ABA is the acronym for applied behavior analysis. ABA is the application of behavioral principles to solve problems of social significance. It is not one procedure, or even a handful of procedures or therapeutic techniques. It is an entire discipline. ABA is behavioral technology; the principles that are applied to solve meaningful problems are derived from research results in basic behavioral science.
Early and intensive ABA by far is the most effective approach for establishing language, self-help skills, and reducing unwanted behavior with children diagnosed with autism and other developmental disorders.

ABA differs from other approaches in many ways, but a few of the more important aspects are provided below.

(1) ABA is a data-driven discipline. Behavior, goals, and treatments are defined objectively and specifically. This allows reliable data to be collected. Decisions about what treatment to use, and whether or not the treatment actually works, are made by analyzing reliable behavioral data. ABA therefore is a scientific enterprise, and all conclusions must be supported by reliable changes in behavior. Compare this aspect of ABA with other approaches that rarely, if ever, involve extended, direct observation of the individual's behavior and collection of reliable data.

(2) ABA is effective. Over 40 years of research demonstrates that the techniques of applied behavior analysis are effective in creating and sustaining meaningful changes in the behavior of individuals. These techniques have been used to teach new classes of behavior (as in verbal and nonverbal communication, self-help skills, etc.), to reduce or eliminate classes of behavior (problem behavior such as self-injury, aggression, etc.), and to modify existing classes of behavior to better suit the individual's environment. One of the most powerful and meaningful conclusions to be drawn from applied research in behavior analysis is that these techniques are extremely effective across clinical diagnoses, co- morbidities, level of functioning, race, gender, and socioeconomic status.

(3) ABA treatments and strategies are individualized. Each individual's behavior is analyzed and modified according to their specific needs and abilities. There is no treatment or strategy that will work with every person; applied behavior analysts therefore tailor treatment approaches and teaching strategies so that they are effective for that individual. Compare this aspect to most other psychological and pharmacological approaches that have been shown to produce average improvements in a group of people. These approaches are used with many individuals at once, even though it may not have the intended effects on many of the people within the group.

(4) ABA involves the entire family unit. ABA places emphasis on the context in which behavior occurs. It is not enough to simply teach a child to speak; ABA involves parents, teachers, siblings and extended family members whenever possible to create and maintain an environment in which the child will speak on a day-to-day basis. In addition, goals for the child's learning are influenced heavily by the input of family members. This is done to help target classes of behavior that will foster a loving, happy and productive family environment for the child and for all people involved.

Several thousand published research studies have documented the effectiveness of ABA across a wide range of:

* populations (children and adults with mental illness, developmental disabilities and learning disorders)

*interventionists (parents, teachers and staff)

*settings (schools, homes, institutions, group homes, hospitals and business offices), and

*behaviors (language; social, academic, leisure and functional life skills; aggression, self-injury, oppositional and stereotyped behaviors)

Applied behavior analysis is the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree, and to demonstrate that the interventions employed are responsible for the improvement in behavior (Baer, Wolf & Risley, 1968; Sulzer-Azaroff & Mayer, 1991).

"Socially significant behaviors" include reading, academics, social skills, communication, and adaptive living skills. Adaptive living skills include gross and fine motor skills, eating and food preparation, toileting, dressing, personal self-care, domestic skills, time and punctuality, money and value, home and community orientation, and work skills.

ABA methods are used to support persons with autism in at least six ways:

*to increase behaviors (eg reinforcement procedures increase on-task behavior, or social interactions);

*to teach new skills (eg, systematic instruction and reinforcement procedures teach functional life skills, communication skills, or social skills);

*to maintain behaviors (eg, teaching self control and self-monitoring procedures to maintain and generalize job-related social skills);

*to generalize or to transfer behavior from one situation or response to another (eg, from completing assignments in the resource room to performing as well in the mainstream classroom);

*to restrict or narrow conditions under which interfering behaviors occur (eg, modifying the learning environment); and

*to reduce interfering behaviors (eg, self injury or stereotypy).

ABA is an objective discipline. ABA focuses on the reliable measurement and objective evaluation of observable behavior.

Reliable measurement requires that behaviors are defined objectively. Vague terms such as anger, depression, aggression or tantrums are redefined in observable and quantifiable terms, so their frequency, duration or other measurable properties can be directly recorded (Sulzer-Azaroff & Mayer, 1991). For example, a goal to reduce a child's aggressive behavior might define "aggression" as: "attempts, episodes or occurrences (each separated by 10 seconds) of biting, scratching, pinching or pulling hair." "Initiating social interaction with peers" might be defined as: "looking at classmate and verbalizing an appropriate greeting."

ABA interventions require a demonstration of the events that are responsible for the occurrence, or non-occurrence, of behavior. ABA uses methods of analysis that yield convincing, reproducible, and conceptually sensible demonstrations of how to accomplish specific behavior changes (Baer & Risley, 1987). Moreover, these behaviors are evaluated within relevant settings such as schools, homes and the community. The use of single case experimental design to evaluate the effectiveness of individualized interventions is an essential component of programs based upon ABA methodologies. This is a process that includes the following components:

*selection of interfering behavior or behavioral skill deficit

*identification of goals and objectives

*establishment of a method of measuring target behaviors

*evaluation of the current levels of performance (baseline)

*design and implementation of the interventions that teach new skills and/or reduce interfering behaviors

*continuous measurement of target behaviors to determine the effectiveness of the intervention, and

*ongoing evaluation of the effectiveness of the intervention, with modifications made as necessary to maintain and/or increase both the effectiveness and the efficiency of the intervention.

