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Behavior problems in children with Autism 

Most individuals with Autism show several behavior issues. Individuals with Autism exhibit difficulties in learning everyday behaviors that are necessary for the social, academic, and personal development. They lack internal motivation and ability to learn from their environment. Instead they engage in various excess and harmful behaviors. Sometimes it may appear that they are lost in their own world. They may be detached from their surroundings and people around them. 

 ABA and  objective of ABA 

ABA is a type of behavior therapy used extensively with Autism. ABA is based on the science of learning and motivation. This science includes general laws regarding how behavior works and how learning takes place. In short, ABA aims to change behavior using the principles of learning. ABA essentially provides techniques to increase good behavior and decrease bad behavior. 

Statistics regarding ABA

ABA is considered to be an “evidence-based best practice” treatment by the US Surgeon General and by the American Psychological Association. “Evidence based” means that ABA has passed scientific tests of its usefulness, quality, and effectiveness. It is recommended that ABA should be started before age 3 and given for 25 to 40 hours per week for best results.

Behaviors that can be targeted using ABA

  • Socially significant behaviors: these are the skills or behaviors required to function in a society or group. These include conversations with other people, playing in a group by following rules and taking turns, behaving appropriately in public, etc
  • Personally important behaviors: these are the skills required for self-help, doing daily activities and personal well-being of an individual. These include washing hands, bathing, wearing clothes, household activities, eating, etc.
  • Academically relevant behaviors: these are the skills related to school work such as alphabet, numbers, colors, shapes, math, reading, etc.
  • Behaviors required to learn all other behaviors: these are the skills necessary to learn all other skills. These skills include attending to tasks, imitating sounds, words, and actions, matching pictures and objects, sitting in a place for extended periods of time, listening to instructions, etc.
  • Excess and harmful behaviors: ABA is used to reduce excess behaviors that may interfere with learning such as hyperactivity, hand flapping etc. ABA also focuses on reducing or eliminating behavior that may be harmful to the individual or others around him.

Settings where ABA can be given

ABA can be provided at school, at home, or in the community depending on the needs of the child and the services that are available in a particular area.

Different teaching procedures: DTT, PRT, Social skills, NET, VB, FBA

  • Discrete Trial Training (DTT): Discrete Trial Training (DTT) is a type of teaching procedure in which each skill is taught separately in a structured manner.
  • Pivotal Response Therapy (PRT): Pivotal Response Therapy (PRT) is used to teach skills that form the bases of all learning. It teaches motivation, learning from multiple cues, self-monitoring, etc which help an individual to increase his overall learning ability.
  • Social Skills Training: School and play are the most important functions of a child. ABA principles are used to teach social skills which facilitate successful school and play behavior. ABA teaches basic independent play skills, playing in a group, social interactions, etc.
  • Natural Environment Teaching (NET): Skills are taught in the child’s natural environment using materials and activities present in that setting. 
  • Verbal Behavior (VB): Verbal Behavior teaches communication using ABA principles. It focuses on communicating the desires and wants of an individual and enabling social interactions.
  • Functional Behavior Assessment: This branch of ABA deals with reducing problem or harmful behaviors. An in-depth assessment is conducted to find out the reason for the harmful behavior and treatment is planned accordingly.

Parent training

Parents are the most important people in a child’s life. Understandably, parents are an indispensable part of ABA. They play a very necessary and critical role in ABA therapy. Studies show that children whose parents are actively engaged in the therapy show very significant improvements. Parents know their child the best. They can provide insightful information that guides ABA therapy. Also, parents are able to continue to prompt the child to learn good behavior and reinforce the child through his and her various daily activities. Parents help in teaching the child to generalize their skills to all settings.

