ABCs of Behavioral Support in 2021

Melissa Olive, Ph.D., BCBA-D describes the components of a quality behavioral support program. She discusses controversial characteristics of applied behavioral analysis (ABA) and outlines current ABA best practices. Olive summarizes the “ABC view” of behavior and considers the impact that reinforcement can have in real-world situations. She discusses techniques for increasing and decreasing behaviors, outlines the Functional Behavior Assessment (FBA), and reviews behavior and data collection terminology. She reemphasizes the need for collaboration and encourages the use of ASD guidelines in ABA treatments. The session concludes with Q&A.

Handouts are online HERE
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In this presentation:

2:00 – What ABA is and isn’t

8:30 – Training definitions of/for practitioners

9:24 – ABC’s of Behavior

10:48 – Reinforcement paradigms & environmental effects on behavior

14:00 – Real-world applications

19:00 –Techniques to increase positive behavior & terminology overview

30:58 – FBA and decreasing challenging behaviors

34:55 – Behavior intervention terms and definitions

39:03 – Data collection terms

42:25 – Types of ABA services and ASD guidelines

44:25 – Q&A

Summary:

Applied Behavior Therapy (ABA) is a therapy technique that aims to increase positive behaviors, decrease challenging behaviors, and maintain learned skills across aspects of life (2:20). Progress is achieved by identifying a behavior’s purpose (context) and using reinforcements (positive or negative) to adjust the frequency or severity of that behavior (2:56). ABA is effective and available for children and adults with and without learning disabilities (3:38) and is based on collaborative decision making (i.e., family, practitioners, teachers) (5:15). Historically, ABA has been seen as abusive (4:03) due partly to the use of aversive punishers. However, Olive describes ways that ABA therapies have evolved and explains that aversive practices are no longer in general use (7:19). She also emphasizes the importance of screening and interviewing potential practitioners to ensure a positive collaborative relationship can be built (4:32).

The presenter outlines the ABC’s of behavior as (9:24):

Antecedent → Behavior → Consequence

** where setting events and establishing operations interact before exhibiting a behavior**

Antecedents occur right before (“cause”) a behavior, and consequences occur directly after (reinforce). Setting events happen earlier and can change the way an individual responds later. For example, if a child does not get enough sleep, they will probably be grumpy the next day (12:40). Establishing operations are things that change the value of a reinforcer (13:05), like a favorite food, or strict meal times, etc. Consequences can be added (positive reinforcement) or removed (negative reinforcement) depending on behavior context. Standard techniques used to increase positive behaviors include:

– Modeling (21:46): where patients learn or change behavior by observing someone else’s behavior

– Shaping (22:46): where new behaviors are taught and reinforced with successive approximations

– Chaining (24:45): where tasks are broken down step by step and taught (forward, backward, total presentation)

The speaker notes the importance of all reinforcements eventually being faded out so patients can function independently.

Plans and techniques used to decrease challenging behaviors are developed in concert with a Functional Behavior Assessment (FBA). FBAs focus on understanding why an individual exhibits a behavior based on the ABCs outlined above. They can occur both at school and in ABA programs and are a required practice for building a behavior plan. An FBA generally includes indirect and direct assessments, functional analysis, hypothesis development, and intervention linking (30:58).

Olive notes again that behavior plans should be a collaborative effort with practitioners, families, and teachers. She highlights behavior intervention (34:55) and data collection (39:03) terms to give an idea of what families should look for while creating ABA strategies and stresses the individuality of each plan and patient (36:12). She closes by reemphasizing the critical ingredients of ABA programs:

– Interview potential practitioners and teams

– Have BCBA (board-certified behavior analyst) oversight and trained providers to implement procedures

– Involve other providers and parents

– Ensure ongoing data collection and consequent program adjustments

During the Q&A session, Olive touches on ABA and sensory issues, the need to use behavior intervention before medication, the effectiveness of online therapy, and more.

PDF versions of the ASD guidelines can be found at https://casproviders.org/asd-guidelines/