The use of ABA principles and techniques to treat people with Autism live happy and productive lives has grown quickly in recent years. According to information provided by the Autism Organization, ABA is used all over the world and is recognized as a safe and effective treatment. http://www.autismspeaks.org/whatisit/index.php There have been many studies done in a variety of settings all examining effects of ABA methods on social behaviors. Donald Baer completed the first published study on ABA in 1968 and there was another study by O. Ivar Lovaas done in 1987. These studies both took a look at using behavior modification interventions on Autistic children. The idea was to use early intervention to teach alternate, socially appropriate behaviors. In the study by Lovaas, subjects were assigned to one of two control groups, one that received 40 hours per week of one-to-one treatment, and the other 10 hours or less. Both treatment groups received treatment for at least two years.
The follow up indicated the groups that received the additional treatment did much better in achieving normal intellectual and educational functioning (Lovaas, 1987). Much of the data I reviewed revealed great success in implementing applied behavior analysis in treating Autistic children in replacing or reducing inappropriate behaviors. According to many reports, ABA is considered by many researchers to be the most effective therapeutic approach in treating children with Autism, but in order for the program to be effective, both parents, educators, and other care providers need to be trained (http://autism.healingthresholds.com/therapy/applied-behavior-analysis-aba). How effective is ABA in reducing aggressive behaviors in Autistic students? There’s actually quite a bit of interest in ABA, an increase in demand for the service, and several universities across the United States are involved in studies on the use of ABA.
In a THE FIVE W’S OF CULTURAL DIVERSITY 4 paper published just a decade ago, Tris Smith carefully studied outcome investigations of ABA programs and found convincing evidence that ABA treatment programs have increased adaptive behavior and reduced inappropriate behavior. He also mentioned that this program may raise IQ and other standardized scores, and even reducing the need for special services. Mr. Smith suggest research is needed to confirm results on IQ and test scores (Smith, 1999). The organization, Autism Speaks, has grown into the nation’s largest autism science and advocacy organization, dedicated to funding research into the causes, prevention, treatments and a cure for autism; increasing awareness of autism spectrum disorders.
With several medical professionals with field experience in Autism and behavior intervention programs, they support the use of ABA with children of all ages, with and without disabilities, in many different settings (Green G, Brennan L., and Fein, D. 2002) Several studies have been done on the effectiveness of ABA. My particular interest is will ABA work with aggressive behavior in Autistic students and I found no study that targeted aggression specifically but targeted social behaviors in general. There is a gap in the literature because I found no study that focused specifically on aggressive behavior and provided the data to support that. I will use the data from the student records at my school to fill in the gap.
Reviewing the Literature
ABA is using what we know about behavior to bring about change; to increase or decrease a particular behavior, to improve the quality of a behavior, to stop an old behavior, or teach a new. The number of children being diagnosed with Autism Disorder each year has increased significantly over the past decade. These students’ social behaviors are affected in various
THE FIVE W’S OF CULTURAL DIVERSITY 5 degrees from mild social awkwardness to extreme physical aggression towards themselves and others. It’s extremely important to find successful interventions which can help autistic students improve these socially significant behaviors which include Reading, Academics, Social skills, communication, and adaptive living skills. Keep in mind that adaptive living skills include things like fine and gross motor skills, eating and food preparation, toileting, dressing, personal self care, money and value, and the list goes on but these skills are detrimental to these students future success, not only in school, but in life.
I will be using pre-existing data on students who have attended the school where I work. These student s have moved on but their records are still assessable. I will have to use fictitious names and delete personal information due to privacy. My plan is to use the correlational research method. I will gather the data from my students as well as looking at studies recorded at the Cambridge Center for Behavior Studies, The New Jersey Education Association, and a study published by McEachin S.J., Smith, T., and Lovaas, O.I. in the American Journal of Mental Retardation.
The theory behind ABA is that you can teach children with autism, as well as others, appropriate social behaviors with simplified instructional steps and consistent reinforcement. There are actually a number of techniques that follow the ABA principal. I suggest that we can use the same approach to reduce aggressive behaviors.
Studies directly related
I did find studies related to my question of what effect ABA has on aggressive behavior in Autistic students, even though aggression was not the focus of the study. These studies both used the same ABA principles but with some differences in technique. O. Ivar Lovaas was THE FIVE W’S OF CULTURAL DIVERSITY 6 interested in ABA and wanted to see if it was effective in treating children with Autism. Many autistic children show minimal emotional attachment, absent or abnormal speech, retarded 1Q, ritualistic behaviors, aggression, and self-injury. The prognosis is very poor, and medical therapies have not proven effective. (Lovaas, 1987) He wrote a detailed article about a study and provided a close look at how the study was conducted.
In this study, intensive ABA treatment was provided to one control group of autistic children under the age of 4, but minimal treatment was provided to the other control group. A variety of ABA techniques were used to try and reduce self stimulatory and aggressive behaviors, building compliance to verbal requests, teaching imitation, and to begin teaching appropriate toy play in the first year. The study continued to address significant behaviors over a period of time. When the study was completed, a follow up assessment was conducted and the control group that received the intense treatment had better scores on their IQ tests had higher educational placement, with 47% of them completing normal first grade in a public first grade. Ann M. Baer, Trudylee Rowbury, Donald M. Baer did a similar study that uses a variation of an ABA. The subjects used in this study were not just Autistic but all students had behavior problems.
