Applied Behavioral Analysis for Kids on the Autism Spectrum

"I've heard that ABA therapy is very effective for children with high functioning autism. Is this true, and how does it work?"

It is often difficult to understand why the child with ASD level 1 or High-Functioning Autism (HFA) behaves the way he does. However, there is a reason for his behavior, and Applied Behavior Analysis (ABA) helps us understand the behavior and determine a method of support for the child so that he no longer needs the behavior to meet his needs.

Using ABA, you can determine the antecedents to behavior, identify the behavior, and identify the consequence for the behavior, or what is currently maintaining the behavior. Using this process, you can determine alternative behaviors that are more appropriate, yet will meet your child's needs, without displaying the inappropriate behavior. This aids moms and dads in understanding their child better and helps outline a method to change their behavior.

ABA is widely recognized as a safe and effective treatment for Autism Spectrum Disorders. It has been endorsed by a number of state and federal agencies, including the U.S. Surgeon General and the New York State Department of Health. Over the last decade, the nation has seen a particularly dramatic increase in the use of ABA to help children and teens with HFA to live happy and productive lives. In particular, ABA principles and techniques can foster basic skills (e.g., looking, listening and imitating) as well as complex skills (e.g., reading, conversing and understanding another person’s perspective).

ABA treatment can include any of several established teaching tools:
  • verbal behavior
  • pivotal response training
  • incidental teaching
  • fluency building
  • discrete trial training

1. An ABA-related approach for teaching language and communication is called "verbal behavior" or VB for short. In VB, the therapist analyzes the youngster’s language skills, then teaches and reinforces more useful and complex language skills.

2. Pivotal response training uses ABA techniques to target crucial skills that are important (or pivotal) for many other skills. Thus, if the youngster improves on one of these pivotal skills, improvements are seen in a wide variety of behaviors that were not specifically trained. The idea is that this approach can help the youngster generalize behaviors from a therapy setting to everyday settings.

3. Incidental teaching uses the same ideas as discrete trial training, except the goal is to teach behaviors and concepts throughout a youngster’s day-to-day experience, rather than focusing on a specific behavior.

4. In fluency building, the therapist helps the youngster build up a complex behavior by teaching each element of that behavior until it is automatic or "fluent," using the ABA approach of behavioral observation, reinforcement, and prompting. Then, the more complex behavior can be built from each of these fluent elements.

5. In discrete trial training, an ABA therapist gives a clear instruction about a desired behavior (e.g., “Pick up the paper.”); if the youngster responds correctly, the behavior is reinforced (e.g., “Great job! Have a sticker.”). If the youngster doesn’t respond correctly, the therapist gives a gentle prompt (e.g., places youngster’s hand over the paper). The hope is that the youngster will eventually learn to generalize the correct response.

Through ABA, moms and dads can learn to see the natural triggers and reinforcers in their youngster’s environment. For example, by keeping a chart of the times and events both before and after Michael’s temper tantrums, his mom might discover that Michael always throws a temper tantrum right after the lights go on at night without warning. Looking deeper at the behavior, Michael’s mom might also notice that her most natural response is to hug Michael in order to get him to calm down. In effect, even though she is doing something completely natural, the hugging is reinforcing Michael’s temper tantrum.

According to the ABA method, both the trigger (lights going on at night without a warning) and the reinforcer (hugging) must be stopped. Then a more appropriate set of behaviors (e.g., leaving the room or dimming the lights) can be taught to Michael, each one being reinforced or prompted as needed. Eventually, this kind of approach will lead to a time when the lights can go on without warning and Michael still does not throw a temper tantrum.


Resources for parents of children and teens on the autism spectrum:
 

==> Videos for Parents of Children and Teens with ASD
 
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Parents’ Comments:

•    Anonymous said... my 12 year old son started 3 weeks ago. It is hard right now, but I know it will get better when we get past all of his manipulation. he likes to control situations if they become difficult he will refuse and shut down . we are trying to stand our ground and undue some bad behaviors that have formed over years of us giving in...
•    Anonymous said... my 7 year old son has been in ABA therapy for about 6 months (only 3 hours per week). We are seeing slight improvement in eye contact and listening skills. From a parent's perspective, it seems like they are just playing with your child, but they have assured me that there is a method to their madness.
•    Anonymous said... it's a therapy. It will only work if the child is receptive. Our 7 year old likes the attention and is doing okay. I would like to more results, but anything is better than nothing. I love my boy and I want him to be able to function happily through life so i want more than he is getting but that is what it is.

