and decreasing the rate of a response is called punishment. (SP) The third kind of consequence is the withholding of reinforcement that has followed a behavior in the past. This results in the eventual reduction in the behavior and the term for this is extinction.

Motivating Operations (MO) Motivating Operations alter the value of something as a reinforcer. Value can increase Value can decrease Motivating Operations can occur naturally or can be brought about by other events or behaviors. Natural: hunger, thirst Brought about by other events: Being offered $20 if you can draw a picture of a cat increases the value of a pencil and paper. Without motivation behavior does not occur. Motivation is affected by many factors: amount of reinforcement, difficulty of the behavior, physical condition of the individual, time since last contact with the reinforcer,

ABA Contingencies: The Functions of Behavior A  B  C When teaching a skill (behavior) we want to be sure we are teaching the skill should be preceded by the same antecedent conditions and consequence conditions that will occur when the skill is needed in “real life.” When we need to reduce a behavior, we need to look at the antecedents and consequences surrounding the problem behavior and find an appropriate alternative behavior to teach in it’s place. We will often ask parents or teachers to record problem behaviors by writing down what happens before and after a problem behavior in order to determine it’s function.

What is ABA therapy? Assess Reinforcers: What does the child like to eat, do, to play with, to avoid? Pairing: Instructor associates themselves with reinforcers. This should be heavily emphasized in early sessions, but continue in every session. Account for MOs: Provide training to teach behaviors/stimulation that may reduce adverse reactions to internal and external stimuli. MOs and reinforcers are keys in ABA. Teaching techniques emphasize success: Want to see 80% of the actions end in success. Child is having fun: If successful 80% of the time and the child accesses his highly preferred items, then it will be fun. Teaches skills that are functional at the child’s level: Skills that are taught should be things that the child can quickly use in the natural environment.

What is ABA therapy? Incorporates multiple teaching techniques that minimize failure: Errorless Learning: The child is shown what to do (prompted) and reinforced for doing what was shown. The prompts are gradually faded so the child is always successful. Natural Environment Teaching (NET): The therapist/instructor lets the child show what the activities will be and then the teaching is incorporated into that activity. Discrete Trial Training (DTT): Here the therapist is determining what will be taught and presents a series of tasks with a specific SD, response from the child, and reinforcement. If errors occur a correction procedure is used to immediately get an independent correct response. Reinforcement is always provided at a level to maintain high motivation and interest. The therapist is working toward specified goals: The therapist or a supervising BCBA should assess the child and provide a treatment plan to the parents that lists the goals the child needs to achieve. Treatment is based on an assessment of the child and on a curriculum: The assessment conducted should follow a sequenced format so that goals are selected in a developmental order. Tools such as the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) or the Essentials for Living programs provide such a curriculum.

What is ABA therapy? Data is collected and shared with parents: The goals selected should be written in very quantifiable terms with a clear criterion for mastery. This data should be shared with the on a regular basis. Parents are involved: For basic language skills and self-care skills the BCBA and therapist should work with the parents so that the parents can teach those skills. The parents concerns and priorities should be considered throughout the program, though the BCBA must take responsibility for the selection of program goals. Decisions are data based: Because the therapy is based on a developmental curriculum and goals have clear criteria with data taken on the child’s performance, decisions on next steps are determined by the curriculum and those data. All Treatment is Evidence Based: If you every wonder why something is being done, the BCBA should be able to site peer reviewed literature on which the technique is based.

Reinforcement Tips for Home Focus on what you want your child to do and reinforce that. If the target is something the child can do, but just needs to do more often then reinforce a completely correct response. If the target is something the child can not do then reinforce a behavior that is an approximation and then reinforce better and better attempts. When you see the approximation, you can show the child what to do and then reinforce the child’s copying your behavior. Be sure reinforcers are effective. What does the child want at the time (The MO)? The same reinforcers are not always going to work.

Tips for following directions When giving directions, say the direction ONE TIME. Always provide reinforcement for following even simple directions if a child has difficulty following directions. If you need to give the direction again, then provide some prompting to complete the task. Get the child’s attention before giving the direction. For children who have a lot of trouble with language and following directions, give some very easy directions and reinforce compliance heavily. Hold out a desired object (candy) and say, “take it.” Praise taking the item. You see they are about to stop an activity and say, “stop.” Praise stopping when asked. Do not bargain once the child has failed to comply. It is fine to promise a reinforcer before giving a direction, but once the direction is given it is too late to promise. However, do not promise a reinforcer for each instruction. Do not offer reinforcers to get a child to stop an undesired behavior. This will end up increasing the undesired behavior.

Tips for Tantrums All kids have tantrums at some time. Tantrums probably originate when a child cries for a valid reason and the parents/caregivers console the child. Later the child cries because he was denied something and consoling is done again. The parent hates to see the crying and is reinforced when the crying stops. Still later the parent offers a candy bar to the crying child in the grocery store, “if they will be quiet.” Over time the child’s crying, screaming, flopping on the floor, etc. is effective in obtaining some form of reinforcement. The parent “gives in.”

Tips for Tantrums If you have had a problem with tantrums, first figure out what the SDs and MOs are surrounding the tantrum. What is the function of the tantrums? If the child can understand a “first – then” situation then convey that message before encountering the situation that is likely to bring on the tantrum. (e.g. First your take a bath, then you can watch television.) Pictures help greatly for children with language delays. The main issue point once a tantrum begins is that it cannot change anything. Keep the child safe by providing padding if head banging occurs. Do not talk to the child about the tantrum, or show emotion. That’s hard, but one of the best things you can do. This is perhaps the only time when repeating what the child needs to do without assistance is a good idea. But just make a short statement in a matter-of-fact tone about once every 30 seconds. This just lets the child know that the expectation is still there. If the child cannot remain where they are use the least amount of physical contact possible to move the child to an appropriate location. An alternative to “waiting them out” is to physically assist the child with completing the needed behavior. This is most appropriate for smaller children who have been told to complete a task.

Verbal Behavior Language or “Verbal Behavior” is a special form of behavior that is always reinforced by another person. If I’m thirsty I can get a drink of water or I can ask for a drink and a willing listener will bring me a drink. The term “Verbal Behavior” comes from a book by that name written by B.F. Skinner in 1957. Skinner noted that the terms “expressive and receptive language” did not go far enough to explain all the ways in which people communicate. In his analysis the behavior of the speaker (expressive language) was of primary importance and he separated expressive language into new classifications which we call verbal operants. Skinner saw receptive language as totally separate and we used the term “lisener” when talking about receptive language.

Verbal Operants There are four basic verbal operants that are most commonly included when teaching individuals with autism. Described in simple terms these are as follows: Echoic: Saying the same thing someone else says, repeating what one has heard. Mand: Requests. Asking for something or an action or information. Tact: Naming an object, action, sound, smell, or the property of any of these. Intraverbal: Saying something in response to another person’s verbal behavior which is not echoic. (e.g. answering a question, filling in a missing word) Listener behavior is also important for things such as following directions or pointing to named objects and those skills are also taught.

Verbal Behavior Verbal behavior IS NOT synonymous with speech or vocal behavior. Verbal behavior includes: American Sign Language, Picture Exchange Communication Systems (PECS), and writing. The important point is to get the child communicating as a speaker and not just following directions or pointing to pictures. Teaching Verbal Behavior skills (communication) is often the key to reducing many undesired behaviors The two most common assessment and curriculum tools for working with children with autism, the Assessment of Basic Language and Learning Skills – Revised (ABLLS-R) and the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) are based on Skinner’s analysis of verbal behavior.

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