Basic principles of ABA: 

  • Antecedent:  These are events that occur immediately before a behavior. An antecedent is what was happens right before the behavior occurred. It could be an instruction given by the therapist for the child to perform an action.  E.g., “touch your head”, “do the puzzle”
  • Behavior: Everything a person does, say, feel, or think is a behavior. E.g., touching head, completing a puzzle.
  • Consequence: Anything that happens after the behavior has occurred. E.g., reactions from the therapist, a special treat, verbal praise, etc.

Antecedent Manipulations (before the behavior has occurred)

  • Task Clarification: break down task into smaller easier steps. Give clear precise instructions.
  • Environment modification: reduce distractions in the environment. Arrange the environment such that the most interesting thing within sight is the activity you want the child to engage in
  • Routines/ Schedules with breaks: set clear routines with frequent breaks so that the child’s day is structured.
  • Rules/expectations: be very firm and clear with what you are asking the child to do. Set age-appropriate expectations
  • Behavior contracts: written contracts where both individuals sign their acceptance of the terms of the contracts. 
  • Capturing motivation: make the activity interesting by engaging in the activity with the individual. Be cheerful and excited when teaching.

Shaping Behavior

  • Shaping a child’s behavior involves three steps : tell, show, do
    • Tell : Give an Instruction to the child such as “ put your toys back” , wait for few seconds for the child to comply, if the child comply at that point provide a huge reinforcement ( verbal praise, clap, favorite food), if not then  ‘Show’
    • Show : Repeat the instruction by modeling or gesturing what you want the child to do such as “put your toys back like this” by actually picking up a few toys and put them away, wait for again few seconds for the child to comply, if the child comply at this point provide reinforcement but to a lesser degree, if they don’t then ‘Do’
    • Do : Physically prompt the child to complete the behavior of putting the toys back

Consequence Manipulations (things to do after a behavior has occurred)

  • a. Reinforcement: Incentive/ reward given to increase the frequency of behavior. It is used to help increase the probability that a specific behavior will occur in the future but giving a reward/stimulus immediately after the behavior is exhibited. Reinforcement can be both Positive as well as Negative.
    • Positive Reinforcement involves presenting a stimulus to the child after the desired behavior is exhibited making that behavior more likely to occur in future. Eg : A mother gives cookie to his son when he keeps his toys back in the cupboard. Here, cookie is a positive reinforcer to reinforce the behavior of keeping the toys back
    • Negative Reinforcement   involves when a stimulus is removed after the behavior is exhibited. Eg : A child keeps his toys back in the cupboard to avoid solving puzzle which s/he doesn’t like.
  • b. Punishment :  Incentive/Reward taken away to decrease the  frequency of behavior. Punishment is a process by which a consequence immediately follows a behavior which decreases the frequency of that behavior to occur in future. Punishment can be both Positive as well as Negative.
    • Positive punishment involves presenting a negative consequence after an undesirable behavior is exhibited making that behavior less likely to occur in future. Eg : A child engages in aggressive behavior with other children is made to finish two pages of worksheet which he doesn’t like.
    • Negative punishment involves removing a desired stimulus after an undesirable behavior is exhibited . Eg : A child if engages in an aggressive manner, then the teacher take his toy away from him which he likes.
  • c. Token economy : Setting up a clear system of rewards so that the child knows what to expect after behaving in a socially desirable manner and exchanging those tokens/ rewards  for a bigger reward. Eg- collecting 10 coins in a day in exchange of half and hour of cartoon.
  • d. Extinction : Not rewarding/ recognizing a behavior that is undesirable. It involves stop reinforcing a behavior after a point of time resulting in decreased probability of that behavior.
  • e. Planned ignoring : Occurs when an adult ignores minor irritants in a child. It requires the adult to determine which behaviors will stop on its own and which behaviors need intervention, such as physical harm or damage to property.

 

Materials Used in ABA

  • Visual Timers
  • Peg Board puzzles
  • Building blocks
  • Flashcards 
  • Matching cards/ toys
  • Board Games 
  • Picture  schedule
  • Worksheets 
  • Matching worksheets
  • Coloring
  • Tracing 
  • PECS