Applied Behavioural Analysis Therapy

Applied Behavioural Analysis Therapy

What is Applied Behavioural Analysis Therapy?

Applied Behavioural Analysis (ABA) is not a specific therapy itself but an approach based on principles of learning and behaviour that seeks to improve social and communication skills through reinforcement and reward-based strategies. It is those reinforcement strategies that have divided many in the autism community, arguing that ABA essentially seeks to change behaviours to make a child with autism, appear to not be autistic through repetition and reward. Through this repetitive reinforcement process the child, it is argued, does not really learn the foundation of the inherent communication or behaviour but rather ‘rote learns’ a response, whether or not they understand the ‘why’.

ABA, which is delivered by qualified behaviour analysts, is among the most widely studied therapies for those on the autism spectrum[3]. Despite that it has also attracted its fair share of controversy [4] based on its drills and routines,

Perhaps reflecting concern around ABA, over the years different versions of developmental therapy have evolved including:

  • Early Start Denver Model (ESDM), [5] a play-based therapy focusing on children 1-4 in a natural setting;
  • DIR/Floortime[6], a parent-driven, play-based intervention that promotes behavioural development through play; and
  • Pivotal Response Training, a play-based model that targets pivotal areas of a child’s development, such as motivation and social initiation.

Much of the criticism directed at ABA is around its approach of using reinforcement to ‘punish’ children for ‘bad’ behaviour, such as hand-flapping, stimming and vocal outbursts. What this is doing is teaching and rewarding rote repetition of skills and behaviours, which without understanding the ‘why’ does not generally translate well in the community and outside the therapy setting.

Does Brain Train provide ABA Therapy?

Brain Train does not offer Applied Behavioural Analysis. In fact, we think there are  substantive flaws in some of its underlying approach. However, we appreciate many parents are curious about ABA, and we would like to provide a detailed explanation of the context and background that led to our position. We will also provide references to some of the research that has led others in the autism community, to reach a similar conclusion as Brain Train. Ultimately, we invite you to explore the research for yourself, and come to your own conclusion about the appropriateness of ABA for your child.

Successful early intervention therapies for autism often focus on four primary areas:

Physical Development

This includes Neurodevelopment. Targeting the child’s body and brain, with research showing motor coordination deficits being pervasive across autism diagnoses and being a cardinal feature of ASD [1].

Social Development

The child’s ability to form relationships, communicate, self-regulate and cope with emotions, with research showing children with autism have sensory and motor difficulties that have been found to impact social functioning[2].

Behavioural Development

The child’s behaviour and behaviours are affected by the environment and the child’s physical, social and cognitive development. This is the focus of ABA, as well as other behavioural development therapies.

Cognitive Development

The child’s ability for higher order processing, thinking and learning. This development assists in building a foundation to expand knowledge and improve problem solving by encouraging critical thinking to make decisions.

Brain Train does not endorse, nor does it provide, ABA therapy.

We proudly have a play and strengths-based approach to all therapies that we offer, which is important for behavioural development. Our belief is that through the joyful process of a play-based approach, appealing to the specific motivations of each child and providing an environment where our therapy team have energy, engagement and enthusiasm and are supportive and non-judgemental, we are able to develop a relationship with each child that helps children learn how to express themselves and develop more intuitive and organic socialisation and communication skills. We incorporate our play-based approach within our multi-disciplinary setting to facilitate and encourage behavioural development. This foundational play-based approach makes therapy much more fun, which in turn amplifies its effectiveness.

One of the most effective strategies we employ, which is a hallmark of developmental therapies, including ABA, is positive reinforcement. What is different about Brain Train is the form of positive reinforcement, which we believe encourages a more meaningful understanding and therefore more sustainable behavioural shift in your child.

When a behaviour is followed by something that is valued (a reward), a child is more likely to repeat that behaviour. Over time, this can encourage positive behaviour change. First, the therapist identifies a goal behaviour, generally in conjunction with the family’s goals. Each time the child uses the behaviour or skill successfully, they get a reward. Whilst many ABA practices use food as a reward, our skilled therapists use other rewards that are meaningful and purposeful. Examples could include praise, choosing what to do next from a list of options, a short playful activity or anything else that appeals to the child’s motivations. These positive rewards that are based around personal interactions (and not the reward of a lolly) encourage the child to continue progressing the skill or behaviour. And when used as part of a multi-disciplinary approach to therapies, over time this can lead to a more functional and organic understanding of social nuance and meaningful behaviour change.

Being strengths-based, Brain Train’s positive reinforcement strategies are focused on functional outcomes and encouraging the child to develop meaningful social and behavioural interactions. We are non-judgemental and supportive of our community. That means that hand flapping, stimming and vocal outbursts are not ‘bad’ behaviours that need to be corrected through punishment. Rather our wonderful team of therapists target the child’s motivations, strengths and interests to develop a therapy plan that is individualised, play-based and designed to foster organic improvement in developmental behaviours.

References

[1] Fournier K, A., Hass, S, K., et al, (2010) Motor Coordination in Autism Spectrum Disorders: A Synthesis and Meta-analysis, J Autism Dev Discord 40(10) 1227-40

[2] Hilton C, Graver K, LaVesser P. Relationship between social competence and sensory processing in children with high functioning autism spectrum disorder Res Autisn Spec Disord (2007) doi:10.1016/j.rasd.2006.10.002

[3] Advances in Our Understanding of Behavioral Intervention: 1980 to 2020 for Individuals Diagnosed with Autism Spectrum Disorder, https://pubmed.ncbi.nlm.nih.gov/32240487/

[4] The Controversy over autisms most common therapy https://www.spectrumnews.org/features/deep-dive/controversy-autisms-common-therapy/

[5] https://www.esdm.co/

[6] https://www.icdl.com/floortime