Applied Behavior Analysis
What is ABA?
Applied Behavior Analysis (ABA) is a systematic process based on principles of learning theory and is used to make meaningful changes to behavior. ABA is considered best practice for the treatment of autism and serves as a foundation for all the services provided by Ally Pediatric Therapy. Many facets of your child’s behavior can be improved, including but not limited to:
- Challenging Behaviors
- Play Skills
- Self-help Skills
- Feeding Skills
While ABA is commonly associated with autism therapy, its applications are much broader. ABA is also used successfully with other childhood diagnoses as well as typically developing children and adults. Research has shown that broadening the scope of ABA beyond the diagnosis of autism spectrum disorder increases collaboration with other professionals and yields positive results (Matson & Nebel-Schwalm, 2007; Ross, 2007).
The objective of each ABA session is to work towards mastery of each objective listed on the individualized treatment plan. ABA sessions can include a variety of teaching methodologies including, but not limited to, Pivotal Response Training (PRT), Discrete Trial Teaching (DTT), Natural Environment Teaching (NET), behavior management, crisis intervention, etc. These teaching methodologies allow information to be presented in a systematic manner, providing more opportunities for your child to learn skills.
Our Approach to ABA
Every child is unique. Their treatment should be too. We believe in a blended approach of ABA methodologies, which allows us to utilize the most effective approach based on each child’s learning style and needs.
- Pivotal Response Training (PRT) is a comprehensive, evidence-based treatment approach that targets your child’s pivotal areas of development, including motivation, social initiations, self-management, and responding to multiple language cues. PRT relies heavily on the motivation of the child to guide the activities of the session and uses natural reinforcement (e.g. if a child is reaching for a toy car, the therapist will prompt the child to say “car”, before handing over the car to the child). A well-run PRT session will make it appear like the child is playing.
- Discrete Trial Training (DTT) is a highly structured method of teaching where each skill is broken down into smaller components. Each smaller step is taught in an intensive and systematic manner using consistent arbitrary reinforcement (e.g. earning a piece of candy or a high-five for responding correctly) to help a child learn each skill. DTT is often associated with doing drills at a table. This may be true when new skills are introduced to make the initial instruction clear and present targets in a systematic manner. As the child learns each skill, sessions are also conducted in more natural contexts to work on generalization (the ability to apply a skill in different environments).
PRT and DTT are both beneficial teaching methodologies with useful applications. Every behavior technician at Ally Pediatric Therapy will achieve and maintain proficiency in both methodologies, allowing the technician to use the approach best suited to the skills being taught and the motivation of the child.
We use The PEAK Relational Training System as an evaluation tool and curriculum guide to teaching language skills to children with autism and childhood disorders. PEAK, which stands for Promoting the Emergence of Advanced Knowledge, enhances the traditional behavior analytic approach by supporting the development of a comprehensive verbal repertoire, including more complex nuances of the human language. The PEAK system incorporates strategies that help to teach your child to use and understand abstract language, read novel expressions, and decode the meaning of words in the context of the situation.
In addition to PEAK, we also utilize the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP), Assessment of Basic Language and Learning Skills (ABLLS), Assessment of Basic Language and Learning Skills-Revised (ABLLLS-R) and/or Assessment of Functional Living Skills (AFLS), Vineland, SSIS, FBA and FAs as appropriate.
Social Skills Groups
We offer Social Skills Groups to improve your child’s social development. Each group will target an area of development pertaining to your child’s age, including:
- Conversation Skills
- Friendship Skills
- Verbal and Non-verbal Cues
- Social Media Manners & Safety
Groups will be led by a Behavior Technician and a Speech-Language Pathologist Assistant. Each participant will have 3-5 individual goals based on the results of the Social Skills Improvement System completed during the initial assessment. The facilitators will take data throughout the duration of each six-week session. At the end of the final session, a post-assessment will be completed and the goals and data are presented to demonstrate your child’s progress. The ratio of staff to participants for groups ranges from 2:10 to 2:12.
Benefits of a Center-Based Therapy Model
When considering ABA programs for their child, parents face many choices. One important choice is the location and setting for therapy. At Ally Pediatric Therapy, we believe that center-based treatment offers clear and important advantages over in-home treatment for the children we support.
Research demonstrates that participants attending a center-based program significantly increase the number of skills and/or targets learned in each hour of treatment. In one study, twice as many learning objectives were mastered per hour when compared with in-home treatment.
A center allows for greater control over the environment, enabling children to learn more effectively during their sessions and improving the quality of parent education. Center-based treatment also allows children to interact with unfamiliar staff and peers, increasing generalization of learned skills.
Staff training and supervision also plays a critical role in the quality of a program. Research shows that the frequency and quality of supervision is tied directly to program outcomes. A center-based program allows for more frequent and higher quality supervision, which promotes higher rates of mastered targets and skills for each client.
An Illustrative Day in Our Center
Note: Each child is different and each day will look different depending on the individual needs of the child. This example is presented to illustrate what a day could look like.
- 8:00am: Johnny arrives for his first session and is greeted in the lobby by Sue, his first behavior technician. Johnny loves playing with trains so Sue takes Johnny to the train room to start the day. Johnny has difficulty sharing toys with his siblings, so Sue works on the goals that are written into Johnny’s Individualized Treatment Plan (ITP) to help reduce the challenging behaviors he demonstrates while sharing toys. At the end of their session, Sue walks Johnny to Zach, his occupational therapist (OT), and shares any pertinent information from the morning.
- 10:00am: Teaching Johnny to dress himself and better tolerate the feel of certain types of clothing was a main concern of his parents when beginning treatment. Zach works with Johnny on dressing goals that are written into his Occupational Therapy Plan of Care. Zach then walks him to the speech offices for his speech and feeding session with Melissa, his speech-language pathologist (SLP).
- 11:00am: Zach updates Melissa on Johnny’s progress from the morning. Johnny has difficulty with stuttering, so Melissa works on goals from Johnny’s Speech-Language Pathology and Feeding Therapy Plan of Care to help with his speech fluency. Melissa takes Johnny back over to the ABA/OT center for Social Skills Lunch Bunch.
- 12:00pm: During lunch, Johnny works on social skills with other similarly functioning children his age. This group is run by a behavior technician and a speech-language pathologist assistant.
- 12:30pm: Cindy meets Johnny in the lunch room to pick him up for his afternoon session. She takes him to the pretend play room and begins to target his pretend play goals outlined in his ITP. Cindy follows Johnny’s lead to see what he is interested in today and begins playing “car wash” with him. She sets up goals to increase his play skills with narrative through a script. Scripts are varied depending on what Johnny is interested in for the rest of the session.
- 2:30pm: Bob, another behavior technician, will step in for Cindy to increase generalization of the skills Johnny has targeted throughout his day. Johnny’s Mom told Sue this morning that he didn’t get much sleep last night, so Cindy lets Bob know that Johnny was more sluggish than normal towards the end of her session. Bob takes Johnny over to the patio to begin working on some of his daily living skills. They first work on hand washing and head outside. Bob has some activities set up to help Johnny learn how to follow a simple set of instructions to plant in the garden.
- 4:30pm: Utilizing the safety objective of safely crossing the parking lot written into the ITP, Bob will walk Johnny over to the speech offices for his PM care until his Mom arrives for pickup at 5:15pm.