Applied Behavior Analysis: The Big Picture and Ultimate Goals
Over the past 50 years, one treatment approach, Applied Behavior Analysis (ABA), has steadily grown in prominence by contributing thousands of studies to the scientific literature, thereby establishing itself as a model of evidence-based practice for treating autism spectrum disorders (ASD). This issue of the Autism Advocate is dedicated to exploring ABA in a way that highlights its utility for people with ASD as well as for parents, teachers and other professionals. As co-editors, we have chosen to emphasize the big-picture accomplishments of ABA and how they relate to the ultimate goals most cherished by those with ASD and their families.
ABA is an applied science based on the principles of behavior, especially those related to operant conditioning. Operant conditioning is a process, best known through the work of Harvard psychologist B.F. Skinner, which focuses on how people learn. In operant conditioning, behavior is influenced by its consequences; specifically, the delivery of positive consequences (reinforcers) that make behavior more likely to occur and the removal of positive consequences that make behavior less likely to occur. The future probability of a behavior is determined by its past consequences. That is how we learn. In addition, behavior is influenced by its antecedents. Thus, stimuli that have been closely associated with reinforcers for certain behaviors (technically, “discriminative stimuli”) are very likely to trigger those behaviors in the future. Putting it all together, we have what is called a three-term contingency (i.e., antecedents-behaviors-consequences). This concept helps us to understand how people learn and, more importantly, how we can teach them new behaviors and encourage them to display behaviors they have already learned. Space limitations do not allow us to do full justice to the wide array of concepts, procedures and strategies that constitute operant conditioning in particular and ABA in general. However, excellent texts are available that describe the approach in detail (e.g., Cooper, Heron, & Heward, 2007) and its application to ASD (e.g., Lovaas, 1981, 2003). These references and some relevant websites and journals are provided, for informational purposes, at the end of this article. In this special issue of the Advocate, we wish to focus on ways to achieve two of the ultimate goals of ABA: validity and quality of life.
Validity refers to whether the procedures we develop can be successfully applied—not in the controlled world of laboratories, clinics and segregated facilities—but rather in the real world of home, school, community and workplace. Valid procedures are ones that can be used by parents, teachers, job coaches and, whenever possible, by people who have ASD. The ultimate goal of valid intervention is to make a positive and pervasive difference in the lives of people with ASD and their families— a difference captured by the term quality of life (QOL). Every article in this special issue not only elucidates varied aspects of ABA, but also reflects high validity and breakthroughs in establishing good QOL.
We begin with an article by O. Ivar Lovaas, Professor Emeritus at UCLA, and the person who, more than anyone in the world, is responsible for the dominant and beneficial influence of ABA on ASD. His article presents a history of ABA, together with important lessons learned—lessons that have served to inform most subsequent work, including that described by other authors in this issue. Svein Eikeseth, a research collaborator of Lovaas, continues in the tradition of his mentor by articulating the essential elements of effective early intervention, an approach noteworthy in clarifying and evaluating the extent to which recovery from ASD is possible. However, since many people with ASD do not recover, a critical question concerns how best to address lifespan issues. Peter Gerhardt discusses meaningful options for people who are beyond childhood, an issue of growing concern to parents, professionals and policymakers. His message is a hopeful one: A good quality of life is possible even in the absence of recovery. It is all a matter of careful planning, clear priorities and skillful support. Since ASD is typically a lifelong concern, families are often under considerable stress in dealing with ongoing behavior and dependency issues. Glen Dunlap offers solutions to these challenges by describing and illustrating home- and community-based strategies that promote family preservation, community integration and constructive outcomes. Robert O’Neill and Lillian Adolphson continue in this vein by amplifying some of the major themes of ecologically valid intervention and focusing on the issue of problem behavior. Aggression, self-injury, tantrums and a host of disruptive behaviors can make family life miserable and education impossible. Their description of functional behavioral assessment and the interventions that flow from it are a powerful demonstration of how ABA can be used to overcome even the most distressing aspects of ASD. Most of the articles just overviewed make clear that ABA involves a lot of hard work and countless hours of intervention effort; hence, the timeliness of Pivotal Response Training (PRT) elucidated by Robert and Lynn Koegel. This breakthrough approach identifies carefully selected targets whose amelioration leads to widespread positive changes. PRT is a model of efficiency, possessing high ecological validity and leading to greatly enhanced QOL. Finally, Doreen Granpeesheh and Jonathan Tarbox present a strong case that ABA, contrary to its stereotype, is capable of successfully addressing and improving complex social and emotional behavior in areas once believed to be the exclusive domain of “neurotypical” people. In sum, the collection of articles just highlighted makes clear that the influence of ABA, in its many forms, is a source of ideas for solving socially significant problems and providing hope for families struggling to deal with the challenges of ASD.
In the concluding article, Edward Carr, Doreen Granpeesheh and Lee Grossman articulate a vision for the future of ABA in ASD. It is a vision that emphasizes the necessity of collaboration across disciplines, systems change, and rethinking our goals and priorities. It is a vision that recognizes that ABA, like all areas of human knowledge, must continue to evolve to address changing circumstances and to capitalize on new opportunities.
Reprinted with the permission of the Autism Society.
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