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Video Game Obsessions in Kids on the Autism Spectrum

"How can I get my son (high functioning autistic) to focus less on his favorite video game (Call of Duty) and spend more time doing other things? He is truly obsessed with war games. It's all he ever talks about."

One of the hallmarks of ASD level 1, or High Functioning Autism (HFA), is the child's tendency to be obsessed with particular topics. He might want to constantly talk about video games, race cars, cartoon characters, movies, or even bugs. 
 
It can be very frustrating for parents and teachers to deal with an obviously bright, articulate youngster who is somehow "stuck" in one particular frame of reference.

How can you get a child on the autism spectrum to have less obsessive thoughts and ideas? The honest answer is: You will not be able to entirely eliminate them. Some HFA kids will gradually leave one special interest behind, only to quickly fixate on a new one.
 

There are two ways to classify these thought-consuming interests. Some are considered "primary obsessions," and others are "secondary interests." Often it's difficult to tell which of the two you're dealing with.

Primary obsessions are intense enough that it is very difficult to get the youngster to think of anything else. The obsession monopolizes conversation and daily activities. It may also interfere with schoolwork. The youngster is consumed by the thoughts.

Secondary interests are a challenge and are somewhat obsessive for the youngster, but ultimately can be managed. Not only that, but secondary interests can be used as motivators to help the boy or girl succeed in school or improve behavior. 

Here are some suggestions:

1. Working with your son's teacher, use the "favorite" topic to promote learning. If he likes war video games, apply them to math problems (e.g., "If there are 5 tanks on the battlefield, and then 7 more line up, how many tanks in all?"). Art projects that teach different techniques could involve the topic. Science experiments could address the topic in some way. Reading can be promoted by providing your son with books on the topic. Use the interest as a starting point, and then build upon it, slowly expanding his areas of interest.

2. Use the topic to motivate good behaviors. Buy a book associated with the topic. Your son can read it when homework is finished, or after sitting quietly. Perhaps allow him to watch a movie on WWII when he's completed a job around the house.

3. Reward your son for making conversation that is correctly related to what's going on at the moment (something other than his special interest). For example, if your son looks at the sky and says, "I see an airplane," and that's a comment which is appropriate and in the moment, then immediately respond with attention and praise (e.g., "You're right! I see it too! Look, it's very far away. You've got good eyes. Do you think you'd like to fly in a plane someday?").

4. Give less of a response to random, meaningless comments about the obsession. If your son mentions the obsessive topic when it has nothing to do with what's currently going on, either don't respond, or act confused. For example, gently reply, "We're not on the topic of video games right now," or "why are you talking about that?" If your son becomes agitated, give a simple "ummm hmmm" with little eye contact. Then ask him a question, which requires him to engage in the present activity or conversation.


Resources for parents of children and teens on the autism spectrum:
 

==> Videos for Parents of Children and Teens with ASD
 
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PARENTS' COMMENTS:

