Understanding autism
Understanding autism

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Understanding autism

5.2 Evaluations and views of ABA

ABA has been difficult to formally evaluate for two reasons. Firstly, like TEACCH, it is a highly individualised approach, with outcomes that are tailored to the behaviour of an individual child. Secondly, ABA is no longer a single unified approach, but rather a set of varying procedures, some of which have also been incorporated into other types of intervention.

Attitudes to ABA among families and professionals are sharply divided. Proponents of the approach argue that it is one of the few really effective treatments, which can make dramatic improvements including the potential to develop language skills in non-verbal children. An early intervention based on ABA principles, known as Early Intensive Behavioural Intervention (EIBI), has been evaluated as particularly effective (Peters-Scheffer et al., 2011). One criticism of ABA claims that it is a simplistic tool, which changes ‘surface’ behaviour rather than underlying thought processes. The fact that parents and therapists decide what behaviour should be shaped has led to the further criticism that ABA is ‘adult-directed’, taking away the child’s autonomy, choice and dignity (Devita-Raeburn, 2016). ABA also requires a level of dedication and expense that makes it inaccessible to some families.

Bear these contrasting viewpoints in mind while watching this clip illustrating how a young boy called Joe is helped with his communication skills by therapists using Applied Behavioural Analysis. Watch this clip now.

Download this video clip.Video player: aut_1_wk05_applied-behavioural-analysis.mp4
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Transcript

REBECCA MOSELEY:
Now let's just see.
JOE:
I can have video DVD.
REBECCA MOSELEY:
You'd like that, would you?
JOE:
Yeah.
REBECCA MOSELEY:
Sit down.
SEAN RHODES:
The programme that we're working on with Joe is based on an approach called applied behaviour analysis, which is the scientific study of behaviour in terms of the behaviours that people will use, the responses in the environment that will maintain those behaviours, and understanding whether or not those behaviours are what might be deemed functional or appropriate.
REBECCA MOSELEY:
Joe, have we crossed anything off the menu?
JOE:
No.
REBECCA MOSELEY:
Fantastic.
JOE:
We are having a good day today.
REBECCA MOSELEY:
OK, Joe. You can finish your biscuit now.
ANDY:
He's gone from being a child who could hardly communicate at all-- well, he could, but not really with functional speech-- to a child who's very sociable and talks, and we can't stop him from talking now.
When we first started, we had little temper tantrums, and that's really the way he got his point of view across.
REBECCA MOSELEY:
Go on. Your go.
JOE:
Whoa. My buffers! Bust my buffers! Six.
REBECCA MOSELEY:
Go on, then.
JOE:
One, two, three, four, five, six.
SEAN RHODES:
What we did with Joe when we first started with him was we identified which specific behaviours were affecting his ability to, firstly, interact with other children and other people and specifically looking at what his language deficits were.
- I'm a cheeky boy, am I? What's going to happen to you? Get your tokens off Becc's first rule, OK?
JOE:
But you're a cheeky boy.
REBECCA MOSELEY:
Joe earns tokens for doing things appropriately, so for doing things straightaway or, for example, walking from school to the car without running off ahead and staying with me, for example, or for-- if it's carpet time at school and putting his hand up. Rather than just calling out, putting his hand up and waiting for the teacher to ask him what he wanted to say.
SEAN RHODES:
So what we identified was the kind of activities and object, games, responses that he finds reinforcing and enjoyable. And we taught him how to ask for those things. So that's how we got access to them.
REBECCA MOSELEY:
What does it say?
JOE:
Well, four and five is nine. One, two, three, four, five, six, seven, eight, nine.
REBECCA MOSELEY:
I don't believe it!
JOE:
Yeah!
REBECCA MOSELEY:
How lucky are you? Oh, I just don't believe it.
Joe loves playing Snakes and Ladders with me, and that's because I was trying make it really, really fun and really reinforcing for him, but, at the same time, being able to bring in lots of math targets, as well, and other language skills.
What's going to stop me from winning?
JOE:
The snake.
REBECCA MOSELEY:
What number is that snake on?
JOE:
98.
REBECCA MOSELEY:
So how many do I need to get to land on 98, on the dice? How many spaces?
JOE:
Two.
SEAN RHODES:
It's all very well, us teaching children lots of language. But if they don't have the social situations where they can go and apply those skills we've taught them, then, really, it's a bit pointless teaching them. Playtime is a time when most children get the opportunity to really practise their language. So Joe needs to be able to go out and interact with children at playtime rather than being stood on the periphery, observing.
ANDY:
It has a huge impact on a family running an ABA programme, because we have people working with Joe all day, every day. So Joe has this big entourage of people, and, initially, we started with them working in the house. So it's quite a big thing having people in your home all the time. So it's not easy in the sort that we have another child, as well, and it's not easy for her. But because of the huge progress that Joe's making, it is definitely worth it.
SEAN RHODES:
Right. So you were watching Star Wars 2.
JOE:
What were you watching?
SEAN RHODES:
Well I wasn't watching television Oh was playing my guitar.
JOE:
Yeah.
SEAN RHODES:
Do you play any instruments?
JOE:
I haven't got any.
SEAN RHODES:
What would you like to play?
At the moment, he's doing very well on his conversational targets. He understands how to have a conversation. The difficulty for Joe at the moment is dealing with the speed at which conversations go and the unpredictable nature of conversations, particularly within peer groups.
So you were telling me about rugby. OK. So how do you play rugby?
Well, adults will be far more forgiving within a conversational setting than his peers will be. Hoe needs to be able to think much faster within those conversations.
JOE:
And if you got the ball, somebody grabs you to the ground. And if they don't grab you to the ground, you run, and then you score a try.
SEAN RHODES:
Fantastic. And what you do after you score the try?
JOE:
You say this-- yeah, try!
SEAN RHODES:
That's right. You do.
End transcript
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