By Wendy Ponte
Issue 134, January/February 2006
As infants, most of us learn basic survival and communication skills by observing the details of our environment and how it responds to us. Then, as we grow up, we extend what we have learned to other areas of our lives and into more formal learning situations. For reasons that are still unclear, autistic children are unable to do this.
The process of applied behavioral analysis (ABA) replicates this normally inborn ability with a teaching process that seems to train the brains of autistic children to interact with the world around them.
Behavioral science stems from the work of John Watson in the early 1900s and, later, the work of B. F. Skinner. The term applied behavioral analysis simply means that the principles of behavioral science have been applied to strategies—in this case, strategies designed for autistic children—that help shape behavior.
In the world of autism, most people tend to link ABA with the work of Dr. O. Ivar Lovaas. In fact, Lovaas's model is not the only type of ABA work being used today, but he is generally acknowledged to be the pioneer of this work for autistic children. It was a landmark study conducted by Lovaas in 1987 that first grabbed the attention of the autism community. He began with two similar groups of 19 preschool children who had been diagnosed with autism.1, 2 One group was given intensive home-based ABA therapy for an average of 40 hours per week for two or more years. The second group received less than 10 hours of treatment per week. At the end of the trial period, 47 percent of the ABA group were able to achieve the normal functioning required to attend a mainstream first-grade class,3 while 40 percent were classified as "mildly retarded" and needed some special education. In the control group, only 2 percent were able to attend mainstream first grades, 45 percent were classified as mildly retarded, and 53 percent were considered "severely retarded."
Amazingly, when all of these children were reassessed at the age of 12, eight of the nine ABA children who had been "mainstreamed" for first grade were still indistinguishable from their typical peers. The ninth continued to have some mild learning problems.
Catherine Maurice's riveting book, Let Me Hear Your Voice, 4 is generally credited with making ABA known to the world at large. It is the story of how two of her children, both diagnosed with severe autism, recovered through the use of home-based ABA therapy at a time when the process was not well known, and was treated with skepticism by many who had heard of it.
The process of ABA therapy can be grueling at first—most autistic children need to be taught how to pay attention, cooperate, and imitate behavior. Tasks are broken down into their smallest components, which are then taught one at a time (see sidebar, "A Sample Task Analysis in ABA"). The goals are to minimize failure and liberally reward success. In the beginning, rewards are often favorite foods or time spent with a favorite toy. Over time, children who have had success with ABA begin to automatically apply what they learn in certain tasks to other areas of their lives. This process of generalization is the ultimate goal of ABA therapy.
Since the 1980s, Lovaas's study has been replicated more than once, with similar successful results. Once highly controversial, ABA is now generally considered a reliable method of helping children learn to live with the effects of autism.
1. O. Ivar Lovaas, "Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children," Journal of Consulting and Clinical Psychology 55 (1987): 3–9.
2. Stephen R. Anderson and Raymond G. Romanczyk, "Early Intervention for Young Children with Autism: Continuum-Based Behavioral Models," Journal of the Association for Persons with Severe Handicaps 24, no. 3 (Fall 1999): 166.
3. See Note 1.
4. Catherine Maurice, Let Me Hear Your Voice, reprint edition (New York: Ballantine Books, 1994).