Opinions may vary, but scientific studies show that Applied Behavior Analysis (ABA) is the most effective treatment for autism compared to other therapies.
Various scientific organizations, including the National Institute of Mental Health, Association for Science in Autism Treatment, and the Organization for Autism Research have concluded that ABA-based procedures are highly effective.
Various government agencies have also advocated for the use of ABA-based procedures, most notably the Surgeon General of the United States (see page 164).
The same is true for academic and trade journals. Pediatrics, and Current Opinion in Psychiatry are among a number of journals that report on the effectiveness of ABA.
What is Applied Behavior Analysis?
ABA is a program used by mental health professionals, including autism psychologists, to increase desired behaviors in children, adolescents and adults with autism and to decrease the likelihood of undesired behaviors.
The first step of an ABA-based program is to identify the factors preceding a particular behavior and the factors following that behavior, as well as other factors influencing whether the behavior will occur. This process refers to the “behavior analysis” part of ABA.
The goal is to determine what happens to trigger a behavior and what happens after that behavior that seems to reinforce it. The plan is to remove these triggers and reinforcers and to use new reinforcers to teach a different behavior in response to the same trigger.
What Happens in ABA Treatment?
There are several established procedures used in ABA. In Discrete Trial Training, clear instructions are given about a desired behavior (“please pick up the toy”) and if the child responds correctly, the behavior is reinforced (“Great job! Here’s a sticker”). If the child doesn’t respond correctly, the autism psychologist gives a gentle prompt (e.g. places the child’s hand over the paper). The hope is that the child will eventually learn to generalize the correct response.
In Pivotal Response Training, the child or adult is taught crucial skills that are important (or pivotal) for many other skills. When improvement is made on one of these crucial skills, similar improvements occur in a variety of other skills that are not specifically trained.
In Fluency Building, the autism psychologist helps the child build up a complex behavior by teaching each element of that behavior until it is automatic or “fluent” using the ABA methods of observation, reinforcement and prompting.
For example, washing hands is broken down into small steps with each step being mastered before moving on to the next step. Turning on the water, getting the hands wet and using soap are each taught in stages. This is done with specific repetition until the behavior is considered fluent.
ABA is not just for undesired behavior like tantrums, aggression, and self-injury but desirable behaviors like language, social skills and following instructions among others.
Whenever possible, ABA-based interventions work best when applied intensively, as much as 30 hours or more a week.
Can Applied Behavior Analysis Cure Autism?
No known treatment can cure autism, but this claim deserves clarification. The term “cure” implies removing the cause of the problem. Presently, the cause of autism is unknown, hence, it is not possible for any treatment or procedure to claim a cure.
On the other hand, it is possible for a child with autism to achieve normal functioning without finding a cure for autism, just as it is possible for a physician to recover patients to normal functioning without having found a cure for their illness.
As mentioned above, ABA is considered by many researchers and clinicians to be the most effective evidence-based therapeutic approach demonstrated so far for children with autism. Several studies have shown that about 50% of children with autism who were treated with the ABA approach before the age of four had significant increases in IQ, verbal ability, and/or social functioning. Even those who did not improve this dramatically did improve more so than children who did not receive any treatment.
ABA is not a miracle cure for autism, but it is one of the best treatments that is currently available today to enable children with autism to reach their maximum potential.