•    Anonymous said... A nine year old that plays video games and surfs the net for hours does not become a computer programmer or video game maker. They become 25 year olds that play video games and surfs the net all day. The electronics allow them to be non-verbal, non-social, and obsessive, all the things that are comfortable for my 16 year old. He can control his environment and is confident and competent within the world of the game. I found that he is more social and plays well with other kids at his level, especially other aspies. I took the video games away completely and internet time is at the end of the day as a reward for good behavior. Some days this really sucks and he turns from aspie to a-hole. But he has friends, he plays some sports, and can be social. You have to make them uncomfortable so they will be comfortable in the long run.
•    Anonymous said... By the way, words written out of grief of mama heart, not to frustrate anyone who posted on the set limits topic. And I meant "advice".
•    Anonymous said... Explain how video games can be addicting. Compare and contrast to something else that is addicting. Then ask how will they know when playing their game becomes a problem for them. What are the signs they see? How can they monitor themselves? Do they need a timer set for instance...All children on the spectrum unwind with video games but they must be taught to self monitor themselves and balance that with outdoor activities.
•    Anonymous said... I appreciate the "set limits" thoughts BUT, my 9 year old Aspie is ONLY interested in video games, computers and electronic devices. I get frustrated with the onslaught of advise to replace the activity because in the case of autism, sometimes you simply cannot. We had him in play therapy since he was a tiny toddler and he has NEVER EVER played. So yes...I homeschool...then he has chores...but by afternoon when all is done there is literally nothing else that can occupy his time. Outside stuff? No. Legos, puzzles, coloring, cars, board games, books...absolutely no interest. If you take away the electronics (which of course I have done a million times), he simply doesn't replace it and he does nothing (and that hurts a mama's heart). I had to rant a bit here because I am up to my eyeballs in advise that doesn't work and it is very frustrating. I wish my son could learn to love other activities (and it is not that we don't try - he starts archery class tomorrow) but it is what it is sometimes.
•    Anonymous said... I think Erik has hit the nail right on the head. You can't help your children by doing things that make them comfortable, especially when they have Aspergers. Most day-to-day things make a kid with Asperger's uncomfortable and the only way to help them grow is to push them out of their comfort level and do the things that don't come naturally.
•    Anonymous said... My boy is more violent and less caring for others especially his siblings when he has been playing fast action video games. We completely banned him from them over a year ago and his behaviour has much improved. He was a little upset, but he knows they affect him and get him into trouble, so those times when he is logical it's easy enough to get over the reasons why which he's accepted. thereare plenty of other games he can play, even some educational ones, he loves maths games.
•    Anonymous said... my boy loves anything to do with games and the internet! too... think I let him play on them too long myself... But then he says you like Facebook and being online too Mom!... He's right it is very addictive.... kids can't just go play outside like I did as a kid, that's why I let both my kids be online and on games more then I should.... Wish my kids could have the freedom that I had..... Say la vie... Goodluck will def be reading the comments
•    Anonymous said... there are a lot of jobs in video games, computers and electronic devices. is he interested in taking them apart and putting them back together? enroll him in computer class or take him to video game conventions for socialization. buy him books or check out books at the library about the video game. get the call of duty lego sets. embrace the obsession. he may outgrow it and appreciate that you accepted it or he may turn the obsession into a career.
•    Anonymous said... try introducing him to sports games, like NBA 2013 or FIFA which is a fun soccer game- my son switched from Halo and Call of Duty to the sports xbox games and loves them.
•    Anonymous said... We also have limits on time for video games. It's my sons down time after school. He gets 30-45 mins depending on what events we have for the evening (homework, etc). I don't let him earn the time but we have a printed schedule that he helped create that I refer to if I have a problem.
•    Anonymous said... We set a daily time limit on video games. He has to do chores to earn the time.
•    Anonymous said... When you take the video games away and he doesn't replace them, how much time are you giving him to choose something else? Maybe he hasn't gotten bored enough. He's old enough, in spite of his condition, to make the choice to be bored. Though it may be upsetting to you to see him "doing nothing" its not hurting him a bit. Adults go to meditation retreats and do nothing for days on end, and its considered a good thing. My son likes to do two things - legos and TV. Due to discipline issues, I took both away for a week. The first day was HELL, I can't believe we made it a day, gradually we did things he didn't normally do and it turned out to be not so bad.
•    Anonymous said... Wow this is my son to a tee, he to is addicted to "call of duty" on his xbox. i hate it he will play al day and have the night if i let him. he is 14yrs old, and was into legos for awhile but he's starting to outgrow them. i just worry in the future that it will be more important then the things he needs to do like school or work. im finding it very hard to set limits.
*   Anonymous said... I didnt see this thread and just posted about this same issue. Its sooo hard. My daughter is getting 'lost' in the world of Pokemon and i do get her interested in other things but Pokemon are everything to her. They are real to her and she relates to them. Its excluding other things. I know its a result of her trying to organize her world and feel safe but i want to help her feel safe somehow without always needing them. i hired her a babysitter over the summer i knew was aware of pokemon but little did i know the 21 year old girl was still obsessed with them herself and it put my daughter over the edge! i feel like she gets angry that i'm not a big pokefan myself. its almost like her and the pokemon vs the world. sad. i wish there were a better way to help her with her anxiety. i get her outside a lot and spend time with her and have done everything i can to get her socialized/friends. i advocate for her at school (but still believe its her big stressor) and i know that there are changes in our life that are hard. i got her a counselor but all she talked about there was pokemon and she didnt connect with her... thanks for letting me vent

