Glossary of ABA terms at the bottom. FAQ 2
Table of Contents
I was asked recently for a definition of ABA. I quickly found that when googling “What is ABA?”, the results are heavily weighted in ABA’s favor. The top result was Autism Speaks (a notorious anti-autistic, fear-mongering organization). Autism Speaks paints a lovely picture, pointing to increased language and adaptive behaviors, ABA being around since the 60s, individualistic, “evidence-based,” and how qualified BCBAs are doing the programming.
It neglects to mention any prevalent controversies or professional complaints in the field. It leaves out the emerging evidence that long-term ABA has adverse effects. And it conveniently doesn’t mention the RBT’s role in ABA or the suspect nature of ABA research.
No wonder this person was having a hard time finding a comprehensive definition.
Since major ABA organizations like ABA-I have taken over the conversation on what ABA is, there is a lot of misunderstanding in every community.
ABA practitioners often have a rosy view of ABA, unaware of a movement from the autistic community against it.
Parents are thrown into a position where every doctor and autism resource is catastrophizing their child, telling them their child will never be able to care for themselves or communicate if they don’t act now.
Autistic people, especially newly diagnosed, may have heard of the controversy and use catchy slogans like “ABA is conversion therapy” that they’ve seen in the community without a real understanding of what ABA is and why it’s problematic.
Which makes informed, nuanced conversations between these groups nearly impossible.
What is ABA?
Applied behavior analysis is an extension of the field of behaviorism. Put simply, behaviorism believes in shaping human and non-human animal behavior through rewards and punishments. ABA uses reinforcers to change behavior according to the social, motor, and other functional/adaptive goals that the client sets. It also seeks to decrease “problem behaviors,” which are loosely defined but typically include behaviors like self-harm, aggression, eloping (running away), and “vocal non-compliance” (which can involve saying no, screaming, crying, etc.)
ABA does not focus on the emotional domain, as it is a purely behavioral-focused therapy. Only cognitive therapies like cognitive behavioral therapy (CBT) handle cognitive/emotional processes directly. While ABA and CBT may share the name “behavioral therapy,” the method and focus of the therapy are very different.
Behavioral therapies like ABA aim to create greater socialization, self-sufficiency (often referred to as adaptive skills), and communication skills through changing behavior with rewards and punishments. The problem is defining those goals as they are subjective goals that ABA therapists attempt to make objective.
ABA can be applied across various contexts. Many ABA providers are trying to re-contextualize it to treat substance abuse, alter education, or provide treatment for other mental health disorders. Despite this, the most widespread use of ABA is on young autistic children, usually between the ages of 2-7. As such, this is the ABA that I am talking about. My concerns about it applied elsewhere stem from my worries about assent from minors/vulnerable populations, but my focus is ABA on autistic children.
How is ABA done?
ABA is used as a description of a field of many practices, so there is no one way that ABA is done. All ABA, however, share some characteristics and are based on the same fundamental principles.
The structure of ABA involves a board-certified behavior analyst (BCBA) who possesses a master’s degree and has obtained certification from the Behavior Analyst Certification Board (BACB, which isn’t confusing at all /s). The BCBA usually meets with the parents and child and does an assessment of some type. The assessment typically assesses the skills the child currently has compared to what the assessment determines is typical for the child’s age. The broad term for this process (including parent interviews, observation, and formal assessment) is a Functional Behavior Assessment (FBA).
They may also do something called a Functional Analysis. A Functional Analysis seeks to scientifically determine the function of a behavior. To determine this, they test a child using things that are known triggers to see if the child reacts. This is to determine if the “problem behavior” is for the function of access, escape, attention, or automatic reinforcement. Because it uses children’s triggers and is often used on non-speaking children, ethical issues can be very prevalent in my experience.
The function of access, escape, attention, and automatic reinforcement believes that ALL behavior (and in the context of the therapy, ALL autistic behavior) falls into four categories. Access believes the child is doing something to gain something (typically tangible, like a toy). Escape believes they are doing it to avoid something (typically unwanted tasks or sensory). Attention believes they are doing something to get attention (get a reaction). Automatic reinforcement is doing something to return to homeostasis (like stimming).
