Understanding ABA Therapy: What Parents Need to Know

Understanding ABA Therapy: What Parents Need to Know

Applied Behaviour Analysis (ABA) is often recommended for autistic children, but many parents don't fully understand what it involves.

What Is ABA Therapy?

The Basics

ABA is a type of therapy based on the science of learning and behaviour. It focuses on:

1. Increasing helpful behaviours (communication, social skills, daily living)
2. Decreasing challenging behaviours (tantrums, aggression, self-injury)
3. Teaching new skills by breaking them into manageable steps

The Evidence Base

ABA is one of the most researched autism interventions:

• 40+ years of peer-reviewed studies
• Recognized as effective by:
• U.S. Surgeon General (1999 report on mental health)
• American Academy of Pediatrics

In Ontario, applied behaviour analysis is one of the core clinical services the Ontario Autism Program can fund, based on a child's needs.

How Does ABA Work?

Assessment

Every ABA program starts with assessment:

• Skill assessment: What can your child do now?
• Behaviour assessment: Why is challenging behaviour happening?
• Preference assessment: What motivates your child?

Goal Setting

Based on assessment, the team sets SMART goals:

• Specific: Clear and defined
• Measurable: Can observe and count progress
• Achievable: Realistic for your child
• Relevant: Important for your child's life
• Time-bound: Clear target date

Teaching Methods

Common ABA teaching strategies:

1. Discrete Trial Training (DTT): Structured, repeated practice
2. Natural Environment Training (NET): Learning during play and daily activities
3. Pivotal Response Training (PRT): Child-directed learning
4. Verbal Behavior (VB): Focus on communication

Data Collection

Progress is tracked through:

• Daily session notes
• Skill tracking charts
• Behaviour frequency counts
• Parent feedback

What Does ABA Look Like?

Typical Session

A typical ABA session might include:

1. Warm-up: Relationship-building, preferred activities
2. Skill building: Working on specific goals
3. Breaks: As needed for regulation
4. Practice in natural contexts
5. Parent wrap-up: Review progress and homework

Intensity Levels

The second edition (2020) of practice guidelines from the Council of Autism Service Providers, a U.S. trade group for autism service providers, describes 10-25 hours per week for focused ABA and 30-40 hours per week for comprehensive ABA. Research on the right number of hours is mixed. Some studies link more hours to better results, but one randomized trial with toddlers found no overall difference in outcomes between 15 and 25 hours per week. The right number of hours depends on things like:

• Your child's age
• Current skill levels
• Family goals
• Other therapies/services

Finding a Quality ABA Provider

Red Flags

⚠️ Avoid providers who:

• Use punishment or aversive strategies
• Won't let parents observe sessions
• Don't track progress with data
• Make guarantees about "cure"
• Won't collaborate with other professionals

Green Flags

✓ Look for providers who:

• Use positive reinforcement primarily
• Encourage parent involvement
• Share data regularly
• Individualize programs
• Continuously train their staff
• Are registered with the College of Psychologists and Behaviour Analysts of Ontario as a Behaviour Analyst, or supervised by one

Important Considerations

The Controversy

Some autism rights and neurodiversity advocates have raised concerns about ABA. Their concerns range from its history to current methods and goals. Modern ABA emphasizes:

• Assent (child agrees to participate)
• Individualized goals
• Quality of life outcomes

Your Role as Parent

You are essential to your child's success:

• Collaborate on goal setting
• Practice skills between sessions
• Provide feedback to the team
• Advocate for your child's needs

Sources: American Academy of Pediatrics, Identification, Evaluation, and Management of Children With Autism Spectrum Disorder (Pediatrics, 2020); Behavior Analyst Certification Board, Ethics Code for Behavior Analysts and About Behavior Analysis; Council of Autism Service Providers, ABA practice guidelines (second edition, 2020); Sandbank et al., BMJ, 2023; Rogers et al., Journal of the American Academy of Child and Adolescent Psychiatry, 2021; Leaf et al., Journal of Autism and Developmental Disorders, 2022; Mental Health: A Report of the Surgeon General (1999); Ontario Autism Program core clinical services (ontario.ca); College of Psychologists and Behaviour Analysts of Ontario