Conceptually systematic: a dimension of ABA

There are seven dimensions of applied behavior analysis; conceptually systematic may be the one that needs a bit more explanation…

Applied behavior analysis (ABA) is a controversial and unfortunately divisive topic in the field of autism treatment. From parents who believe behavioral techniques have helped their children on the spectrum thrive, to adults with autism who believe treatment is paramount to abuse.

To Autism Parents Magazine we believe parents need all the latest relevant information to make informed decisions for their child and family. Although the information provided should not be taken as an endorsement of the ABA, it may be useful for parents who are wondering about some of the more complicated terms – such as conceptually systematic – and the role these concepts play according to the seven fundamental dimensions of ABA.

What is Applied Behavior Analysis?

Before discussing the specific dimensions of behavior analysis, it may be useful to provide a brief explanation of what evidence-based therapy is. Ole Ivar Lovaas pioneered ABA interventions to reduce challenging behaviors and develop communicative language for children on the spectrum (Smith & Eikeseth, 2011).

A definition by Cooper, Heron, and Heward (2007) tells us that it is a scientific approach to discovering environmental variables that reliably influence socially significant behaviors. Another definition (Leaf et al., 2021) referring to the practice of ABA, mentions “the application of behavior analysis principles to improve socially important behaviors, which may include several types of interventions”.

Simply put, it is a scientific approach to understanding behavior better. ABA therapy uses such understanding to change behaviors. For some autistic adults who wish to see treatment abolished, improvement involves modifying behavior to fit a neurotypical view of what is appropriate. They believe ABA is about making children “less autistic,” rather than truly enriching their lives. Conversely, proponents of evidence-based treatment, which they claim targets functionally appropriate behavior, believe it improves the quality of life of children with autism.

It is important to note that the modern use of the term ABA is almost like an umbrella; it covers a range of therapeutic approaches aimed at breaking down desirable behaviors or skills and encouraging those behaviors with a reward. Therapists can also target behaviors that interfere with progress, using various interventions and principles to replace those behaviors with more positive behaviors.

As mentioned, this feeling may be the source of the backlash against ABA: desirable or positive behaviors are often classified according to neurotypical norms. For example, a child who lowers their gaze when having a conversation may be encouraged to maintain eye contact – their lack of gaze may be seen as interfering with appropriate and focused social interaction in therapy sessions.

Special offer

Don’t miss our special offer.
Click here to find out more

For the autistic child, however, maintaining eye contact can be difficult, even painful. A behavior analyst may view averted gaze as undesirable and use intervention and rewards to establish better eye contact. Those who wonder about ABA therapy may wonder if the child actually enjoys or really benefits from the “desired behavior”. Yes, eye contact is socially meaningful, but for whom?

Is it really necessary for people with autism to maintain eye contact, or is avoidance only desirable for neurotypical people who expect this behavior? Intervention to change behavior becomes much murkier when the motivation behind such change is no longer viewed from a neurotypical perspective. Worryingly, children still report finding eye contact uncomfortable or meaningless after the procedure, but say they force themselves to do so to please their therapist or for reward.

On the other hand, behavioral change (the child may possibly maintain the gaze in other settings outside of therapy, such as school) can lead to the child being included and accepted by their peers as they communicate in a familiar way. The autistic child accommodating the neurotypical child for social acceptance is a topic that deserves more attention.

Controversy aside, parents may want to consider the various ABA dimensions to help inform their opinion of behavioral techniques. When a child is diagnosed with autism, ABA can be one of the main recommendations. Parents should therefore do their own research, in advance, to enable informed decision-making.

