Autism Teaching Methods: Applied Behavior Analysis and Verbal Behavior
Applied Behavior Analysis, or ABA, is a method of teaching children with autism and Pervasive Developmental Disorders. It is based on the premise that appropriate behavior – including speech, academics and life skills – can be taught using scientific principles.
ABA assumes that children are more likely to repeat behaviors or responses that are rewarded (or "reinforced"), and they are less likely to continue behaviors that are not rewarded. Eventually, the reinforcement is reduced so that the child can learn without constant rewards.
Research shows that ABA works for kids with autism. "Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior," according to a U.S. Surgeon General's Report.
The most well-known form of ABA is discrete trial training (DTT). Skills are broken down into the smallest tasks and taught individually. Discrete, or separate, trials may be used to teach eye contact, imitation, fine motor skills, self-help, academics, language and conversation. Students start with learning small skills, and gradually learn more complicated skills as each smaller one is mastered.
If a therapist is trying to teach imitation skills, for example, she may give a command, such as "Do this," while tapping the table. The child is then expected to tap the table. If the child succeeds, he receives positive reinforcement, such as a raisin, a toy or praise. If the child fails, then the therapist may say, "No." The therapist then pauses before repeating the same command, ensuring that each trial is separate or discrete. The therapist also will use a prompt - such as physically helping the child tap the table - if the child responds incorrectly twice in a row. This "no-no-prompt" method is used in some traditional ABA programs.
However, many ABA programs now use prompts for every trial, so the child is always correct and always reinforced by praise or a toy. This technique is called "errorless learning." The child will not be told "no" for mistakes but rather will be guided to the correct response every time. The prompts will be gradually reduced (or "faded," in ABA language), so the child will learn the correct response on his own.
ABA may take place in the home or a school. A consultant or board certified behavior analyst -- usually someone with a master's or doctoral degree in psychology -- often supervises the therapy.
Some people incorrectly assume that ABA only describes the method developed by the late Dr. O. Ivar Lovaas, a pioneering researcher in the Psychology Department at UCLA. Lovaas developed one form of ABA. In 1987, he published a study showing that nine of the 19 preschoolers involved in intensive behavioral intervention -- 40 hours per week of one-on-one therapy -- achieved "normal functioning" by first grade. Note: Several decades ago, Lovaas described using mild physical punishment for severe behaviors during therapy sessions. He later rejected punishment, and modern behavior therapists do not use it.
ABA programs usually draw upon Lovaas's decades of research, but they also may incorporate different methods and tools.
Applied Verbal Behavior or VB is the latest style of ABA. It uses B. F. Skinner's 1957 analysis of Verbal Behavior to teach and reinforce speech, along with other skills. Skinner described categories of speech, or verbal behavior:
- Mands are requests ("I want a drink.")
- Echoes are verbal imitations, ("Hi")
- Tacts are labels ("toy," "elephant") and
- Intraverbals are conversational responses. ("What do you want?")
A VB program will focus on getting a child to realize that language will get him what he wants, when he wants it. Requesting is often one of the first verbal skills taught; children are taught to use language to communicate, rather than just to label items. Learning how to make requests also should improve behavior. Some parents say VB is a more natural form of ABA.
Like many Lovaas ABA programs, a VB program will use errorless teaching methods, prompts that are later reduced, and discrete trial training. Behavior analysts Dr. Vincent Carbone, Dr. Mark Sundberg and Dr. James Partington have helped popularize this approach.
One drawback to ABA/VB: some school districts and insurance companies do not pay for it, and it can be expensive for parents to fund. If you decide to pay for it yourself, carefully research the credentials of anyone claiming to be an ABA or VB consultant or experienced therapist. A program leader should have, at a minimum, a master's degree in psychology or ABA, or should be closely supervised by someone who does. When hiring therapists, some families find volunteers or students willing to work for lower pay in order to gain experience with autism.
ABA and VB Web resources
- AutismWeb's ABA and VB Directory of teaching materials.
- Large organizations that set up and supervise home and group-based intensive behavioral intervention programs include the Lovaas Institute for Early Intervention, the Center for Autism and Related Disorders and the Carbone Clinic (VB). Check your area for smaller, regional programs.
- Articles, Reports, and Opinion Pieces Describing Applied Behavior Analysis (ABA) and the Research That Supports It
Books about ABA:
A Work in Progress: Behavior Management Strategies and A Curriculum for Intensive Behavioral Treatment of Autism edited by Drs. Ron Leaf and John McEachin. This ABA classic provides practical advice and easy-to-understand explanations about how to set up an ABA program. It discusses how to teach toilet training, social skills, play skills and conversation, along with how to address eating problems and disruptive behavior.
The ABA Program Companion: Organizing Quality Programs for Children With Autism and PDD. This book and CD-ROM by J. Tyler Fovel explains ABA, how to teach language and social skills, and organize your child's program. The CD helps you choose from 500-plus educational goals in 54 areas, based upon the curriculum outlined in A Work in Progress.
Understanding Applied Behavior Analysis: An Introduction to ABA for Parents, Teachers, and Other Professionals. Psychologist Albert Kearney explains ABA to teachers and parents alike using everyday language and examples.
The classic autism recovery memoir is Catherine Maurice's Let Me Hear Your Voice: A Family's Triumph Over Autism. Maurice writes movingly of the shock of her two children's diagnoses and how they both recovered from autism with ABA therapy. Although there is no guarantee of a full recovery, her book is a powerful testimony to the benefits of ABA.
Right from the Start: Behavioral Intervention for Young Children with Autism by Sandra L. Harris and Mary Jane Weiss. A guide to ABA methods and how they can be used to teach speech, language, social skills and self-help skills through repetition and rewards. They help parents evaluate school-, home- and center-based programs.
Books about Verbal Behavior:
Teaching Language to Children with Autism or Other Developmental Disabilities by behavior analysts Mark L. Sundberg Ph.D. and James W. Partington Ph.D., who have researched Verbal Behavior and helped popularize it through their articles and books. Probably the most complete book on Verbal Behavior available, from an expert's point of view.
The Verbal Behavior Approach: How to Teach Children With Autism and Related Disorders by Mary Lynch Barbera, a Board Certified Behavior Analyst and parent of a child with autism, and Tracy Rasmussen. One of the few parent-oriented books about using Verbal Behavior to teach communication, speech, self-help skills, potty-training and more.
Books about Pivotal Response Treatment
Overcoming Autism: Finding the Answers, Strategies, and Hope That Can Transform a Child's Life by Lynn Kern Koegel Ph.D. (featured on The Supernanny) and Claire LaZebnik. Koegel uses a form of applied behavior analysis called Pivotal Response Treatment (PRT). PRT targets certain pivotal skills, such as motivation, that affect development in many other areas. Dr. Koegel says PRT is a more "child-friendly" form of treatment. Her book has chapters on teaching communication, breaking the cycle of meltdowns, repetitive behaviors like flapping, social skills, battling fears and fixations, school placement and family life.
Useful links for parents and behavior analysts:
- The Behavior Analysis Certification Board lists certified behavior analysts by state and country. See if your ABA or VB team leader is certified.
- The Association for Behavior Analysis is a professional organization for ABA and VB therapists and researchers.
- Verbal Behavior articles at Mark Sundberg.com.
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