How successful is ABA therapy? Case studies explained
ABA therapy is successful because it’s a tried-and-tested, effective technique that’s proven to help autistic children and adults to develop social, communication and life skills. In fact, ABA therapy has been around since the 1960s and while that makes it a relatively new science, techniques have been developed and enhanced to decrease problem behaviors in children who have been diagnosed as being on the autism spectrum.
ABA is a flexible, customizable therapy that’s tailored to the precise needs of each individual client, outlining clear goals from the outset. The success of ABA therapy is rooted in its ability to address undesirable behavior and encourage positive behavior by rewarding progress. When trained therapists identify a client’s strengths and build on their interests and abilities, children develop communication and social skills that form the bedrock of their ability to thrive unaided in real-life situations.
Is ABA therapy successful?
The statistics speak for themselves. In 1987, research by O. Ivar Lovass Ph.D reported that 90% of children ‘substantially improved’ following intensive ABA therapy. Of children treated in the seminal research study, 47% progressed to become ‘indistinguishable among their peers’ – proving that ABA therapy can help youngsters to develop real-world skills and realize their potential.
A separate study called Intensive Behavioral Treatment for Children with Autism: Four-Year Outcome and Predictors, published in 2005, proved that ABA therapy is successful by demonstrating how quickly problematic behavior can be transformed. The report, by Sallows and Graupner, found that 48% of children experienced rapid improvements in their learning and, at the age of seven, were succeeding in regular education classrooms.
The Surgeon General of the United States has said: “Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and increasing communication, learning and appropriate social behavior.”
According to data released by the Centers for Disease Control and Prevention (CDC) in 2018, one in 37 boys and one in 151 girls in the United States are likely to have Autism Spectrum Disorder (ASD). This highlights the need for ABA therapy to provide autistic children with the best possible start in life.
How do ABA therapists set goals for success?
To illustrate how ABA therapy is successful, Rebekah Kakos, a Board Certified Assistant Behavior Analyst with Illuminate ABA Therapy, explains how setting goals paves the way for tangible results.
“Every client is different and success depends on goals,” says Rebekah. “For one client, the first signs of success can be when they begin to communicate their wants and needs – many cannot do so at first. For another client, appearing to be happy when coming to therapy is also an indication of success. Because of Covid, some clients have not been out of their houses for some time, so simply being away from home is a huge accomplishment. Whether a small indicator of success is evident or a big achievement, ABA therapy provides all the support and tools needed to make life easier for clients and their families.”
Length of therapy is different for every client. Rebekah adds: “I’ve seen children in therapy for 20 hours a week while others have three or four hours. Doctors can recommend 40 hours per week, but that’s a full-time job. We provide the right balance between giving clients time to develop but not burning out.”
Case Study: Child A – 6-year-old male
Getting to grips with communicating his feelings, learning to cope with change and developing life skills topped the agenda when Child A embarked on ABA therapy a year-and-a-half ago. After an initial assessment, and with continuous involvement from his parents, client-specific goals were outlined and therapy began in the child’s home.
“A number of self-management goals were set,” explains Rebekah, adding: “These included learning to tolerate changes in his environment, to practice waiting for what he wanted, being able to tolerate being told ‘no’ and improving his life skills.”
What behavior needed to be addressed? “Prior to therapy, if a routine or schedule were to be interrupted, he would become upset. He didn’t display too many unwelcome behaviors but needed teaching how to cope with change – and to learn that schedules can’t always be followed. I needed to teach him how to be okay with change,” says Rebekah.
What did success look like – and how was it identified? Rebekah explains: “He began to be okay with small changes in play routines. For example, if we were playing a board game, I’d suggest that we swap and I play with the blue piece and he takes the red piece instead. Or I’d take the first turn to go, instead of him. If he wasn’t happy, he started to communicate his feelings to me.
“He developed life skills quickly, such as brushing his teeth and making his bed. He learned how to identify hot versus cold items and not to touch hot items without his mom and dad – essential safety skills. The breakthrough came when he started communicating, telling us how he felt, rather than swiping toys or crying. Of course, most young children have tantrums and cry, but this client needed more time to learn about feelings that made him sad or mad,” Rebekah adds.
“The way forward is to keep working on communication, emotions and self-management skills. Once he is in school full-time he will be able to succeed on his own.”
Case Study: Adult B – 30-year-old male
While ABA therapy is successful for equipping autistic children with educational and personal care skills, the process is effective in supporting adults, too.
Adult B began his treatment in winter 2021, following an initial assessment in his home where he could be observed and assessed in his natural environment. Goals were set: improvement in communication, being out of the house – which had been hindered by Covid shutdowns, following routines and schedules and learning to tolerate change.
Rebekah says: “Managing parents’ expectations is just as important with adults. We have regular parent meetings and parent training with families. We go over basic ABA principles and look at data progress, discussing challenges. Every behavior happens for a reason, whether to gain attention, get an item they want or to escape something the client doesn’t want to do.
“You have to watch closely for breakthroughs. For the first few days, he didn’t want to come to therapy and appeared quiet and unsure of the environment. Now, he comes straight in, walking faster, beginning to smile, laugh and appear comfortable. He started talking more and would request certain games or music to be played and began singing to music. Communication had been challenging at first, with a limited number of interests, so we progressed by focusing on activities that he wanted to engage in to help teach communication skills – in this case, games, music and Subway!”
Rebekah says that the client is already going home and communicating with his parents about how he had a great day with friends. She sums up: “Treatment is ongoing and the end goal is to get him into a day program of structured group activities, designed to be social with peers, get out of the house and develop a routine.”