This process incorporates all of the features that constitute a favorable and accountable approach to behavior change (Sulzer-Azaroff & Mayer, 1991).

Hingtgen & Bryson (1972) reviewed over 400 research articles pertinent to the field of autism that were published between 1964 and 1970. They concluded that behaviorally-based interventions demonstrated the most consistent results. In a follow-up study, DeMeyer, Hingtgen & Jackson (1981) reviewed over 1,100 additional studies that appeared in the 1970s. They examined studies that included behaviorally-based interventions as well as interventions based upon a wide range of theoretical foundations. Following a comprehensive review of these studies, DeMeyer, Hingtgen & Jackson (1982) concluded ". . .the overwhelming evidence strongly suggest that the treatment of choice for maximal expansion of the autistic child's behavioral repertoire is a systematic behavioral education program, involving as many child contact hours as possible, and using therapists (including parents) who have been trained in the behavioral techniques" (p.435).

Support of the consistent effectiveness and broad-based application of ABA methods with persons with autism is found in hundreds of additional published reports. Baglio, Benavidiz, Compton, et al (1996) reviewed 251 studies from 1980 to 1995 that reported on the efficacy of behaviorally-based interventions with persons with autism. Baglio, et al (1996) concluded that since 1980, research on behavioral treatment of autistic children has become increasingly sophisticated and encompassing, and that interventions based upon ABA have consistently resulted in positive behavioral outcomes. In their review, categories of target behaviors included aberrant behaviors (ie self injury, aggression), language (ie receptive and expressive skills, augmentative communication), daily living skills (self-care, domestic skills), community living skills (vocational, public transportation and shopping skills), academics (reading, math, spelling, written language), and social skills (reciprocal social interactions, age-appropriate social skills).

In 1987, Lovaas published his report of research conducted with 38 autistic children using methods of applied behavior analysis 40 hours per week. Treatment occurred in the home and school setting. After the first two years, some of the children in the treatment group were able to enterkindergarten with assistance of only 10 hours of discrete trial training per week, and required only minimal assistance while completing first grade. Others, those who did not progress to independent school functioning early in treatment, continued in 40 hours per week of treatment for up to 6 years.

All of the children in the study were re-evaluated between the ages of six and seven by independent evaluators who were blind as to whether the child had been in the treatment or control groups. There were several significant findings:

In the treatment group, 47% passed "normal" first grade and scored average or above on IQ tests. Of the control groups, only one child had a normal first grade placement and average IQ.

Eight of the remaining children in the treatment group were successful in a language disordered classroom and scored a mean IQ of 70 (range = 56-95). Of the control groups, 18 students were in a language disordered class (mean IQ = 70).

Two students in the treatment group were in a class for autistic or retarded children and scored in the profound MR range. By comparison, 21 of the control students were in autistic/MR classes, with a mean IQ of 40.

In contrast to the treatment group which showed significant gains in tested IQ, the control groups' mean IQ did not improve. The mean post-treatment IQ was 83.3 for the treatment group, while only 53.3 for the control groups.

In 1993, McEachin, et al investigated the nine students who achieved the best outcomes in the 1987 Lovaas study. After a thorough evaluation of adaptive functioning, IQ and personality conducted by professionals blind as to the child's treatment status, evaluators could not distinguish treatment subjects from those who were not.

Subsequent to the work of Lovaas and his associates, a number of investigators have addressed outcomes from intensive intervention programs for children with autism. For example, the May Institute reported outcomes on 14 children with autism who received 15 - 20 hours of discrete trial training (Anderson, et al, 1987). While results were not as striking as those reported by Lovaas, significant gains were reported which exceeded those obtained in more traditional treatment paradigms. Similarly, Sheinkopf and Siegel (1998) have recently reported on interventions based upon discrete trial training which resulted in significant gains in the treated children's' IQ, as well as a reduction in the symptoms of autism. It should be noted that subjects in the May and Sheinkopf and Siegel studies were given a far less intense program than those of the Lovaas study, which may have implications regarding the impact of intensity on the effectiveness of treatment.

Finally, according to a cost/benefit analysis conducted by Jacobson, Mulick & Green (1996), competently-delivered, early, intensive behavioral intervention can offer the hope of unprecedented gains for both children and taxpayers: estimated savings per child to age 22 are about $200,000; to age 55, $1,000,000.

Behavioral intervention is not without controversy, despite the empirical support. Detractors theorize behavioral programs produce robotic children. Research reviewed by MADSEC reveals nothing to substantiate this theory. On the contrary, one of the more consistent findings of the research is improved social skills in those children treated (eg Lovaas, 1987; Maurice, 1993). Others question whether Lovaas (1987) used a representative sample of children with autism. While that debate continues, subsequent research using a variety of samples (eg Anderson, et al, 1987; Sheinkopf & Seigel, 1998; Birnbrauer & Leach, 1993; Fenske, et al, 1985) shows that unlike other treatments proposed for autism, there have been no studies which do not support the effectiveness of behavioral intervention. To date, there are no published studies which refute the effectiveness of this approach.