Effectiveness of Applied Behavior Analysis in Treating Autism - Research Paper Example

?Running Head: APPLIED BEHAVIOR ANALYSIS Effectiveness of Applied Behavior Analysis in Treating Autism Effectiveness of Applied Behavior Analysis in Treating Autism Introduction & Background Autism is a pervasive developmental disorder that was first recognized and described by Kanner in 1943. He reported that the three defining features of autism are language impairments, social isolation and insistence on sameness (Mandell, Stahmer & Brodkin, 2008). There is a wide range of behaviors associated with autism; therefore, there is not a "typical" behavioral profile for people with autism and each person's profile is somewhat different (Moldin & Rubenstein, 2006). According to the Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition, autism is a pervasive developmental disorder characterized by the presence of “markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interest” (APA, 2000, p. 70). There are also many other characteristics associated with autism, but they are not defining aspects of the disorder. These characteristics include cognitive impairments, disruptive and violent behaviors (e.g., tantrums), unusual responses to sensory input (e.g., oversensitivity or undersensitivity to smell, touch, taste, sounds or sights) difficulties with sleeping and eating, and abnormalities of mood (American Psychiatric Association, 2000). There is no known cure for autism. However, there are intervention programs that attempt to improve the functioning of children with autism. If children are diagnosed and treated at an early age, the outcomes are better than the outcomes of people who do not receive early services (Alberto & Troutman, 2006). There have been a number of early treatment methods developed for children with autism. These treatment methods vary widely in approach and also vary in their level of empirical validation. Although there are many alternatives used to treat young children with autism, one of the most common educational interventions for children with autism is Applied Behavior Analysis (ABA) Behavioral Theory and Applied Behavioral Analysis (ABA) The ABA approach views autism as a disorder of behavioral deficits and excesses that have a neurological basis. The ABA approach is based on the operant conditioning model (Erba, 2000). The operant conditioning model asserts that behavior that is positively reinforced will continue, while behavior that is punished (e.g., aversives, a verbal "no") or ignored will cease (Lovaas & Smith, 1989). Positive reinforcement is believed to be the main agent of behavioral change (Erba, 2000). Previous research demonstrates that autistic children do not learn from their environment like typically developing children, however they are capable of learning through appropriate instruction (Alberto & Troutman, 2006). Treatment through ABA focuses on systematically teaching small measurable behaviors. Each skill that the child is lacking is taught through dividing the skill down into smaller steps. Each of the steps is taught until the entire skill is taught. Teaching typically occurs on a one-to-one basis in a format called discrete trial training (Alberto & Troutman, 2006). Each step is taught by presenting an instruction or cue and appropriate responses from the child are followed by a reinforcer. The reinforcer used depends on each particular child and what is reinforcing to that individual. When children have difficulty with a task, a prompt such as physical guidance, is often used. In addition, problematic behaviors (e.g., tantrums) are not reinforced and instead are ignored, while the teacher attempts to guide the child to more age-appropriate behavioral responses. Teaching trials are repeated many times and the child's progress is graphed. This tracking of progress through graphing allows for modification of ineffective programs (Alberto & Troutman, 2006). Overall, discrete trial training can be tailored to each child's needs, learning style and pace. Skills developing through this method are also practiced in less structured settings. The goal is gradual progression from one-on-one teaching to small group instruction and then finally to large group instruction. The ultimate goal of ABA is to teach the child how to learn from his/her environment (Alberto & Troutman, 2006). Applied Behavior Analysis (ABA) Research suggests that autism can be managed through the use of a behavioral and educational program. The effectiveness of ABA has been investigated by many studies (e.g., Eikeseth, Smith, Jahr, & Eldevik, 2002; Harris, Handleman, Arnold, & Gordon, 2001; Lovaas, 1987; McEachin, Smith, & Lovaas). As with all treatments for children with autism, often effectiveness is difficult to assess. The difficulty often stems from the lack of a control group not receiving any type of intervention. A control group in this instance is considered unethical because of denying services to children in need. However, a literature review reveals that many studies find ABA effective, suggesting that this intervention has some merit. The investigation that found the most dramatic results was completed by Lovaas (1987). He conducted a study consisting of 38 subjects, divided into control and experimental groups. The experimental and one control group received more than 40 hours and 10 hours or less respectively, and the other control