Following this assessment, a treatment plan will begin targeting behaviors using these functions. Generally, if something is for the function of access, you make the thing the child wants access to unavailable until they provide the desired behavior. If it’s escape, you return the child to the task and model appropriate ways of asking for escape or not letting them up until they finish. If it’s attention, many therapists will use planned ignoring, where the therapists ignore a child until they stop doing the attention behavior or display the “appropriate way” to ask for attention.
The ones actually performing this therapy are called Registered Behavior Technicians (RBTs). They are currently only required by the BACB to have a high school diploma, complete a 40 hr training, and pass the RBT exam. They are not allowed to create the programming, but they are the ones implementing the program. Generally, most training programs very minimally prepare RBTs to handle behaviors such as aggression (with emphasis on restraint in many places) and very little information about autism.
RBTs must have 5% of their hours supervised, but only half of those have to be individual. So if an RBT works 40 hrs a week, only 4 hrs per month have to be individual supervision.
The RBT (generally one-on-one) will run the child through their goals, collecting data from trials. For NET, they will follow the child around and figure out ways to incorporate goals. This may look like stopping a child at a slide and saying “go” before letting the child down the slide or bringing the child to sit next to another child and play alongside them. For DTT, they would sit the child down with flashcards or objects and have the child label them. A kid would be rewarded with a wanted item, break, or other reinforcers for labeling correctly.
All ABA therapists use the “prompt hierarchy” (also called errorless teaching). The prompt hierarchy consists of verbal, second verbal, gestural, model, partial physical, and full physical. This means you work from “least restrictive to most restrictive” until the child performs the desired behavior. For example, if I want a kid to put on their shoes, I would remind them to put them on, tell them again, gesture at the shoes, model grabbing the shoes and putting them on, touch the kid’s hand to prompt them to put them on, and finally, grab the kid’s hands and have them put on their shoes.
The final concept crucial to all ABA I’ll present is the ABCs of behavior. The ABCs of behavior is antecedent, behavior, and consequence. All behavior has the factors immediately before that elicit a response, the behavior, and the consequence of that behavior. This is why behaviorists look for the function of the behavior. It’s to see what is reinforcing a behavior to later manipulate it into happening more or less often.
Please let me know if I missed any terms in the glossary or if the definition isn’t correct, more information in part 2.
ABCs of Behavior – The ABCs of behavior is antecedent, behavior, and consequence. That is, all behavior has the factors immediately before that elicit a response, the behavior, and the consequence of that behavior.
Adaptive Skills – Skills of self-sufficiency like personal hygiene, day-to-day activities, interacting with others, managing money, and other functions required to take care of yourself.
Allistic – Not autistic.
Applied Behavior Analysis (ABA) – ABA focuses on shaping behaviors through reinforcement with the goal of improving communication, social, and adaptive functioning. Since it is a branch of behaviorism, it does not focus on the emotional domain or other internal states. It also seeks to decrease “problem behaviors” (as defined by the individual ABA provider). There are many different types and settings.
Aversives – harsh or abusive punishments like beatings, spray bottles, verbal harassment, withholding food, restraint, seclusion, public shaming, uncomfortable noises/sensory stimuli, and shock treatment.
Behavior Analyst Certification Board (BACB) – The independent body overseeing all ABA professionals and programs. It creates ethical standards, tests, requirements and publishes updates about ABA.
Board Certified Behavior Analyst (BCBA) – possesses a master’s degree and has obtained certification from the BACB. The BCBA usually meets with the parents and child, does an assessment of some type, and creates programming for the client that RBTs implement.
Behavioral Therapies – Behavioral therapies like ABA aim to create greater socialization, self-sufficiency (often referred to as adaptive skills), and communication skills through changing behavior with rewards and punishments.
Cognitive Behavioral Therapy (CBT) – CBT is a cognitive therapy that takes a multi-modal approach. It helps people identify their cognitions and consequent behaviors, allowing them to gain better emotional recognition and self-regulation. While ABA and CBT may share the name “behavioral therapy,” the method and focus of the therapy are very different.
Cognitive Therapies – Only cognitive therapies like CBT handle cognitive/emotional processes directly. Cognitive therapies are helpful if the client’s concerns are emotional issues, cognitive distortions, or self-regulation skills.
