ABA?

ABA - Applied Behavior Analysis

There are many well-written articles about ABA available on the internet. Despite this, the public seems to have become somewhat confused, and that confusion is only likely to deepen as ABA becomes more visible and government (state and federal) becomes more involved. ABA is, at its most basic level, the use of behavior science in modifying the behaviors of individuals. In other words, it is a tool for achieving certain outcomes, which include reducing problem behaviors, increasing appropriate behaviors, and teaching behaviors or skills. This is incredibly broad, and can apply to children or adults, with or without various disabilities, and individually or in classes.

What it is
In its simplest form, ABA is a method of achieving certain behavioral goals for a child by changing the responses of individuals that interact with the child. This means using careful planning to understand what may trigger certain behaviors in a child and what responses have been used when the child engages in certain behaviors. Once this is understood, then it is easier to help decrease problem behaviors and replace them with appropriate behaviors. Yes, this means that it is "programming the child", but it is helping them to become more successful, which is also called "teaching." Typically when people say, "ABA" they are actually referring to "intensive ABA services", which means working one-on-one with the child (or adult) to modify the behavior, record data, and monitor progress. In reality, "ABA" is such a broad term that it may include intensive services, classwide behavior management, or parent education/consultation. Ideally, a child is receiving support through all of these methods simultaneously.

ABA stands for "Applied Behavior Analysis." The methods of ABA are mostly attributed to the work of B. F. Skinner, though in truth behavior science began well before Skinner, and some of the most important concepts were made popular by Thorndike (the "Law of Effect"). There are two main approaches to modifying behavior: operant conditioning, and associative (or "classical") conditioning. The first method basically means, "If you do ____, then you will get ____." The second method is essentially saying, "When you see ____, then it means that ____ is about to happen." The first relies on the individual doing something, whereas the second helps the individual know what to expect next. These two ideas are very important, but also very vague and not easy to apply. During the 100 years between the early development of behavior science and the present, many specific techniques have been developed to help with applying behavior science in day-to-day use. The result is that we now have a large collection of techniques and strategies that can be used by parents and educators to help children, and we have professionals who are trained specifically in behavior science and can develop new techniques as needed. 

What it's for (not just Autism)
ABA is increasingly popular in the treatment of Autism Spectrum Disorders, and for good reason. Behavior modification techniques are quite possibly the most effective treatment option to address problem behaviors, teach appropriate behaviors, and develop useful life skills in individuals with Autism Spectrum Disorders. Behavior modification is the single most consistently supported treatment option with a great deal of evidence behind it. It is also very flexible because it can be used to develop a wide range of skills (including communication) and reduce a wide variety of problem behaviors. However, this does not mean that ABA = "Autism Treatment."

ABA can (and has been) used for a wide range of disorders (and non-disordered behavior). It simply means "behavior modification", which is useful for children with other developmental disorders, other behavior problems (including ADHD), and non-disordered problem behaviors (such as tantrums, toilet training, or aggressive behaviors). It is a tool, which has many uses. Behavior is essentially anything that an individual does, and behavior modification can be used for any kind of behavior. That means it is highly versatile.

Who does it
This is a more complicated question. In the most hypothetical sense, everyone uses ABA every day when interacting with others (if you smile because someone gave you a compliment, you just used a social reward to increase that behavior in the future). Usually when parents ask this question, they're wanting to know which professionals provide ABA services. Let's look at some professionals that are likely to have some experience with behavior modification.

Behavior science is the most pure representation of psychology, which should mean that psychologists can provide ABA. However, many psychologists do not train in behavior science heavily and would not be qualified to provide ABA services. With that said, there are also many psychologists that do train heavily in behavior science and can provide ABA services. This is not necessarily obvious and parents should feel encouraged to ask about the psychologist's background if seeking behavioral services. As discussed in a moment, we're in a transition phase with respect to behavioral credentialing, which should eventually make it easier to identify a qualified provider.

Teachers must learn effective classroom management strategies, which rely heavily on behavior modification, which should mean that they are familiar with ABA techniques. However, many regular education teachers do not train heavily in behavior science and have other responsibilities, and special education teachers must learn such a wide variety of skills that they are unlikely to be able to provide methodical ABA services (though they can often implement behavior plans within classrooms).

Pediatricians learn about child development as part of their medical training and are almost certain to come across a great deal of literature about behavioral development and behavior modification. However, they are primarily focused on medical health and are likely to refer parents to another professional (such as a psychologist or BCBA) to provide behavioral health services.

Board Certified Behavior Analysts (BCBAs) are specially trained in behavior science and often provide "intensive ABA services." Intensive services essentially means they will spend a lot of time one-on-one with a child (or adult) doing behavior modification techniques to achieve specific goals. BCBAs should also record data demonstrating progress toward specific goals. One very important component of the work a BCBA does is that they are very specific in defining a goal, how the goal will be measured, and tracking progress. Because of the nature of intensive services (many hours per week in one-on-one services), BCBAs are typically not able to see a large number of clients at a time. However, the services they provide may produce rapid gains in specific skills and are extremely valuable in certain circumstances (such as with reducing self-injurious or aggressive behaviors). Education of BCBAs usually includes a Master's level degree, though some have a doctorate (BCBA-D). BCBAs may supervise individuals with less experience or training, such Board Certified Assistant Behavior Analysts (BCaBA) or Registered Behavioral Technicians (RBT).

The BCBA certification is relatively new within the umbrella of psychological services, but is increasingly prevalent and is becoming more likely to be covered by insurance providers. Some psychologists will hold a BCBA credential in addition to their educational degree, but certainly not all. Likewise, some BCBAs may have other educational backgrounds in addition to their training as a BCBA. Seeing a BCBA credential should provide a guarantee of qualifications to provide behavioral services; otherwise, parents should ask about background training. 

How to make the most of it (parent training)
As mentioned earlier, ABA services may include parent education/consultation. In this the parents receive training and support from a professional (often a psychologist or BCBA) to help them understand the child's behavior, the role of the environment and themselves in the behavior, and how to support the child's successful behavior in the future. Many parents may have an expectation that they bring their child to a professional and the professional "fixes" the child's behavior problems. However, this is rarely how things work, and almost never the most effective approach. The child's behavior develops in and responds to the environment. Ignoring the role of the environment (which includes the parents) would be a terrible mistake and could undermine any behavior program the child receives. To make the most of ABA, the parents should be learning at the same time as the child's behavior is changing.