The most popular autism treatment methods are based on the principles of Applied Behavior Analysis (ABA).
Applied behavior analysis (ABA) is designed to correct behavior and teach skills for dealing with specific situations. It is based on the principle of reinforcement. The theory is that behavior can be changed by rewarding desired behavior and removing reinforcement for unwanted behavior. A person will naturally repeat behaviors for which they are rewarded. Most autism treatment programs include a number of ABA therapies.
These comprehensive treatment approaches differ in their specifics but are highly structured, intensive programs in which the child spends a large amount of time (15-40+ hours per week), usually in one-on-one activities with a therapist or parent, to change behaviors.
The theory is positive behavioral interventions and support are designed to replace problem behaviors with positive behaviors and improve the person's quality of life. This approach requires examination of the individual's unique strengths and problems and development of strategies to improve his or her quality of life overall.
The Applied Behavior Analysis approach teaches social, motor, and verbal behaviors as well as reasoning skills. This approach can be used by a parent, counselor, or certified behavior analyst.
ABA uses careful behavioral observation and positive reinforcement or prompting to teach each step of a behavior. A child's behavior is reinforced with a reward when they perform each of the steps correctly.
Undesirable behaviors, those that interfere with learning and social skills, are watched closely. The goal is to determine what happens to trigger a behavior, and what happens after that behavior to reinforce it. The idea is to remove these triggers and reinforcers from the child's environment. New reinforcers are then used to teach the child a different behavior in response to the same trigger.
ABA autism treatment can include any of several established teaching tools:
• In discrete trial training, a clear instruction is given about a desired behavior (e.g., "Pick up the paper."); if the child responds correctly, the behavior is reinforced (e.g., "Great job! Have an M&M."). If the child doesn't respond correctly, the practitioner gives a gentle prompt (e.g., places child's hand over the paper). The hope is that the child will eventually learn to generalize the correct response.
• Incidental teaching uses the same ideas as discrete trial training, except the goal is to teach behaviors and concepts throughout a child's day-to-day experience.
• Pivotal response training uses techniques to target crucial skills that are important (or pivotal) for many other skills. Thus, if the child improves on one of these pivotal skills, improvements are seen in a wide variety of behaviors that were not specifically trained. The idea is that this approach can help the child generalize behaviors from a therapy setting to everyday settings.
• In fluency building, the practitioner helps the child build up a complex behavior by teaching each element of that behavior until it is automatic or "fluent," using the ABA approach of behavioral observation, reinforcement, and prompting. Then, the more complex behavior can be built from each of these fluent elements.
•Finally, an ABA-related approach for teaching language and communication is called "verbal behavior" or VB for short. In VB, the practitioner analyzes the child's language skills, then teaches and reinforces more useful and complex language skills.
Many experts believe that children with autism are less likely than other children to learn from the everyday environment. The ABA approach attempts to fill this gap by providing teaching tools that focus on simplified instructional steps and consistent reinforcement for autism treatment. Research suggests that this positive outcome is more common for children who have received early intervention. This may be due to critical brain development that occurs during the preschool years and can be affected by training.
Experts disagree as to whether the ABA approach should be used alone or along with other autism treatment methods. While there are varied opinions, most practitioners agree upon the importance of early intervention, intensive treatment for as much time as possible each day (in the range of 25 to 40 hours per week), well-trained practitioners, and consistent application of the ABA approach within and outside of school. A crucial element is finding appropriate reinforcement for each child. Because praise may not be rewarding for these children, careful analysis of each child's behavior can help reveal more effective reinforcement tools. Examples of successful reinforcers may include access to a favorite toy or chair.
If you have the money, you can hire an ABA consultant and ABA therapists to work with your child. If you do not have the money, you may have to sacrifice your career to work with your child from age three to six to teach him what he needs to learn before he goes to school. What he learns now will determine how independent he will be as an adult.
There is no guarantee that ABA is the correct autism treatment for any child of autism, but he or she will be better off for having learned some important skills. You have a small window of opportunity to teach him. Use it wisely and put everything else on hold. Your child is the reason God brought you into this world at this moment - there is nothing else more important!
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