So, what is this ABA of which you speak?

I’ve been thinking about this a lot,  especially since when I started this post, it was April.  Yikes. OK, so I need to get on the stick a little.

There are lots of websites and blogs out there about “doing ABA”  or “ABA as a treatment for autism”.  I’ve been the “consultant for the ABA program” and an “ABA therapist”.  Once, I got a hard-lined nasty-gram from a mother asking me why I dared to question that all BCBAs weren’t autism consultants.  I’ve been told that ABA is a “proven treatment for autism”,  and I’ve been called “vain” for being a researcher.

(BTW, I just checked my user stats and found out that I come up if you’re looking to date Zac Efron.  Zac, if for some reason you need a behavior analyst, call me.  Otherwise,  I hate to say that I’ve never seen High School Musical).

So, what is this ABA?  Is it a proven autism treatment?  What is the hype?  Should be believe the hype (to paraphrase Flavor Flav)?

Hmm….well, yes and no.

Baer, Wolf and Risley saw this coming.  In 1969, there was this new field called Applied Behavior Analysis.  People thought it might be a good idea to create a journal where Applied Behavior Analysis results could be published.  They called it – you guessed it – the Journal of Applied Behavior Analysis. It still exists today, and boasts a huge readership.  It’s also very tough to get published in JABA.

The field needed direction.  What would be considered Applied Behavior Analysis research?  Intervention? What are the operational definitions of ABA?  Baer, Wolf and Risley set out to provide these definitions in their article “Some Current Dimensions of Applied Behavior Analysis”.  You can read it here.  You can also print a PDF File if you are so inclined.  So what were the dimensions of Applied Behavior Analysis?  Well,  let’s see:

Applied

The intervention needs to address something important.  Well,  in this day and age, I would say autism is pretty darn important.  But, so is the economy.  Global warming.  There are certainly other issues that are important to individuals. For example, my husband gets really annoyed when I forget to uplug my flatiron.  Going to change the world?  Probably not.  Important to him?  I would say so! That is,  Applied is somewhat relative.  That’s why programs and interventions are so individualized – they are contextual.

Behavioral

We change what we can measure or get reliable reports about.  Maybe this is why people think that behaviorists don’t deal with thoughts, feelings, and what we call private events – we do, but not in a way some others might.

For example, I once implemented a functional communication training procedure for a child that reduced their problem behavior.  The parent said to me, “it never occurred to me before that she might have an opinion”.  Am I dealing with her opinions?  No – that’s collateral.  I’m measuring the times she made a choice.  Steve Hayes has done some remarkable work in this area.  Change the behavior, and the thoughts often follow.

The things that we can see and measure are everywhere. Can we just measure autism symptoms or skills kids with autism often lack, to the exclusion of the world around them?  No – that’s silly.  They are but one thing that we can measure.

To make matters a little more complicated, there’s more to this than seeing and measuring behavior.  We also need to look at what’s triggering responding and what’s making us persist.

There are lots of things that trigger our responding.  Sometimes we see something, like a sign that says, “Do Not Enter or You will be Eaten”.  Maybe it’s something we hear, like a siren.  Maybe it’s something we smell, like a latte.  Whatever it is, it prompts us to respond.  Our kids with autism are no different. It’s just that their triggers don’t necessarily seem logical, or they might not respond to as many as we do.  And really, look around you.  Does everyone respond the same way to the same triggers?  Heck, no.  So what?

We’re also very interested in tapping into the motivations of people.  A simplistic, non-behavioral way of saying this is that we find out what is important, and make the learning relevant and important to the learner.  I once had a teacher tell me “I don’t do that behavioral crap anymore.  I used to give M&M’s to the kids when they were good, and put them in time-out when they were bad.  Some kids got better, and some kids got fat.”

Of course.  Because ABA is easy to learn and easy to do, and ABA is easy to mess up.

We’re also sometimes accused of “creating little robots” in the autism field.  If you’re more in the area of reading, one of the criticisms of Direct Instruction is that children become champion decoders with no comprehension.  Is this true?