Conflict of Interest – A personal relationship of a researcher to an organization or consequence that would bias the results. They must be disclosed, but only certain types like financial conflicts of interest are commonly disclosed. One of the most common in ABA is clinical/training conflict of interest, where working in ABA or consulting ABA providers may bias the researcher towards a favorable result.
Desensitization – The process of exposure to an aversive stimulus. It is intended to be done in small iterations of the feared object/sensation but is often practiced as forced exposure to the item/sensation. Improper desensitization practices are traumatic for the client, making it a controversial technique.
Differential Reinforcement – Reinforcing one behavior over another behavior. There are four types, DRI, DRO, DRA, and DRL. DR of incompatible behavior (DRI) seeks to reinforce a behavior that is incompatible with the one the therapist doesn’t want (like chewing gum prevents whistling). DR of other behavior (DRO) reinforces when a behavior doesn’t happen over a period of time. DR of alternative behavior (DRA) reinforces alternative behaviors to the one the therapist wants to reduce (like raising your hand instead of yelling). DR of low rates (DRL) reinforces lower rates of a behavior instead of eliminating the behavior.
Discrete Trial Training (DTT) – Commonly included in old aba. The client is shown many flashcards with requirements to label them, point to the correct one, or do another similar task. After a certain number of correct answers, they are provided with a reinforcer, though punishment is also sometimes used to deter wrong answers or increase the effectiveness of a reinforcer. It is practiced less often due to its historically abusive nature and lack of generalizability.
Discriminative Stimuli (Sd) – An Sd is a stimulus that indicates what behavior someone should be doing. If I call your name, that is an Sd for you to respond.
Early Denver Start Model (EDSM) – Commonly included in new ABA. EDSM was proposed to target younger children (between 18 mo – 5 yrs) to start fostering skills as young as possible. It is highly effective at teaching skills but is questioned for the vulnerability of the population it’s used on.
Extinction Burst – The immediate increase of behavior after a behaviorist has targeted behavior for reduction. This is somewhat controversial as it can also indicate a withdrawal of consent.
Extinction Plan – A plan a BCBA sets to reduce a “problem behavior” through punishments and reinforcers.
Four Functions of Behavior – The function of access, escape, attention, and automatic reinforcement believes that ALL behavior falls into four categories. Access believes the child is doing something to gain something (typically tangible, like a toy). Escape believes they are doing it to avoid something (typically unwanted tasks or sensory). Attention believes they are doing something to get attention (get a reaction). Automatic reinforcement is doing something to return to homeostasis (like stimming). It is phenomenological, making it difficult to provide evidence for the categories.
Functional Analysis (FA) – A Functional Analysis seeks to scientifically determine the function of a behavior. In order to determine this, they test a child using things that are known triggers to see if the child reacts. This is to determine which of the four functions of behavior are reinforcing the “problem behavior”.
Functional Behavior Assessment (FBA) – The assessment a BCBA or other professional administers to determine the skills and behaviors the child currently has compared to what is typical for the child’s age. This includes parent interviews, observation, formal assessment, and may include a functional analysis. FBAs are not exclusive to ABA.
Group Design – A study design involving more than one participant.
Judge Rotenburg Center (JRC) – An ABA organization that is highlighted at major ABA conventions currently practicing electric shock torture . The shocks they administer are four to twelve times stronger than a police taser. They recently went after an autistic-run non-profit for publishing statements regarding the inhumane treatment.
Motivating Operations – the environment and/or circumstance that will make a reinforcer more or less motivating. For example, if I present a cookie when you’re full, you’re going to want it a lot less than if I present it to you when you’re hungry.
Naturalistic Environment Teaching (NET) – Considered part of the new ABA. Developed in the 80s, NET tried to address the issues with generalizability in DTT. The therapist follows the child and attempts to implement goals using natural reinforcement. It still shares a lot of ABA techniques that were used in DTT.
New ABA – A loosely defined cut-off in time for the evolving field of ABA. ABA therapists often claim that the “new ABA” is good, pointing to advancements in naturalistic techniques that are not as explicitly punitive. The “old ABA” vs. “new ABA” debate has served to silence people that experienced ABA, regarding them as having “old ABA” and therefore not having an informed perspective on current ABA practices.
