It’s 9:05 Monday morning, and Eli, 4, eagerly reaches for his favorite, little green train.
He can’t say what he wants, but his therapist smiles, and patiently models the word, “train.” Eli, who has been diagnosed with autism, reaches again and again but remains silent. After several attempts, he finally says, “…ay.” His therapist lavishes him with praise, and most importantly, his beloved toy.
“Choo! Choo!” says his therapist playfully.
While Eli didn’t say the entire word, “train,” he’s starting to learn how making certain sounds help him get his favorite things. Over time, his therapists will help shape his sounds into words, and then his words into full sentences. This is applied behavior analysis.
The use of applied behavior analysis (ABA), the systematic approach of influencing socially important behaviors, is slowly revolutionizing the lives of families and their loved ones. In areas from health and exercise to substance abuse to staff management and performance, ABA can drastically improve human behavior. Its wide range of applied areas include organizational function (e.g. pay structure interventions), skill deficits (e.g. communication, toilet use), and problem behavior (e.g. aggression, self-harming), among others. However, it’s gained popular recognition for its progress in gerontology, traumatic brain injury, and, especially, autism. (In the world of autism, ABA is widely accepted as the gold standard.)
Through as much as 40 hours a week of one-on-one therapy, certified behavior analysts create individualized programs that treat specific skill deficits, such as delayed language or classroom readiness. They break down long-term goals and necessary life skills into small, achievable steps, and then reinforce the completion of each step. ABA’s data-based approach means that progress with skills and behavior are regularly tracked, which helps ensure success. When done correctly, the therapy motivates learning through fun, dynamic, engaging opportunities that speak to each individual, and over time, changes the world of families and their loved ones.
“ABA prepared my son to be independent,” says Christine Abilla, whose son, Mateo, 14, is on the autism spectrum.
When Mateo first started ABA therapy with an agency that specializes in ABA therapy, he wouldn’t communicate or use the toilet, which precluded him from starting preschool. Today, he’s taking two AP classes as a high school sophomore, tests as extremely gifted among his peers and plans to become a teacher.
Mateo isn’t alone. A 1987 randomized trial study by Dr. Ivar Lovaas, who popularized ABA therapy as a treatment for autism, found that 47 percent of children with autism who received ABA 40 hours a week passed general education first grade, compared to just a two percent pass rate for those who received only 10 hours a week of ABA. In addition, a 2005 study by Howard, et al. concluded that children receiving intensive ABA made significantly more progress, including becoming six times more likely to score in normal range for life skills, than those receiving mixed treatments. At this time, ABA is the most researched, evidence-based treatment available for autism.
However, the science of ABA has a wide variety of applications since its core strategies generally focus on modifying the environment and teaching alternative skills. In public health, for example, behavior analysts make “wash your hands” signs in bathrooms visible from both the door and the sink, which dramatically increases the number of individuals who will clean up. In business settings, behavior analysts may change a pay structure such as instituting bonuses for better accuracy and increased efficiency. In gerontology, ABA specialists will replace white, square napkins with colored, patterned ones to prevent those with dementia from eating what they think looks like toast.
“The successes really prove equally great across fields in terms of improving people’s lives and problematic situations,” says Dr. Linda LeBlanc, a board member of the California Association of Behavior Analysis(CalABA). She noted one study that found that 80 percent of a nursing home’s residents who had been incontinent became continent after receiving ABA treatment, for example.
“Behavioral and environmental modification just makes a lot of sense across the board,” echoed Dr. Megan Heinicke, a psychology professor at CalState Sacramento and former board member of CalABA.
Heinicke went into ABA when she realized how much her father, a brain injury victim, could’ve benefitted from the treatment. She recounted the joys of helping people and their families figure out the unsolvable is solvable, from an individual learning to speak after being mute for 10 years to another individual no longer needing severe sedation medication after learning how to control his aggression.
“These people and their families, they’ll be thankful for the rest of their lives. It’s extremely impactful,” says Heinicke, “I hope people know that.”
Fortunately, access to qualified behavior analysts is on the rise. University programs in the field are growing, and boards and professional organizations such as the Behavior Analyst Certification Board (BACB) and CalABA support behavior analysis professionals to ensure the highest treatment standards.
“ABA has provided previously unimaginable outcomes for so many individuals living with autism and we are beginning to see these outcomes across additional populations,” said Matt McAlear, Executive Director of CalABA. “This is an exciting time for our field and those we treat. Simply put, our science works and everyone is deserving of the most effective treatment available,” he said.
CalABA is the professional organization representing behavior analysts in California. The group serves as one of the nation’s most trusted resources in the field.
To find out more about ABA treatment and where you can get help, visit CalABA today.
This article originally appeared in the SF Gate and has been republished with permission.