Only if we don’t take into account the environment.  Comprehension can be taught through behavioral methods.  Variability and spontaneity can be taught as well. Again, it takes a skilled practitioner with lots of experience to untangle the complicated web that is behavior.

Analytic

We’re scientists. We’re objective.   We show results on graphs and with data.  As the late great Joe Lalli was fond of saying, “In G-d we trust.  Everyone else must have data.”  Testimonials aren’t enough.  Nor are opinions. We also need to show that it’s our treatment, and our treatment alone, that made the difference. We do this through manipulation of the data.

This sounds arrogant.  In fact, that might be why we’re sometimes branded that way.  But it’s not.  Let me explain.  Let’s say you broke your leg, and the doctor explains that a typical treatment package consists of 5 days per week of PT,  a low-carb diet, surgery, and standing on your head for at least one hour per day.  You are really wondering about the head standing – what does this do?  Does it make a difference?  If I DON’T stand on my head, will my leg heal?

You ask your doctor, and she says, “Uh…I don’t know.  We’ve just always done it with the head standing, and people report that it makes a difference”

You: “But I don’t stand on my head well, and besides, I’m implementing all these other treatments.  Couldn’t they really be the reason that I’m getting better? And while we’re at it,  why am I on a low-carb diet?”

Doc: “Because people say that people on a low-carb diet tend to be more compliant with the intervention. And maybe you can get better without standing on your head, but why take the chance?”

You: “Have you tested it? I really don’t stand on my head well.  And well, I love bagels.”

Doc: “Uh, no…but I have plenty of testimonials here that say that it works.  I gotta go….”

Yet, how many of us make decisions this way on a daily basis?  I’ll admit that I’ve purchased the first car that I drove without taking data on all of the variables.  Went on a diet without first taking baseline data on my dieting behavior.  Used B12 supplements for my carpal tunnel.  Did yoga for the slipped disks in my neck.

Yes, Gerry Shook, feel free to call me and ask for my certificate back.

Technological

This is where we get into the intervention piece in more detail.  ABA is a “technology” of behavior change – that is,  it’s supposed to be used.  So, as behavior analysts,  we’re supposed to give you the tools so you can use it, too.

Now, for many of you, you hope to read a book or a blog and get the job done.  Again, remember that ABA is easy to do, but easier to mess up.  So, you should be getting guidance along the way from someone who has studied this stuff in-depth.  BCBA is a good start.  You wouldn’t try to do post-surgery PT on that broken leg all by yourself, why would you try to implement a behavior change program on your own?

Conceptual Systems

ABA is not a bag of tricks.  ABA is not a bag of tricks. It’s a systematic way to change behavior using changes in the environment and tapping into personal motivation.  Not everyone is going to respond exactly the same way to a system, no matter how well-tested and user-friendly the system is.  This is why there is no one, set “ABA Manual”.  There never will be one.  It’s all about the data.  I wish things were more simple than that, but honestly, we’re complex animals.

Effective/Generality of Findings

When done correctly,  interventions work, and work in a variety of settings and for lots of different people.

Uh, wait a minute.  I’m confused.  Didn’t you say that interventions are based upon individual data? Yes, I did, and they are.  However, many times we use the same procedures as our framework for most of our clients.  The details might change, but the general concepts will stay the same. That said, when the data say that things aren’t working, we’re not afraid to go “outside the box” for a solution.  Then we test that solution on others to see if maybe we stumbled onto something that improves our practice.  This is how we go about testing for effectiveness and generality of findings.

Almost 40 years later, we have a good body of literature out there on which to base our treatments. Many of our interventions are shown to be effective for lots of different populations in many different circumstances.  Functional Analysis is a good example of an effective, generalized procedure.  But we are still learning.  We will never be done testing ABA interventions, for any population – we still have a lot to learn about effectiveness and generality of findings.  Anyone who tells you differently should be questioned.

Well, that only took the better part of 6 months to write.  Y’all can wake up now… I’m done.