Applied Behavior Analysis (ABA)

We help families create and implement behavioral programs that cover techniques such as ABA, Verbal Behavior and more. We value consistency and use a client center approach with all professionals and other providers to keep services consistent across all settings.

What is ABA?

Behavior analysis is a unique method of treatment based on the idea that most importantly human behavior is learned over time and that it is currently maintained by consequences in the environment. The job as a lead behavior therapist if to work with behavior you would like to change. With your input, we can help you discover what is maintaining a behavior, discover more appropriate replacement behaviors, and then set up a plan to teach those behaviors. We can also develop a plan to help you acquire a new behavior or improve your skill level. Some of the time we will be treating you directly and at other times we may be training significant others as well.

How We Work

As behavioral analysts, we do not make judgments about behavior. We try to understand behavior as an adaptive response (a way of coping) and suggest ways of adjusting and modifying behaviors to reduce pain and suffering and increase personal happiness and effectiveness. You will be consulted at each step in the process. We will ask you about your goals, and we will explain our assessments and the results of our assessments. We will describe the plan for intervention or treatment and ask for your approval of that plan. If at any point you want to terminate our relationship, we will cooperate fully. Please know that it is impossible to guarantee any specific results regarding your goals. However, together we will work to achieve the best possible results.

Client Responsibilities

We will need your full cooperation as we try to understand the various behaviors that are problematic for you. We will be asking a lot of questions and making a few suggestions and we need your total honesty with us at all times. We will be showing you data as a part of my ongoing evaluation of treatment and expect that you will attend to the data and give me your true appraisal of conditions.

If at any time and for any reason you are dissatisfied with our professional relationship, please let us know. If we are not able to resolve your concerns we will make a referral to obtain services elsewhere or seek guidance from our Clinical Director.

Behaviors ABA Can Help Increase

Language (i.e., requesting, tact/expressive, listening responder/receptive, following directions)
Imitation skills
Gross/fine motor skills
Visual/perceptual skills (e.g., puzzles, matching, sorting)
Activities of daily living (e.g., toileting, dressing, and brushing teeth)
Social and independent play skills
Community skills (e.g., crossing the street safely, grocery shopping and cooking)
Reading
Writing
Group instruction

Behaviors ABA Can Help Decrease

Hitting
Biting
Screaming
Hand flapping
Non-compliance
Scripting
Any repetitive/stereotypic behaviors

Teaching Strategies

Verbal behavior (VB)
Discrete trial teaching (DTT)
Prompting and fading
Shaping and chaining
Natural environment teaching (NET)
Errorless learning
Reinforcement

Focused ABA Treatment

Focused ABA Treatment Focused ABA generally ranges from 10-25 hours per week of direct treatment (plus direct and indirect supervision and caregiver training). However, certain programs for severe destructive behavior may require more than 25 hours per week of direct therapy (for example, day treatment or inpatient program for severe self-injurious behavior).

Focused ABA refers to treatment provided directly to the client for a limited number of behavioral targets. It is not restricted by age, cognitive level, or co-occurring conditions.

Focused ABA treatment may involve increasing socially appropriate behavior (for example, increasing social initiations) or reducing problem behavior (for example, aggression) as the primary target. Even when reduction of problem behavior is the primary goal, it is critical to also target increases in appropriate alternative behavior, because the absence of appropriate behavior is often the precursor to serious behavior disorders. Therefore, individuals who need to acquire skills (for example, communication, tolerating change in environments and activities, self-help, social skills) are also appropriate for Focused ABA.

Focused ABA plans are appropriate for individuals who (A) need treatment only for a limited number of key functional skills or (B) have such acute problem behavior that its treatment should be the priority. Examples of key functional skills include, but are not limited to:

establishing instruction-following
social communication skills
compliance with medical and dental procedures
sleep
hygiene
self-care skills
safety skills
independent leisure skills (for example, appropriate participation in family and community activities)

Focused ABA treatment may involve increasing socially appropriate behavior or reducing problem behavior. Examples of severe problem behaviors requiring focused intervention include, but are not limited to:

self-injury
aggression
threats
pica
elopement
feeding disorders
stereotypic motor or vocal behavior
property destruction
noncompliance and disruptive behavior
dysfunctional social behavior

Behavior that threatens the health or safety of the client or others, or that constitutes a barrier to quality of life includes:

severe aggression
self-injury
property destruction
noncompliance
absence of developmentally appropriate adaptive, social, or functional skills that are fundamental to maintaining health

When the focus of treatment involves increasing socially appropriate behavior, treatment may be delivered in either an individual or small-group format. When conducted in a small group, typically developing peers or individuals with similar diagnoses may participate in the session. Members of the behavior-analytic team may guide clients through the rehearsal and practice of behavioral targets with each other. As is the case for all treatments, programming for generalization of skills outside the session is critical. When the focus of treatment involves the reduction of severe problem behavior, the Behavior Analyst will determine which situations are most likely to precipitate problem behavior and, based on this information, begin to identify its potential purpose (or “function”). This may require conducting a functional analysis procedure to empirically demonstrate the function of the problem behavior. The results enable the Behavior Analyst to develop the most effective treatment protocol.

When the function of the problem behavior is identified, the Behavior Analyst will design a treatment plan that alters the environment to reduce the motivation for problem behavior and/or establish a new and more appropriate behavior that serves the same function and therefore “replaces” the problem behavior.

The ABA services delivered in these settings typically require higher staff-to-client ratios (for example, two to three staff for each client) and close on-site direction from the Behavior Analyst. In addition, such treatment programs often have specialized treatment environments (for example, treatment rooms designed for observation and to keep the client and the staff as safe as possible).

Comprehensive ABA Treatment

Comprehensive ABA Treatment often involves an intensity level of 30-40 hours of 1:1 direct treatment to the client per week, not including caregiver training, supervision, and other needed services. However, very young children may start with a few hours of therapy per day with the goal of increasing the intensity of therapy as their ability to tolerate and participate permits. Treatment hours are subsequently increased or decreased based on the client’s response to treatment and current needs. Hours may be increased to more efficiently reach treatment goals. Decreases in hours of therapy per week typically occur when a client has met a majority of the treatment goals and is moving toward discharge.

Comprehensive ABA refers to treatment of the multiple affected developmental domains, such as cognitive, communicative, social, emotional, and adaptive functioning.

Maladaptive behaviors, such as noncompliance, tantrums, and stereotypy are also typically the focus of treatment. Although there are different types of comprehensive treatment, one example is early intensive behavioral intervention where the overarching goal is to close the gap between the client’s level of functioning and that of typically developing peers.

Comprehensive treatment may also be appropriate for older individuals diagnosed with ASD, particularly if they engage in severe or dangerous behaviors across environments. Initially, treatment is typically provided in structured therapy sessions, which are integrated with more naturalistic methods as appropriate. As the client progresses and meets established criteria for participation in larger or different settings, treatment in those settings and in the larger community should be provided.

Training family members and other caregivers to manage problem behavior and to interact with the individual with ASD in a therapeutic manner is a critical component of this treatment model.

Check out this factsheet from The Council of Autism Service Providers (CASP)!

Find out more on the CASP website here.