Non-speaking/Non-speaker – A person that does not communicate verbally. People who did not speak used to be referred to as non-verbal, but this is inaccurate because many non-speakers have verbal abilities to communicate. They may not reliably speak or speak at all.
Non-verbal language – Communication without words, like body language, gestures, or silence.
Old ABA – A loosely defined cut-off in time of what was considered historical ABA. It generally encompasses a conglomerate of unethical practices like the rigidity of DTT, aversives, and punishing autistic behavior like stimming. If you talk to most ABA therapists, they would agree that the old ABA was bad. The “old ABA” vs. “new ABA” debate has served to silence people that experienced ABA, regarding them as having old ABA and therefore not having an informed perspective on current ABA practices.
Ole Ivar Lovaas – One of the attributed founders of ABA. He believed that autistic children were “not people in the psychological sense” and that they responded best to manipulating behavior. One of the major criticisms of “old ABA” is that its methods heavily influenced Lovaas’s involvement in The Feminine Boy Project, which was foundational to conversion therapy for gay and trans youth.
Pairing – The process where a therapist tries to establish themselves as a reinforcer for the child. The therapist gives children non-contingent access to reinforcers like their favorite items, activities, and even food preferences. The therapist provides the child with their full attention and doesn’t make any new demands, showing interest in whatever they are doing. After the child is bonded to the therapist, reinforcement and attention becomes contingent on fulfilling demands. The child has to comply with demands to receive this loving support to which they’ve grown attached. Therapeutic rapport is a more ethical way of establishing client relationships.
Picture Exchange Communication System (PECS) – An ABA speech therapy that involves a child exchanging a picture for a reinforcer. This is highly controversial among speech therapists as generally only a very limited number of communication options are given, and it makes communication contingent which can have a punitive effect on not communicating “the right way.”
Pivotal Response Training (PRT) – Commonly categorized in “new ABA”. PRT sets crucial developmental skills for different ages and attempts to teach children those pivotal skills through reinforcement and punishment. The biggest critique of this therapy is interpreting what skills are pivotal and implementing allistic versions of these skills.
Planned Ignoring – The therapist intentionally ignores the child until attention is requested “the appropriate way” or the child stops doing the behavior the therapist targets for reduction. Highly controversial, but commonly practiced.
Positive Behavior Support/Intervention (PBS or PBI) – Commonly categorized as “new ABA”. System-wide implementation of an ABA approach, generally used in schools. Its goals are to examine the structure and environment, target a specific group using ABA techniques, and finally examine individuals and correct behavior on the individual level. While it does take ABA a step in the right direction by examining the environmental structure, it still contains the problem of ABA ignoring non-behavioral factors.
Problem Behavior – A loosely defined concept that each ABA provider sets for the client. Typically this includes behaviors like self-harm, aggression, eloping (running away), and “vocal non-compliance” (which can include saying no, screaming, crying, etc.). Problem behaviors can be reductivist and generally eliminates the behavior without eliminating the cause.
Prompt Hierarchy (also called errorless teaching) – The prompt hierarchy consists of verbal, second verbal, gestural, model, partial physical, full physical. You work from “least restrictive to most restrictive” until the child performs the desired behavior. For example, if I want a kid to put on their shoes, I would remind them to put them on, tell them again, gesture at the shoes, model grabbing the shoes and putting them on, touch the kid’s hand to prompt them to put them on, and finally grab the kid’s hands and have them put on their shoes.
Punishment – Anything that reduces the frequency of a behavior. Punishment is sorted into two categories, positive and negative (which can be aversive or natural). Positive punishment adds something negative as a consequence to a behavior. Negative punishment removes something as a consequence.
Reinforcer/Reinforcement – Reinforcers/reinforcement is anything that increases the likelihood of a behavior. This similarly has positive and negative. Positive reinforcement means adding something the person likes as a consequence. Negative reinforcement means removing something the person doesn’t like.
Single-Subject Design – A study containing one subject. Behaviorism created single-subject designs to measure baseline and subsequent behaviors, which has been the foundation of much of ABA’s evidence base. While single-study designs can help prove a behavior has successfully changed, they are not generalizable to broad populations. They also only prove that the behavior successfully changed. They don’t adequately address any effects of the intervention beyond behavior change.
Verbal language – Using words to convey meaning, does not have to be spoken.
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