Applied Behaviour Analysis
We are often contacted by parents who have concerns that we use ABA and we often hear people discuss ABA negatively. so, let's unpack those concerns. I have been in the field of Psychology and Education as an expert in Behaviour Analysis, for 20 years now. I have contributed to research, practiced across the world and been privileged to develop evidence based programmes for others to implement alongside developing our own assessment and practices which only we use in our team.
We love to see those we work with progress and we are always developing programmes to help those who slip under the radar. I have witnessed the development and implementation of very successful interventions for those who have been traumatised by school and society and who I have had the privilege of walking with to give them wholeness and to a place of really thriving. It is an even bigger privilege to work with families to spot things early, which many professionals dismiss, and to put interventions in to place even before visible struggles rear their heads and before true anxiety sets in. It is true that all of this is grounded in evidence based practice and that the majority is from the field of behaviour analysis. None of those I work with have been traumatised, and I know that because many people I have worked with I am still in touch with many many years later.
Trauma is not my jam … and I do NOT think that the outcome is worth the pain / no pain, no gain or anything like that. Despite the successes we encounter (it isn’t all roses by the way!), I have a painful understanding of conflict and ‘camps’ which have done nothing to provide solution and have further damaged progressing action for our children and families. There is so much fear when it comes to our children and the mere mention of ‘evidence based practice’ or of ‘ABA’ can trigger extreme reactions. I have been shouted out, sworn at and even jabbed in the stomach when I was pregnant and speaking at an expo. I understand these concerns arise from part misconception but also sometimes unfortunately from extremely bad or historic practice. I would like to provide you with a nutshell perspective of what Today’s ABA is and should be and, more importantly, how we practice as a team.
Before I do, if you or your child has been hurt by any practice arising from somebody who has trained in our field whether now or historically I apologise with every fibre of my being. Our field has progressed extremely quickly in its relatively short life. That means that we see change and action in real time. The curve is more pronounced, unlike for example in education or medicine where change is not as rapid. As in all fields, interventions and procedure and practice change significantly as research and outcomes progress. Interventions today look very different to interventions of the past. The same is for all psychology and medicine. Mainstream education does not seem to have changed so much across the board.
It is very hard to articulate how we work as much of how we work, although based firmly in evidence based practice, is organic and completely individual to the child, teen and / or family with whom we work. We leave no stone unturned to do the best for those we have the privilege of working with. We are solution focused and we seek to make gains for our children and families every single day. Most of the families I journey with send me videos and messages every day. We do not work just 9-5 and I really do dream about those I work with. If a child isn’t making the gains we want them to, I will do everything I can to find out why and to ensure they do. I am all about the ‘why’ as opposed to the ‘what’ and I think that really helps.
There are lots of misunderstandings about ABA and what it is; or perhaps more so what it is not. From a personal perspective, I am a parent who has had to parent each child very differently due to their differing strengths, giftings and barriers. I am a parent who seeks to practice child centred and human centred interactions. I am a parent (and human) who tries (although admittedly isn’t always successful!) to interact peacefully … always. We endeavour to practice peaceful parenting at home. We are massive advocates of attachment parenting and of genuine co parenting. We work hard to meet the needs of each other and to put each other first. We also work hard on recognising our own strengths, challenges, barriers and wounds … because we all have them! Anyhow, enough about me … I just wanted you to know that although I am a radical behaviour analyst who loves the results and success of what we do … and although I LOVE data, an excel sheet and white boards (we have three downstairs and one upstairs), it is because I love people first. I don’t want people to mask and to fit in. I did that for years myself and was determined that would not be the life my daughters endure and your daughters endure. I want a ‘masks off’ life for everybody and that will be my passion and drive until the day that I leave this lovely Earth. Today’s ABA is NOT a ‘compliance first’ practice. It should never be about “you do this, and then you get that”. It is not about adults being in ‘control’. It is never about having the upper hand. It is about relationship and about thriving.
Our mission when we first meet children is NOT to gain compliance. Instructional control is of course very important, but it should never come at a cost. We do not bribe a child to sit at a table in spite of their emotional state. If you know of anybody who practices this way, you must report them. This practice is out dated and dangerous with short and long term consequences. We do not seek to change behaviour come hell or high water. We seek to equip our children and their families with the tools they need to deal with emotions and to regulate emotional states which are unhelpful to that child. A human who is upset many times a week or even day is not a human who is living their best life. ABA today, and certainly here in our team, is about being able to live our very very best lives. Our overarching aim for all of our children and families is to remove vulnerability first and foremost. It is not about outcome but about the process. A healthy outcome will always follow a healthy process. Are we building or destroying? Is the process delightful or it painful? Today’s ABA isn’t about restricting toys and putting stuff away.
The main drivers of behaviour change should be prompting and differential reinforcement. It should be errorless teaching and success. Not learning from mistakes . Emergency retracing … fine … but we should not rely on it. If we have had to do it once, that is too much. It is the same with extinction or punishment. If non reinforcement is used more than a handful of times, we need to look at prompting and motivation. Everything should be about motivation and natural environment teaching. That should be at the core of every single thing we do. Treatments and supports are not about working children through negative emotional states … ever. If we observe that a child is upset then we need to see that, teach them we understand and to change it right there and then. We do not push through negative emotional states. Nothing is worth that. Trauma is trauma and our children DO remember. We have high expectations for our children and we see the children we work with exceed those.
