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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, so the child will learn the correct response on his own.

ABA may take place in the home or in special preschools. A consultant, usually someone with a master's or doctoral degree in psychology, often supervises the therapy.

Some people incorrectly assume that ABA is synonymous with the method developed by Dr. O. Ivar Lovaas, a pioneering researcher in the Psychology Department at UCLA. Lovaas describes one form of ABA. In 1987, he published a study showing that almost half of the 19 preschoolers involved in intensive behavioral intervention -- 40 hours per week of one-on-one therapy -- achieved "normal functioning."  Note: Several decades ago, Lovaas described using mild physical punishment for severe behaviors during therapy sessions. He no longer advocates such punishment, and current 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. It also uses the errorless learning technique described above. Skinner describes categories of speech, or verbal behavior. Mands are requests, echoes are verbal imitations, tacts are labels, and intraverbals are conversational responses. 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. 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 analyst Vincent Carbone has helped popularize this approach.

One drawback to ABA/VB: some school districts and insurance companies do not pay for ABA, 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 consultant 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 sites and Books:

1. Major 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).

2. Articles, Reports, and Opinion Pieces Describing Applied Behavior Analysis (ABA) and the Research That Supports It.

3. The Behavior Analysis Certification Board lists certified behavior analysts by state and country. The Association for Behavior Analysis is a professional organization for ABA therapists and researchers.

4. The Surgeon General's Report supports the effectiveness of Applied Behavioral Analysis for autism. Show this information to your school district to help make a case for ABA.

Books about ABA:

Let Me Hear Your Voice: A Family's Triumph Over Autism by Catherine Maurice. Maurice writes of the shock of her two children's diagnoses and how they both recovered from autism. Though the experience of complete recovery is not as common as one would like, her book is a powerful testimony to the benefits of ABA therapy. A good first book for parents of newly diagnosed children.

Behavioral Intervention for Young Children With Autism: A Manual for Parents and Professionals, edited by Catherine Maurice, Gina Green and Stephen C. Luce. A how-to manual for families starting a home ABA program. Includes teaching programs, a chapter on how to pay for ABA, and samples of data collection sheets.

Right from the Start: Behavioral Intervention for Young Children with Autism by Sandra L. Harris and Mary Jane Weiss, ABA experts from Rutgers. A guide to Applied Behavioral Analysis methods and how they can be used to teach speech, language, social skills and self-help skills through repetition and rewards. The book helps parents evaluate school programs, home ABA and center-based 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.

It's Time for School!: Building Quality ABA Educational Programs for Students with Autism Spectrum Disorders by Drs. Ron Leaf, Mitchell Taubman and John McEachin. These psychologists, who studied with Dr. Lovaas at UCLA, show how schools and parents can make sure they have effective ABA classrooms, reinforcement programs and data collection.

Teaching Individuals with Developmental Delays: Basic Intervention Techniques, by Dr. O. Ivar Lovaas, the psychologist whose name has become synonymous with ABA-discrete trial instruction programs for young children with autism. Includes revised teaching programs and detailed instructions for implementing each one.

Triumphs in Early Autism Treatment, edited by Ennio Cipani PhD, documents the cases of seven children who achieved "best outcomes" (being indistinguishable from other kids) after ABA. All ABA isn't equal, nor is ABA a guarantee of reaching best outcomes, but this 2008 book helps a parent see what an excellent ABA program should look like.

Books about Verbal Behavior:

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.

Educate Toward Recovery: Turning the Tables on Autism by Robert Schramm, a Board Certified Behavior Analyst. This book is an easy-to-read teaching manual for parents who are new to the concepts and "language" of VB. He includes information on children who don't respond to conventional ABA methods, and on how VB can be used along with the Relationship Development Intervention method.

Web site with VB articles to download: Mark Sundberg.com

See AutismWeb's ABA and VB Directory of companies that sell teaching materials, along with toys for "positive reinforcement."

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