This post summarises changes to the recommendations about ABA (applied behaviour analysis), for the NZ ASD Guideline book published by the New Zealand government. (To see an introduction to the book itself, please refer to my previous post.)
These recommendations appear in a paper published in May 2010 (yes I’m a bit late coming to it, but it was the first I’d heard of the paper, so I thought it worth sharing in the likelihood other parents were unaware too.) They are updates to the existing recommendations in the book, which was published in 2008.
The NZ ASD Guideline defines ABA in the following way: “the process of systematically applying interventions based on the principles of learning theory to improve socially significant behaviours to a meaningful degree and to demonstrate that the interventions employed are responsible for the improvement in behaviour”.
In practice, ABA “refers to a collection of methods and techniques designed to increase positive behaviours and decrease negative ones.” Examples of such methods and techniques include reinforcements, establishing stimulus control, and fading prompts. Decreasing negative behaviours requires consideration of the function of the behaviour at issue. Careful considerations are also required around increasing “positive” behaviours, including “the social validity or importance for the individual’s development, its acceptability to the individual and his or her social network (e.g., family, culture).”
Behaviour changes are ideally maintained and generalised beyond the training situation, and behaviour changes must be monitored.
The paper then clarifies that “[i]t has become quite common for highly structured, intensive early invention programmes to be called “ABA” however this is not correct, since ABA refers to a wide variety of techniques and principles.” Then goes on to define what is meant by “early intensive behavioural intervention” (EIBI).
EIBI is not simply the “Lovaas Method”. It has a variety of features, which are listed on page 5 of the paper (it’s a long and detailed list, do click-through if you’d like all the details.) Those features include that the programme is intensive, year-round, and at least 20 hours a week, usually running for two or more years, and usually starting around the age of two or three years-old.
The paper notes that if you do not see progress by the three month mark, then the system used should be modified. They also note that physically aversive procedures should not be used as part of the programme.
One of the new recommendations made is: “Interventions and strategies based on applied behaviour analysis (ABA) principles should be considered for all children with ASD.” They point out that there is a lack of knowledge though about the suitability of ABA for those with Aspergers, and for people over the age of 15.
There is also a new recommendation about EIBI: “Early intensive behavioural intervention (EIBI) should be considered as a treatment of value for young children with ASD to improve outcomes such as cognitive ability, language skills, and adaptive behaviour.” They again though point out a lack of knowledge about its usefulness for Aspergers, and for diverse cultures. There is also uncertainty about the “optimal intensity of hours” and whom it benefits.
The paper also introduces some new “Good Practice Points”: That cultural awareness is important when using ABA, and that ABA interventions can be used before a confirmed diagnosis; there is no reason to delay access to effective treatment: “Services should not wait for the diagnostic process to be completed but should be available as soon as a significant developmental need is identified.”
That is simply my summary of what I take as the key important points from the paper. Again, I encourage you to click-through to the paper itself if you’d like more detail. (You can also access the 2008 NZ ASD Guideline book online.)