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Defiance in Teenagers with High-Functioning Autism

"My son (high functioning autistic) is now 13 ...he was diagnosed at the age of 8. All of a sudden he is acting out, cussing all the time, lying, being disrespectful and verbally abusive, and has an overall grumpy attitude. Are these years the hardest, or is this just the beginning? When he finally hits puberty, will things get better?"

Yes, the teen years are the hardest, whether your son has High Functioning Autism (HFA) or not! He has probably “hit” puberty already, but it’s just beginning.

Raging hormones and frustration with social interactions at school can cause a lot of anger and bad behavior during the teen years, especially for adolescents with "special needs!" Many need counseling to negotiate this time in their lives successfully. Peer-rejection, teasing, bullying, and all other other stressors that your son may have to endure can take a psychological toll, which may in turn influence him to act-out his frustration on a "safe" target at home (i.e., YOU).

Your son is exhibiting rebellious behavior, and this type of behavior fulfills his needs. For example, he may have the need to:
  • Avoid responsibility (e.g., attending school, obeying parents)
  • Get something (e.g., his way in a decision, your attention, control over a situation)
  • Manage pain (e.g., physical and/or emotional stress that must be alleviated)
  • Fulfill sensory needs (e.g., relief from heat, cold, or to satisfy thirst)

Having a developmental disorder such as HFA or Asperger’s is no excuse for being verbally abusive. However, it is important for you to understand that some of the associated symptoms do contribute to defiant behavior. Teens on the autism spectrum may display some - or all - of the following characteristics, many of which contribute to problematic behavior:
  • the teen may be able to talk extensively on a topic of interest, but have difficulty with more practical tasks such as recounting the day’s events, telling a story, or understanding jokes and sarcasm
  • sensitivity to criticism 
  • preference for playing alone or with adults
  • narrow field of interests (e.g., a teen with HFA may focus on learning all there is to know about cars, trains or computers)
  • language may be considered to be very advanced or ‘precocious’ when compared to their peers
  • lack of appreciation that communication involves listening as well as talking (e.g., they may not allow their communication partner an opportunity to engage in the conversation)
  • inability to understand the rules of social behavior or the feelings of others
  • difficulty ‘reading’ body language (e.g., a teen with HFA may not understand that someone is showing that they are unhappy by frowning)
  • having rules and rituals that they insist all family members follow
  • difficulty in forming friendships
  • behavior varies from mildly unusual, eccentric or ‘odd’ to quite aggressive and difficult
  • apparently good language skills, but difficulty with communication
  • anger and aggression when things do not happen as they want

 
Your son is unlikely to identify with your feelings or comprehend others’ objections to his behavior. The only explanation you should use with him is to specifically state that the objectionable behavior is not permitted. Your son needs to follow rules, and following rules can help to focus and modify his rebellious behavior.

Behavior modification is a therapeutic approach that can change your son’s behavior. You need to determine the need that his rebellion/aggression fulfills and teach him an acceptable replacement behavior. For example, your son can be taught to ask for, point to, or show an emotion card to indicate the need that he is trying to fulfill.

Sometimes, self-stimulating behaviors such as rocking or pacing are taught as replacement behaviors, but it will take time for your son to integrate these behaviors into his daily activities. If your son is severely out of control, he needs to be physically removed from the situation. Granted, this may be easier said than done, and you may need someone to help you; yet, behavior modification can be helpful, and it must be started as soon as possible.

For adolescents on the autism spectrum, the importance of maintaining a daily routine can't be stressed enough. A daily routine produces behavioral stability and psychological comfort. Also, it lessens their need to make demands. When you establish a daily routine, you eliminate some of the situations in which your son’s behavior becomes demanding. For example, by building in regular times to give him attention, he may have less need to show aggression to try to get that attention.