The Seven Dimensions of ABA

Applied behavior analysis interventions or techniques fall under seven fundamental dimensions as described by Baer, ​​Wolf and Risley (1968). Dimensions are often arranged to form the easy-to-remember GET A CAB:

  • Generality: the desired skill or behavioral goal must be taught, practiced, and achieved in settings other than the training environment alone. Even when the therapy stops, the child must implement what he has learned in several environments. Generalizing new skills to contexts outside of therapy can be a challenge for children with autism
  • Efficient: the intervention should actually produce practical changes in behavior. In other words, he should actually change the behavior he set out to change. By collecting data, the therapist can monitor whether behavior is changing in a practical way
  • Technological: the ABA procedures and interventions used should be described in detail and clearly. The written plan should be concise and explain the procedures in order to inform team members in a way that allows for standardized and high quality treatment
  • Applied: the changes sought must be in socially meaningful, relevant behaviors in the child’s life (and in the life of their family) rather than simply in therapy
  • Conceptually systematic: while the concept will be broadened, essentially, this central dimension aims to ensure that the child’s intervention is research-based and representative of the principles of ACA; therefore, each intervention must be described in the language of ABA and the behavior analyst must be able to explain these interventions in terms of the basics of behavior analysis
  • Analytic: To make informed treatment decisions, the child’s treatment plan should always include the use of data. Using the data, the therapist will be able to show how interventions change behavior; if a certain variable is applied, the behavior changes, while removing that variable makes the change disappear. Data shows when particular changes are warranted and also whether implementing those changes is effective
  • Behavioral: The behaviors that a therapist wishes to work on (as outlined in the treatment plan) must be measurable and observable. As data is collected, having measurable goals means the therapist can check for improvement or lack of improvement

Those advocating the use of ABA state that all seven dimensions must be integrated into the child’s treatment plan to ensure that it is effective, socially meaningful, and actually causes behavioral change from measurable way to help the child thrive. Bringing it all together, the plan must be conceptually systematic – every technique, every intervention, even the language used, must therefore relate to the larger conceptual goal of ABA.

Conceptually systematic

Because ABA has become a broad term, there is a danger that philosophies and methods from other disciplines will be used rather than the evidence-based principles of ABA. Additionally, therapists may be tempted to use shortcuts to achieve smaller behavioral changes. This fundamental dimension therefore seems to be a reminder to therapists to constantly rely on the principles of behavior and to always use them in every technique or intervention they use.

Advocates of ABA rely on the scientific backing that sets the treatment apart from other autism interventions. According to Dillenburger (2015), evidence for ABA interventions involves all accepted research methodologies, including: “single system design (SSD), randomized controlled trials (RCTs), meta-analysis, and sequential meta-analysis , systematic reviews, social validity studies, neuroscience studies and cost-benefit analysis.

The fact that it is one of the only autism treatments backed by substantial empirical research is one of the reasons it is often recommended by medical professionals. Of course, this only applies if such an intervention is conceptually systematic (in practice this means that all procedures are derived from ABA principles rather than shortcuts or tricks to see what works).

When behavior analysts and the entire ABA treatment team use the same language and all interventions conform to the principles demonstrated in the literature and research, the fundamental dimension of conceptual systematics is respected. This still does not mean that the treatment is appropriate or beneficial for every child on the spectrum, it does mean that the intervention represents the authentic concepts of ABA.

References:

Baer, ​​DM, Wolf, MM and Risley, TR (1968). Some current dimensions of the application of behavioral analysis. Journal of Applied Behavior Analysis, 1(1), 91–97. https://doi.org/10.1901/jaba.1968.1-91.

Cooper JO, Heron TE, Heward WL (2007) Applied Behavior Analysis (2nd ed.) Upper Saddle River, New Jersey: Pearson; 2007

Dillenburger, Karola. “Evidence-Based Management and Intervention for Autism Spectrum Disorders”. Autism Spectrum Disorder – Recent Advances, edited by Michael Fitzgerald, IntechOpen, 2015. 10.5772/58983.

Leaf, JB, Cihon, JH, Leaf, R., McEachin, J., Liu, N., Russell, N., Unumb, L., Shapiro, S. & Khosrowshahi, D. (2021). Concerns about ABA-based intervention: an assessment and recommendations. Journal of Autism and Developmental Disabilities, 10.1007/s10803-021-05137-y. Early online publication. https://doi.org/10.1007/s10803-021-05137-y.

Smith, T., & Eikeseth, S. (2011). O. Ivar Lovaas: pioneer of applied behavior analysis and intervention with children with autism. Journal of Autism and Developmental Disabilities, 41(3), 375–378. https://doi.org/10.1007/s10803-010-1162-0.