What Is ABA (Applied Behavioral Analysis) Therapy for Autism?

ABA Therapy Session
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What Is ABA?

ABA is short for Applied Behavioral Analysis, and it is often described as the "gold standard" for autism treatment. Applied Behavioral Analysis (ABA) is a system of autism treatment based on behaviorist theories which, simply put, state that "correct" behaviors can be taught through a system of rewards and consequences (or, more recently, rewards and withholding of rewards). One definition of the technique describes it as follows:

  • Applied - principles applied to socially significant behavior
  • Behavioral - based on scientific principles of behavior
  • Analysis - progress is measured and interventions modified

History of ABA

Dr. Ivar Lovaas, a behavioral psychologist, first applied ABA to autism at the Psychology Department at UCLA in 1987. He believed that social and behavioral skills could be taught, even to profoundly autistic children, through the ABA method. The idea was (and is) that autism is a set of behavioral symptoms which can be modified or "extinguished." When autistic behaviors are no longer evident to the observer, the assumption is that the autism itself has been effectively treated.

When he first began using ABA, Lovaas had no hesitation about employing punishments for non-compliance, some of which could be very harsh. This approach has been modified in most situations, but it is still in use in some settings.

In general, however, "punishment" has been replaced by "withholding of rewards."  For example, a child who does not properly respond to a "mand" (command) will not receive a reward (reinforcer) such as a favorite food.

Whatever one's opinion about Lovaas's approach (and many people feel that ABA is both dehumanizing and inhumane), his idea turned out to be quite correct: many if not most children who receive intensive ABA training learn to behave appropriately at least some of the time -- and some even lose their autism diagnosis after years of intensive therapy.

Whether learning appropriate behavior is the same thing as "being cured" is, of course, a debatable question.

Over time, Lovaas's techniques have been studied and modified by therapists with slightly different visions of behaviorism. Techniques such as "pivotal response" and "language-based ABA" have become well-established autism treatments in their own right.

How ABA Works

The most basic Lovaas method starts with "discrete trials" therapy. A discrete trial consists of a therapist asking a child for a particular behavior (for example, "Johnny, please pick up the spoon"). If the child complies, he is given a "reinforcer" or reward in the form of a tiny food treat, a high five, or any other reward that means something to the child. If the child does not comply, he does not receive the reward, and the trial is repeated.

It's important to note that the specific content of the discrete trials therapy is based on an evaluation of the individual child, his needs, and his abilities. So a child who is already capable of sorting shapes would not be asked to sort shapes indefinitely for rewards -- but would focus on different, more challenging social and/or behavioral tasks.

The very youngest children (under age three) receive a modified form of ABA which is much closer to play therapy than to discrete trials. As they master behaviors, well-trained therapists will start to take children into real-world settings where they can generalize the behaviors they have learned and incorporate them into ordinary social experiences. ABA can also be used, in one of its many forms, with older children, teens, or even adults.

Pros and Cons of ABA as an Autism Treatment

ABA has a reputation for being the most successful form of therapy available for autistic children. It also has a reputation for creating robotic, emotionless children. A bit of truth is in both of these claims.

ABA has been around longer than any other behavioral or developmental intervention for autism. ABA therapists are also required to keep extensive notes on their outcomes.

This means that ABA has been more fully researched and replicated than any other form of therapy. Lovaas and his team can show significant success in their work; according to one Lovaas study:


  • “We found that 48% of all children showed rapid learning, achieved average posttreatment scores, and at age 7, were succeeding in regular education classrooms. These results are consistent with those reported by Lovaas and colleagues (Lovaas, 1987; McEachin, Smith, & Lovaas, 1993).”

There are, however, several "down" sides to ABA. The biggest concern that most families have is the insistence on the part of the Lovaas group that children must receive approximately 40 hours of ABA per week.

Not only do many families feel that this amount of therapy is simply too much for a young child, but few families can afford it. Some school districts will provide an ABA program -- but it is a rare district that is willing to spring for 40 hours a week.

This means that the burden of therapy falls on parents and hired helpers who are often untrained or minimally trained.

How Much ABA Is Enough?

Another down side to ABA is the reality that a great many "practitioners" are, themselves, untrained in the Lovaas Method. This means that, while many are competent providers of discrete trials, they have no clear idea of how to take the skills learned in a home or school environment and help learners to implement those skills in the real world.

As a result, some autistic learners develop "robotic" speech and behavior patterns that are directly drawn from discrete trials. With little support for generalization, they may have a very tough time handling the unexpected.

Is ABA the Best Choice for Your Child?

In general, practitioners suggest that intensive ABA is most appropriate for children with more profound autism, and/or for children who thrive in a structured atmosphere. Unfortunately, there is no good research comparing interventions head to head, which means that parents must make a choice based on (1) practical considerations such as finances and availability of therapy; (2) what works best for the family as a whole; (3) intuition (do you like the idea of a very structured, very intense program for your child? Do you think your child will do well in this program?). Of course, one easy way to find out whether ABA will work for your child and your family is to give it a try. If it works -- terrific! If not, plenty of other options are available.

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