These students were between the ages of 4 and 6. The study examined the possibility of instructional control over extremely non-compliant children. In this study, a token reward system was used to reinforce appropriate behaviors. The classroom was divided into two sections, one for pre-academic tasks where tokens can be earned, and the other section was a play area where students could exchange their tokens for free time. The students were allowed to choose the task they complete but earned more points or tokens for completing a task the teacher suggest. As a students’ compliance increases, time outs were introduced. When THE FIVE W’S OF CULTURAL DIVERSITY 7 this happened, compliance increased significantly. This study demonstrated two procedures that can be effective in increasing children’s compliance but keep in mind there are many variables that come into play. (Baer, Rowbury, Baer)
Studies tangentially related
All the studies I found were relevant to my question and were also based on the question of whether or not ABA methods were effective in improving behavior.
The subjects in this study were students at my school. There were 9 total, 8 males and 1 female. Each of these students had been diagnosed with Autism. None of these students had received any type of behavior intervention prior to this study. The students were tracked for three months prior to receiving treatment (the first 3 months of school). We were measuring the number of aggressive behavior episodes each school day. After recording incidents in the students for 3 months, ABA treatment on all 9 students began.
The treatment was provided at school by a teacher who was also a certified behavior specialist. The treatment began the 1st of December and we began measuring the behavior incidents two weeks after treatment started. Aggressive behavior was described as behavior that causes, or is intended to cause pain, harm, or damage to oneself, to another person, or to property. Aggressive behavior can be described as mental, verbal, or physical. Inappropriate behavior is when the student is not following rules, is loud or unruly, disruptive, offensive, refusing to complete work, not listening, not cooperating with authority figures, etc.
The design I used was a One-Group Pretest-Posttest. I used a single group and measured THE FIVE W’S OF CULTURAL DIVERSITY 8 them before and after they received applied behavior analysis treatment. I used the T test and paired two samples for means and the results indicated a “t” statistic of 5.199 and a p value of .0004 which is less than 0.05. There is a significant difference between the two means. So what does all this mean to me and my research? It appears as though applying applied behavior analysis techniques may have a positive effect on reducing aggressive behaviors in students with Autism. Of course, there are many factors that can also affect the results such as whether or not students care providers receive in home training, what kind of training have the teachers had, and how many hours of treatment is each student receiving?
The research I’ve done so far did suggest that by providing intense treatment over long periods of time, by ensuring that all care providers and teachers working with the students are highly trained, and these techniques are used consistently and appropriately, the number of behavior incidents will decrease significantly. As I was reading all the literature about ABA and how important it is for individuals implementing these techniques to receive specialized training, and how intense the training should be in order to achieve the optimal results, I became more interested. As I was recording the results after the treatment and in some students I saw really big changes, but in other students the changes were minimal. I also knew that some students care providers had received in-home training while others had not so I was not really surprised by the results. My data analysis findings are pretty much what I expected in some ways but surprising in others.
Both studies done by Lovaas, and several others related to using ABA techniques for behavior intervention therapy, had more control over the variables. In the study done at my school, we did THE FIVE W’S OF CULTURAL DIVERSITY 9 not get to select our subjects based on any specific criteria other than their diagnosis of Autism and no previously recorded ABA treatments were received by the subject prior to our study. Many experts believe that parents and other care providers should receive intense training on ABA techniques in order for the treatment to help. Lovaas devoted an entire study on the importance of parental factors in the success of treatment. He noted that the role parents play is crucial in determining how much progress a child makes. I noticed in our study, the students who had a more significant change in the number of behavior incidents after treatment, also received in home training/treatment. Our district offered in home training to parents as well as treatment. Most of the parents refused the training.
I’ve been working with the Autistic students this year and I noticed that at the beginning of the school year, they all have a lot of difficulty, and many have several behavior incidents. Autistic students need lots of structure and routine. As the students get settled into the routine of being in school, they get used to their new environment, and transitioning around campus, the incidents for most students decrease, even without a certified behavior therapist on site. It’s the more severe students who continue to show the least amount of progress. In Lovaas’s study, he began treatment very early in the child’s life. Even with the child find program, many times, we don’t get to start any type of behavior intervention until 5 or 6 years of age. Many behaviors are already in place by then.
Most of my students came from single parent homes, and more than one child with a disability in the home. Most of our parents had little education and even less training on how to help a child with Autism. There are new studies being done every day in this area. I look forward to finding “easier ways” to teach these students.
It is very challenging, frustrating, and extremely exhausting, but since the number of people being diagnosed in the Autism spectrum is growing THE FIVE W’S OF CULTURAL DIVERSITY 10 Baer, D.M., and Wolf, M.W., Some still current dimensions of Applied Behavior Analysis. Journal of Applied Behavior Analysis, 1987, 209, 313-327 Baer, A. M., Rowbury, T., and Baer, D. M. The development of instructional control over classroom activities of deviant preschool children. Journal of Applied Behavior Analysis, 1973, 61, 289-298 Green, G., Brennan, L., and Fein, D. Intensive behavioral treatment for a toddler at high risk for autism. Behavior Modification, Vol. 26 No. 1, January 2002, 69-102
Koegel, R. L., Russo D. C., and Rincover A., Assessing and Training Teachers in the Generalized use of Behavior Modification with Autistic Children. Journal of Applied Behavior Analysis, 1977, 10, 197-205 Lovaas, O. I., Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 1987, Vol 55, No. 1, 3-9 Lovaas, O. I., Koegel, R. L., Simmons, J. Q., and Stevens, J. Some generalization and follow up measures on autistic children in behavior therapy. Journal of Applied Behavior Analysis, (in press) Smith T. (1999). Outcome of early intervention for children with autism. Clinical Psychology: Research and practice, 6, 33-49