group received some unspecified different treatment. The treatment for the groups lasted two or more years. Lovaas found his method of treatment to be highly successful. Specifically, he found that nearly half (47%) of the children in the experimental group demonstrated normal intellectual and education functioning. He also found that another 40% had mild retardation, while only 10% had profound retardation. In contrast, of the subjects in the control group, only 2% demonstrated normal intellectual and educational functioning, 45% had mild retardation, while 53% had severe retardation. In a follow-up study, McEachin, Smith and Lovaas (1993) reassessed the subjects at a mean age of 11.5 years. Overall, the results of both the original study and the follow-up study demonstrate that almost 90% of the students who were in the experimental group had substantial increases in intellectual functioning and were placed in "less restrictive" educational placements compared to the control groups. Therefore, behavioral treatment might not only produce significant gains for children with autism but these gains might be long lasting. Anderson et al. (1987) carried out a study of 14 preschool-age children who participated in a home-based ABA program. Children received a total of 15-25 hours of individualized instruction per week provided by a combination of a therapist and each child's parents. The children had a statistically significant change in mental age after one year in the program. These gains ranged from 2 to 23 months during the first year of treatment, with a mean increase of almost 10 months. Forty-six percent of children had at least a 13-month gain in their mental age scores, indicating that their progress in general was accelerated to typical rates of development or higher. A significant change in mental age score also occurred between first and second year scores for the five children who completed a second year in the program. Eikeseth, Smith, Jahr, and Eldevik (2002) investigated the effectiveness of ABA with children ages 4 to 7 years. Their study consisted of 25 children assigned to treatment and control groups based on availability of treatment supervisors. Both groups received a minimum of 20 hours of treatment in public schools for typically developing children. The treatment group consisted of 13 children who initially were instructed with discrete trial training and then the focus shifted gradually to help children generalize skills to natural settings and acquire new skills within that setting. In contrast, the control group's (i.e., 12 children) treatment program was eclectic, incorporating elements from a variety of different interventions, such as sensory-motor therapies, and ABA, as well as unspecified methods derived from the investigators' personal experience. After one year of intervention, the children who received behavioral treatment had significantly larger gains than the children who received eclectic treatment. Findings of this study strongly support the superiority of ABA as a treatment method over an eclectic program. Conclusion There is no known cure for autism. Nonetheless, there are intervention programs that attempt to improve the functioning of children with autism. The effectiveness of Applied Behavioral Analysis approach to treating autism in promoting development change and decreasing the symptoms of autism has been investigated by a variety of studies. Studies discussed in this paper have highlighted that ABA is the most effective treatment for changing negative behaviors in children with autism. References Alberto, P. A., & Troutman, A. C. (2006). Applied behavior analysis for teachers (7th ed.). Upper Saddle River, NJ: Prentice Hall. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorder (4th ed., text revision). Washington, DC: Author. Anderson, S.R., Avery, D. L., DiPietro, E. K, Edwards, G. L., & Christian, W. P. (1987). Intensive home-based early intervention with autistic children. Education and Treatment of Children, 10(4),352-366. Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2002). Intensive behavioral treatment at school for 4- to 7-year-old children with autism. A l-year comparison controlled study. Behavior Modification, 26(1),49-68. Erba, H. W. (2000). Early intervention programs for children with autism: Conceptual frameworks for implementations. American Journal of Orthopsychiatry, 70(1), 82-94. Harris, S. L., Handleman, J. S., Arnold, M. S., & Gordon, R. F. (2001). The Douglass developmental disabilities center: Two models of service delivery. In J. S. Handleman & S. L. Harris (Eds.), Preschool Education Programs for Children with Autism (2nd ed., pp. 233-260). Austin, TX: Pro-ed. Lovaas, O., & Smith, T. (1989). A comprehensive behavioral theory of autistic children: Paradigm for research and treatment. Behavior Therapy and Experimental Psychiatry, 20, 17-29. Mandell, D. , Stahmer, A. C. , & Brodkin, E. S. (2008). Autism spectrum disorders in childhood. In T. P. Gullotta , ed. & G. M. Blau (Eds.), Handbook of childhood behavioral issues: Evidence-based approaches to prevention and treatment. New York: Routledge. McEachin, J. J., Smith, T., & Lovaas, O. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation. 97(4), 359-372. Moldin, S. O., ed., & Rubenstein, J. L. R. (Eds.). (2006). Understanding autism: From basic neuroscience to treatment. Boca Raton, FL: Taylor & Francis. Read More