We keep hearing references to ‘old ABA’ or ‘Lovaas style ABA’ in a way which suggests that it is now out-of-date and old fashioned. This can bring many misconceptions and concerns, so clarification is needed. ABA has not changed, although, it has been refined. It has not been superseded by alternate strategies. It continues to build a strong evidence support base.
Let us start by looking at some definitions: ABA – whatever its style, is just applying all we have learnt about the cause and maintenance of behaviours from cumulative evidence collected over time, in order to manage behaviour in a given situation. We need to analyse the situation looking at all possible variables, as each situation and each individual will be unique. Hence the label of Applied Behavioural Analysis. This analysis allows us to plan an individual intervention and if our analysis is correct we can produce an effective program.
Discrete Trial Training (or DTT) is simply providing a contingent consequence to each instruction (Discriminative Stimulus) given in a teaching situation. Obviously the consequence needs to be shaping the behaviour in the desired and planned for direction, to make it either more or less likely for that behaviour to reoccur. This has to be the basis of most effective teaching as no opportunity to teach is lost when every instruction is given appropriate feedback. DTT tends to vary according to the way that prompts and feedback are given. Unfortunately sometimes it is done in such a way that the child does not feel motivated and engaged, and consequences given are actually not seen as reinforcing for the child. Many practitioners have learnt to go through the actions of delivering instructions, prompts and feedback without considering the child. So DTT has been given bad press.
Lovaas used DTT, over a quarter of a century ago, when working with preschoolers with ASD and proved that they can improve to where some no longer have obvious symptoms. He mostly used Trial – Trial Prompt, or what we (ISADD) call No-No-Show, as that is the easiest to ensure consistency across trainers and to reduce possibility for Prompt-bound behaviour getting established. This is well supported by research. However there are also other ways of prompting which need to be considered for individual situations where No-No-Show may not be appropriate.
Lovaas, always emphasised that it is essential that the child enjoy the session and motivation needs to be high, and secondly he emphasised the need for compliance if learning is to proceed at optimal pace. His critics seem to only have noted the last. If the child is not happy, if the child tries to escape there will be no learning. In that case we need to review the procedures. There are a number of options in delivering feedback and prompts. Given well trained therapists and parents we can vary the type of DTT we use to suit the situation. We need to find what suits the child and we need to be flexible. At the same time we need to provide consistency, give appropriate feedback, and not allow the child to end a learning situation, before some learning takes place.
So what has changed about “ABA”? As I see it, it is no more than balancing the rules of social efficacy with the rules of learning. Social efficacy makes us check for the social acceptability of a procedure. We know that it is not socially acceptable to treat babies in the same way we would treat a school aged child who is noncompliant, nor is it acceptable to use pain as punishment even if learning may take place. At the same time it is our task to make the baby comply if he/she is to progress. DTT must still be applied and contingent positive consequences are need if the toddler is to discriminate between the correct response and the incorrect. The child must enjoy the situation, once he/she has learnt that positive consequences are available and attainable, and the positive consequences need to be something the child likes and wants. Punishment, other than opportunity lost to get a reinforcer, is not acceptable. However to ensure the discrimination is obvious, some little signal, like facial expression, head shake or a quiet “nuh” will be needed in cases where the child is learning to make a choice.
ABA and the laws of learning have not changed over the years. What has changed is our better understanding of the details of the learning process and our ability to achieve more accurate analyses of situations a child faces. This is a result of cumulative research evidence, hours of practice and fine tuning of basic principles. However it takes a lot of effort. Unfortunately it is much easier to forgo the rigours of fine tuned ABA and focus on having a nice time with the child. With all the alternatives to ABA on offer, always ask to see the long-term results. There is no use-by date for good science (which ABA is), but there is always room for advancement.