Effectiveness of ABA on supporting children with ASD

Abstract

This review article starts with broad categories of ASD interventions and identifies the need to study effectiveness of ABA therapy. It establishes ABA to be gold standard based on research done in the past. Further, it defines ABA and then deep dives into the advantages and limitations of ABA therapy. Finally, it concludes by strongly vouching for ABA as the treatment of choice on the premise that advantages certainly outweigh its limitations

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How to Cite:
Kohli, G., Chandel, N. K., & Agarwal, A. (2022). Effectiveness of ABA on supporting
children with ASD. International Journal of Health Sciences, 6(S2), 14613–14616.
https://doi.org/10.53730/ijhs.v6nS2.8834
International Journal of Health Sciences ISSN 2550-6978 E-ISSN 2550-696X © 2022.
Manuscript submitted: 09 March 2022, Manuscript revised: 18 April 2022, Accepted for publication: 27 May 2022
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Effectiveness of ABA on supporting children
with ASD
Ms. Gurbani Kohli
PhD Scholar, SGT university, Chandu, Budhera, Gurugram, Haryana 122505
Corresponding author email: gurbanisahdev93@gmail.com
Dr. N.K. Chandel
Associate Dean, M.A., M.Phil., Ph.D. Dept of Clinical Psychology at SGT Hospital
& University, Gurgaon, Haryana -122505
Dr. Anant Agarwal
MBBS, DNB – Psychiatry DMC/R/12207 Delhi Medical Council, 2015
Abstract---This review article starts with broad categories of ASD
interventions and identifies the need to study effectiveness of ABA
therapy. It establishes ABA to be gold standard based on research
done in the past. Further, it defines ABA and then deep dives into the
advantages and limitations of ABA therapy. Finally, it concludes by
strongly vouching for ABA as the treatment of choice on the premise
that advantages certainly outweigh its limitations.
Keywords---ABA therapy, autism, ASD, limitations ABA,
interventions.
Introduction
Two different types of ASD interventions are eminent, comprehensive and
focused. Comprehensive treatment models (CTM) consist of a set of
interventions, established within a specific conceptual framework and measured
to result in a broader positive impact on the principal deficits of ASD (Wong, 2015).
Focused interventions (FI) are designed to help improving a single or a small
number of skills of a child with ASD (Odom, 2010). FI are usually defined
operationally, target specific outcomes, and are quicker than CTMs. FI are the
building blocks of CTMs and educational programs for individuals with ASD.
Need for the study
ABA belongs to CTM model and most first-rate assessments of ASD interventions
today unswervingly and unequivocally identify ABA-based interventions as the

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gold standard and treatment of choice for individuals with ASD (Maglione, 2012)
(National Autism Center, 2015) ( New York State Department of Health Bureau ,
2017). In 1987, Dr. Ivar Lovaas, known as the father of Assisted Behavior
Analysis (ABA) therapy proved that early intervention and intensive behavioral
therapy helped children with Autism. He also determined that 90% of children
made substantial gains by receiving ABA therapy (Lovaas, 1987).
Definition of ABA
ABA is founded upon effective learning and teaching principles. ABA can be defined
as a scientific tool that imparts specific skills which are reinforced to achieve
targeted goals. Moreover, it is an individualized approach of teaching that stresses
on increasing appropriate behaviors while decreasing the inappropriate behaviors
(Smith, 2010), creating an environment of growth and learning that is applicable
to all areas of teaching. ABA based interventions can be applied in various
settings ranging from vastly structured programs that are conducted as a one to
one treatment to more holistic programs that include developing children as
models.
Advantages of ABA
The key benefit of the ABA approach is that it breaks down larger skills into small
manageable sub-skills. Then, by using reinforcement techniques, the child learns
and eventually masters each of those sub-skills. In order to implement ABA, a
therapist needs to go through extensive training and is required to get a board
certification .An ABA therapist understands the functions of behaviours
(communication, attention seeking, avoidance ) and develops programs, using
effective teaching techniques like discrete trial teaching (DTT), to meet the
child’s needs.
Concurrent and continuous monitoring ensures enough data to make objective,
data driven decisions in which one is able to achieve measurable changes in
appropriate target behaviors that stand the test of time and environments
(Dillenburger, 2009).The ABA model empowers the therapist to isolate one
behaviour for intervention, thereby decreasing the chances of other variables
influencing the results. A much easier way to assess an intervention compared to
RCT (Randomized Control Trials) that are highly dependent on data from multiple
sources. The success rate with ABA is high as each subskill is introduced one at a
time repeatedly till the child masters the first subskill. ABA has led to positive
developments and changes in relevant social behaviors within the framework of a
child’s social environment (Dillenburger, 2009).
Limitations of ABA
Although there is strong research support for using ABA, there is still statistical
evidence of heterogeneity in response to the therapy. Researchers approach this
heterogeneity by considering two predictors of response to the therapy that are
either child specific or treatment specific variables (Perry A, 2009). Various studies
examine whether child-specific characteristics, such as age (Granpeesheh D,
2009), autism symptom severity (Ben-Itzchak E, 2007), cognitive functioning

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(Ben-Itzchak E, 2007) and adaptive functioning (Makrygianni MK, 2010) affect
response to therapy. Treatment-specific variables, such as treatment intensity
(Reichow B, 2009), teacher training (Koegel RL, 1977), treatment location (Dixon
DR, 2016) and clinical supervision (Dixon DR L. E., 2016) have also been
examined. Treatment ‘dosage’ continues to be a contentious issue that needs to
be studied further to recommend a standard for all the treatment/child specific
variables discussed.
A shortcoming of ABA model is lack of clarity on the question of the no change in
behavior of ASD child with a particular intervention. In that case a Randomized
Control Trial has a clear advantage as each outcome of an intervention would be
backed by similar findings among many children, but the nonexistence of
previous results in case of ABA does not guide the therapist . For example, the
therapist would not know if other variables had been introduced during the
course of the therapy for a particular intervention. Another disadvantage is the
ethical issue of identifying a successful intervention but withdrawing it later
owing to high costs, availability and other uncontrollable factors (Suryasa et al.,
2021).
Conclusion
In order to be successful at ABA based programs it is essential to be consistent,
concentrated, and resilient for accepting constant feedback and correction of a
child’s behavior. This requires persistent one to one instructions at the start of
the intervention, indicating that parental involvement is very crucial. According to
Lovaas’s research (Lovaas, 1987) about 50% of the children in the ABA program
accomplished higher functioning as compared to only 2% of the control group.
Children receiving ABA therapy had an improved level of cognitive skills, language
skills, adaptive skills as well as compliance skills. Some children were even able to
attend classes with their non-autistic peers, suggesting that ABA interventions
imparted early on in a child’s life can lead to long-term positive goals. (John R.
Lutzker, 2018). Advantages of ABA certainly outweigh its limitations. After analysis
it is deducible that ABA allows one to see progression and regression easily, it is
geared towards the child’s needs, and almost every child that has done ABA has
shown some amount of progression in its abilities.
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