Decades of research support the use of applied behaviour analysis in helping those with autism
What has the global transportation of oil and petrol products got in common with caring for people with autism? Behaviour analysis techniques are used in both areas to help create change and improve outcomes or, in the case of those with autism, improve real quality of life.
In global transportation, for example, behaviour analysis is used to improve crew attitude and how their behaviour relates to safety, crucial to the success of companies such as Chevron and their 3,000 per year deep-sea tanker voyages.
In terms of autism, behaviour analysts (BAs) are helping schools and other organisations utilise these techniques to help the children and adults with severe autism in their care to live as normal lives as possible.
Born in the ‘30s
Applied behaviour analysis (ABA) is the science in which the fundamental principles of behaviour are applied systematically to predict and change socially significant behaviour. It is based upon the work of US psychologist B F Skinner. While studying the behaviour of animals and humans in the early 1930s, he noted how behaviour occurs within the context of a particular environment and how this behaviour can be altered by changing the environment. A 1968 article by Baer, Wolf, and Risley helped standardise the field by outlining the basic dimensions of ABA methodology.
Since that time, the discipline has grown exponentially in its scope and applications in the States and it is starting to gain a foothold in the UK. ABA has been used in a variety of areas, such as medicine, public safety, parenting, education and industrial settings.
ABA and autism
One of the biggest problems facing a child with autism is that because they are often disconnected from the outside world, they don’t develop functional skills, such as social skills and communication, in the way that neuro-typical children do. The BA can work with others to manipulate the environment to cause behaviour to occur, and then shape that behaviour into skills that help the child to get along in life. For example, in a one to one teaching session a BA might want to teach a child to request help or ask for something. They may then place an empty cup in front of the child with a milk carton in view. The BA would then prompt the child to request the item or ask for the milk carton. If the child attempts the request without displaying challenging behaviours, then they would be reinforced with the item they are requesting and/or praise. The basic idea is that BAs want to use a child’s motivation to make learning fun and meaningful.
ABA can also be used to work with dangerous or anti-social behaviours such as self-injury and physical aggression, both of which are common with children with autism. BAs will conduct an assessment and try to figure out what it is that is causing the challenging behaviour and ways to help staff manage that behaviour. For example, if a child learns to hit himself because that’s what gets mum’s attention, he will keep doing it. The BA will teach him safer and more socially meaningful ways to get attention and engage in positive interactions with other people.
Helping adults too
ABA can also provide interventions for adults with autism. BAs can work with staff members on teaching activities such as cooking, recycling or growing vegetables and, for those who can, they may work towards outside employment. For some, it just helps make everyday life easier.
Greg is a 31 year old male diagnosed with autism, learning disability and severe challenging behaviour. Greg engages in inappropriate undressing, in which he will pull his trousers down in front of other people. It was identified that Greg did this every time that he met a specific female member of staff.
Through what is called a functional behaviour assessment, which involved interviews with staff and observations and analysis of data, it was hypothesised that inappropriate undressing was accidentally being reinforced by others. When Greg undressed, he was given verbal and physical attention: a male member of staff would come to support, would take hold of Greg’s hands and tell him to stop.
An intervention was introduced to reduce inappropriate undressing and to teach an alternative method for Greg to gain the desired attention. When Greg meets the specific female member of staff, she greets him by saying hello and offering a hand shake. If he shakes her hand, he is praised. If he inappropriately undresses, she provides no attention and immediately leaves the room. The member of staff supporting Greg would then say “Pull your trousers up” and provide no further attention. Once he does so he is praised and the female member of staff re-enters the room.
Greg responded well to social praise and showed strengths in co-operation and vocal imitation. The identification of why the inappropriate behaviour was happening, the adaptation of the environment around Greg and coaching him to respond differently have all enabled Greg to lead a more normal life.
Although ABA methodology and techniques are very powerful and successful, it should be noted that one of the most important skills a BA must possess is the ability to work collaboratively with others. This includes not only the parents or caregivers but also professionals such as speech and language therapists, psychologists, medical professionals, and occupational therapists.
Catching up with the US
In the UK, ABA is lagging behind the US. This seems to be due to less awareness and acceptance of the field in the UK, where a more traditional model of service has been the norm and ABA is wedged in between health and education in terms of funding. Also, in the States, there has been more time to build up a head of steam through professional organisations and parent groups.
Currently there are less than 50 qualified board certified BAs in the UK. As each BA needs 1,500 supervised practice hours to achieve their professional qualification, this lack of qualified specialists is causing a bottleneck in the system. Inevitably, the UK will catch up, as the evidence that ABA is effective is presented both in the literature and on the ground. Parents are the catalysts for ABA growth and there seems to be growing support throughout the UK.
ABA can help change a young man’s behaviour from socially unacceptable to socially acceptable so that he has the freedom to go out to the cinema or shops. ABA can release a young woman from a solitary existence to socialise with her house companions without showing physical aggression. ABA can help a young child to make eye contact and play. As professionals trying to help people with autism, we have to ask why it is not being used more widely in the UK and provide better exposure to its successes.
Further information
Brad Bezilla is a behaviour analyst based at the Hesley Group, which provides residential, care, education and vocational services for children and adults, all of whom have complex needs, challenging behaviours and severe learning difficulties, arising mainly from autism: www.thehesleygroup.co.uk
For further information about ABA, visit:
www.abainternational.org
This article was first published in issue 49 of SEN Magazine (Nov/Dec 2010).