We have worked with so many children whose parents have been told to accept that their child will never talk or interact and that the struggles they present with at the time are lifelong. We have been those parents. It isn’t about our goals though … it is about your goals and your children’s goals. Despite the evidence base, there are different ‘forms’ of ABA many of which are from the dinosaur era. Evidence based behaviour analysis is motivation based and feels and looks natural and easy. It is happy and relaxed, and so is your child. I have been accused of having too many ‘values’. On a personal note, our ‘ABA’ is ‘Value free’ after my basic assumption of everybody being entitled to be happy and relaxed. I am also fairly frequently called an ableist. Yes, I am ableist in the sense that I presume that every human has the right to communicate better (and therefore not be frustrated and misunderstood and miserable), to tolerate better (and therefore feel relaxed, purposeful and comfortable) and to be more flexible (which allows us to thrive). Remember that Darwin’s theory isn’t that the strongest survive, it is that the most flexible survive. I believe that every human being has the right to be happy and to be relaxed and that this is achievable (for the most part). I presume that better communication as opposed to engaging in behaviour which hurts ourselves or others is a basic human right and desire. I presume that being able to use the toilet and ask for what you need is a better experience than being in nappies and unable to have needs met. In that sense then yes I am unashamedly an ableist. Beyond that, I try to ascribe no values and I aim to work collaboratively with what the child and family wants and needs.
My motto is: “Just because you CAN change behaviour, does not mean you should” Just because you CAN change behaviour a certain way, does not mean you should. I always look at who the behaviour change would benefit and I always, always use our ‘decision making triangle’.
Everything that we do, and the advice that we give to families, is about connection and is always relationship over target/goal every single time.
Just because the research it is out there does NOT mean you should do it
Escape extinction should not be needed
Non responsiveness to a child or another human being is NOT acceptable
Ignoring is NOT okay
Did you know that research shows it is even more aversive than traditional ‘punishments’? - Did you know that raising your voice/shouting is just as traumatic as actual smacking or hitting?
Happy - relaxed - engaged is always the gauge and always the aim. Nothing else is acceptable. We should be bringing the joy every day and, until we bring the joy, we should not be teaching! We are here to empower our children and our families. Empowerment is so very powerful and it is the answer to many challenges that our children face.
It is all about empowerment, human rights and true choice. If our children want to leave our connection in the moment, they can do. If they don’t want to engage, that is okay. We need to look at why and we need to do better. Honesty and transparency, regardless of our child’s communication status, is absolutely key. In our team we always try to remember that children who don’t start, can’t finish and that children who don’t like to start have no chance of finishing. It is our job to fully and truly gain the trust of our children and to motivate them. Relationship is absolutely everything A child does not need to ask to leave the room. Motivation and interaction from the child guides our teaching at all times. We require full assent of our children and we fully understand their rights. We work hard to reduce vulnerabilities for our children and to minimise, at all times, all feelings of coercion and feeling trapped and any force. It is crucial to look at consent, assent and withdrawn sent! Mammals do not do well when they feel trapped, and that is the same for us!
THE EFFECTIVENESS OF ABA
Behaviour Analysis is simply the science of how behaviour works. Applied Behaviour Analysis uses that science and creates programmes to make socially significant changes in peoples lives. ABA is used in many settings from developmental delays through to the workplace. It is used for all behaviours, which means language, fine motor, gross motor, academic skills, and social skills just to name a few.
Many decades of research have validated the efficacy of ABA. The Report of the MADSEC Autism Task Force (2000) provides a succinct description, put together by an independent body of experts. Over the past 30 years, several thousand published research studies have documented the effectiveness of ABA across a wide range of:
Populations, including children and adults with mental illness, developmental disabilities and learning disorders.
Interventionists, including parents, teachers and other professionals.
Settings, including schools, homes, institutions, group homes, hospitals and in the work place.
Behaviours, including language (which is a learned behaviour), social skills, academic performance and the acquisition of appropriate and healthy behaviour patterns.
Treatment approaches grounded in ABA are now considered to be at the forefront of therapeutic and educational interventions for children with autism. The large amount of scientific evidence supporting ABA treatments for children with autism have led a number of other independent bodies to endorse the effectiveness of ABA, including the U.S. Surgeon General, the New York State Department of Health, the National Academy of Sciences and the American Academy of Pediatrics (see reference list below for sources).
Applied behaviour analysis is the process of systematically applying interventions based upon the principles of behaviour analysis to improve socially significant behaviours to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behaviour (Baer, Wolf & Risley, 1968; Sulzer-Azaroff & Mayer, 1991). “Socially significant behaviours” include any behaviour that is important for that individual, family and situation. Each family has different needs and priorities, which ABA can address to satisfy your unique situation.
ABA is an objective discipline. ABA focuses on the reliable measurement and objective evaluation of observable behaviour. Reliable measurement requires that behaviours are defined objectively. Vague terms such as anger, depression, aggression or tantrums are redefined in observable and quantifiable terms, so their frequency, duration or other measurable properties can be directly recorded (Sulzer-Azaroff & Mayer, 1991). For example, “Initiating social interaction with peers” might be defined as: “looking at classmate and saying, “Hello.”
ABA interventions require a demonstration of the events that are responsible for the occurrence, or non-occurrence, of behaviour. ABA uses methods of analysis that yield convincing, reproducible, and conceptually sensible demonstrations of how to accomplish specific behaviour changes (Baer & Risley, 1987). Moreover, these behaviours are evaluated within relevant settings such as schools, homes and the community.
DID YOU KNOW?
ABA is not currently practiced on the NHS in spite that is now widely recognised as the most effective way of teaching children with autism and other developmental delays, as well as children with behavioural problems or language and communication difficulties. However, 2012 is seeing some NHS Institutions and government organisations recruit behaviour analysts.