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Applied Behavior Analysis: Overview and Summary of Scientific Support
Authors: Louis P. Hagopian & Samantha L. Hardesty
The Kennedy Krieger Institute and Johns Hopkins University School of Medicine
Applied Behavior Analysis
Applied behavior analysis (ABA) is a discipline concerned with the application of behavioral science in real-world settings such as clinics, schools, and industry with the aim of improving socially important issues such as behavior problems and learning (Baer, Wolf, & Risley, 1968).
With regard to individuals diagnosed with intellectual and developmental disabilities including autism, ABA-based procedures can be loosely categorized as “comprehensive” or “focused.” It should be noted that these categories are broad and are mainly distinguished by the goals of treatment. Many children with autism and intellectual disabilities require both types of procedures.
Comprehensive ABA interventions are aimed at producing changes in specific skills that impact global measures of functioning including IQ, adaptive skills, and social functioning in children with autism. Typically, such treatment is provided for an extended period (often spanning several years) and is often a home- or center-based program (sometimes in an educational setting). Skills frequently targeted include attention, discrimination, language/communication, socialization, as well as more advanced educational skills (e.g., reading, math, etc.). These programs rely on the use of clear instructions, reinforcement, teaching small units of behavior, and repeated learning trials to maximize learning opportunities. When utilized with younger children, these interventions are often referred to as “early intensive behavioral interventions” (EIBI). Several research studies have demonstrated that center-based comprehensive ABA interventions are highly effective in improving IQ, adaptive skills, and social functioning when programming is delivered 25-40 hours per week. Research also suggests that these gains are more robust the earlier programming is initiated. Therefore, comprehensive ABA-based treatment is often sought out when a diagnosis of autism is made. Research on comprehensive interventions, or EIBI is summarized below.
Focused ABA interventions are generally more time-limited in nature because they are designed to address specific concerns including aggression, self-injury, disruptive behavior, pica and other challenging behaviors. Individuals with such problem behavior often meet criteria for certain psychiatric diagnoses, such as “Disruptive Behavior Disorder” or “Stereotypic Movement Disorder with Self-Injurious Behavior.” ABA-based treatment of these problems involves first conducting a functional behavioral assessment to identify the variables controlling problem behavior (i.e., the cause of the behavior). Then, this assessment information is used to guide the development of an individualized treatment(s). Typically, function-based treatments involve altering the environment to minimize problem behavior, establishing and reinforcing adaptive behaviors, and withholding reinforcement for problem behavior. Focused interventions can also address other concerns such as anxiety and skills deficits (i.e., social skills and self-care deficits). These services are generally needed when attempts to address these concerns using standard teaching and parenting practices are unsuccessful. Nearly four decades of research has shown that ABA-based treatment approaches are effective in reducing problem behavior and establishing appropriate skills with children and adults; in home, school, and community settings; and with individuals with different types of intellectual and developmental disabilities, including autism. Research on focused interventions is summarized below.
Regardless of the specific category or goals of treatment, features common to all ABA-based approaches are: 1) the objective measurement of behavior, 2) use of procedures based on scientifically established principles of behavior, and 3) precise control of the environment to allow for the objective evaluation of outcomes. Any clinical procedure or research investigation adhering to these basic criteria can be considered to be an ABA-based procedure. This includes "functional behavioral assessment," approaches such as "Positive Behavioral Support," and forms of "Behavior Therapy" that rely on direct observation of behavior, procedures based on behavioral principles, and analysis of behavior-environment relations.