ABA is the method of behavioral management -- of using positive reinforcement to encourage and shape positive behaviors while discouraging and eliminating negative behaviors -- that is widely used in teaching people with autism everything from bathroom etiquette to talking, reading and writing. But for a range of reasons -- it's challenging to do well, it's labor intensive, it's demanding on everyone involved, if not done well it can make conditions worse -- ABA has a PR problem. (Notice how the presenter in this article, What Makes An Effective Home-Based ABA Provider, advises behavior analysts to avoid generating negative perceptions of ABA service providers.)
Enter into this context Angela Mouzakitis' blog, called Applied Behavior Analysis: Current Topics. Not all entries appear written for laypeople, but most of the ones I have scanned are interesting. Take a recent essay on "the table, the chair and Applied Behavior Analysis," in which she explains why it's wrong for ABA therapists to insist on doing discrete trials at a table with very young children who are upset. She writes:
The focus of the first couple of weeks of session should be getting to know the child, performing assessments in the natural environment through observation of the child's interaction with family, people, and the environment. Language samples should be monitored. As the child becomes more comfortable and begins to get excited to see his therapists, more structured programs can be implemented. However, the majority of ANY session, with ANY age child, should not be at the table. This is a tool used in therapy, but not the only one, and certainly should not be the focus of an ABA program.
This is a challenge for many therapists and families. Many of us are married to the table, and find it challenging to pull away from the table and engage the entire environment that a child lives in. While challenging, it is necessary, and requires talented and creative therapists to be able to use all aspects of a child's environment.
Therapists will not leave the table on their own and may require training and coaxing to leave it. The table is easy. Sitting a child in a chair, once instructional control is established and running cards and programs, is easier than identifying learning opportunities in the natural environment. Training is necessary. Often natural environment instruction is perceived as playing in the natural environment and questioning a child on labels, colors and shapes in everyday objects. Natural environment teaching requires planning, programming, and data collection and monitoring.
The bottom line is that the child's instructional environment should from the beginning be positive and enjoyable. If the child is screaming when he sees a therapist, crying at the table, something has gone terribly wrong and must be changed. ABA therapy for children with autism does NOT equate discrete trial teaching in a chair at a table. The principles need to be applied to teach a child functional language and skills that will promote independence in his life. This should be done in any and all environments that a child will experience. Divorce the table.
What's interesting about Angela's post is her ability to explain both the discipline and creativity involved in delivering quality ABA services. Another recent post on "Parent Anecdotal Records" does a similar good job explaining the need for parents to collect accurate information about what happens at home, and suggestions for how to do it well.