Ideally over time, your son will learn to recognize and communicate the causes of his aggression and get his needs met by using communication. Unfortunately, teens who get their needs met due to aggression or violence are very likely to continue and escalate this defiant behavior.

A behavior therapy program may help; however, an individualized program has to be designed specifically for your son because adolescents on the spectrum vary greatly in their challenges and/or family circumstances. Treatment approaches that work well with other diagnoses may not work with HFA. Consult a psychiatrist who can oversee a treatment plan as well as any medication regimen that your son may be need.

In addition to the suggestions listed above, here are a few simple parenting tips that may help:
  • Take care of yourself. Counseling can provide an outlet for your own mental health concerns that could interfere with the successful management of your son's defiant behavior. If you're depressed or anxious, that could lead to disengagement from your son, which can trigger or worsen oppositional behaviors. Let go of things that you or your son did in the past. Start each day with a fresh outlook and a clean slate. Learn ways to calm yourself, and take time for yourself. Develop outside interests, get some exercise, and spend some time away from your son to restore your energy.
  • Set up a routine. Develop a consistent daily schedule for your son. Asking him to help develop that routine can be helpful.
  • Set limits and enforce consistent reasonable consequences.
  • At first, your son is not likely to be cooperative or appreciate your changed response to his behavior. Setbacks and relapses are normal, so be prepared with a plan to manage those times. 
  • Remind yourself that your son’s defiance is most likely a temporary inconvenience rather than a permanent catastrophe.
  • Recognize and praise your son's positive behaviors. Be as specific as possible (e.g., "I really liked the way you cleaned up your room tonight").
  • Pick your battles carefully. Avoid power struggles. Almost everything can turn into a power struggle — if you let it.
  • Model the behavior you want your son to exhibit.
  • Develop a united front. Work with your partner/spouse to ensure consistent and appropriate discipline procedures.
  • Remember that behavior often temporarily worsens when new limits and expectations are set. However, with persistence and consistency, the initial hard work will pay off with improved behavior.
  • Build in time together. Develop a consistent weekly schedule that involves you and your son being together.
  • Assign your son a household chore that's essential and that won't get done unless he does it. Initially, it's important to set him up for success with tasks that are relatively easy to achieve, then gradually blend in more important and challenging expectations.



Resources for parents of children and teens on the autism spectrum:
 

==> Videos for Parents of Children and Teens with ASD
 
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COMMENTS FROM PARENTS:

•    Anonymous said... Its so good to not feel alone in this. My son emailed the principle and councilor this week with a page of cuss words, then says "he doesn't remember it". He never talks at home like that. Trying to find alternatives for anger, like using a punching bag. But that day I had no idea he was even upset that is what scares me. Praying lots and lots.
•    Anonymous said... My Son doesnt like going outside at all eather!... Not very nice if he's got a little Sis that does want to go and do nice things tho... But tried to take him out today, but it was Far to Busy! Really made him have a Noise overload in his head till now... We'v been back for 10 hours... Must be horrible for him...
•    Anonymous said... my son like that as well. Does not want to go outside because the kids are making poor choices
•    Anonymous said... Not only does the stew of Aspie issues flare up at new situations and new social expectations. But puberty hits and the hormones kick in like they do in non-Aspie kids. So you get a double dose of Teenage attitude.
•    Anonymous said... Puberty makes them begin to resemble something of aliens. lol Seriously though they do become quite difficult. The acting out, cussing, lying, etc., all are magnified x 3 during this time. Counseling and keeping the schedule has helped us. In the end however not much helps lately. Praying a lot. Good luck.
•    Anonymous said... There may be commorbid conditions. Mine has ODD and ADHD. But, yes, teens will always test limits. Be thankful he's a boy; ) Deep breaths. And approach delicately. Never demand, request. Always give him time to respond, and make a consequence that fits the "crime" and stick to it. Consistency is key to any austism spectrum disorder. Hugs.
•    Anonymous said... We have been through hell with my son since he turned 13 and now he is 16. I try to see the silver lining with him having to deal with ASD - one is that he doesn't want to leave the house because of his heightened social anxiety - so I know where he is at all times! At least he is not out hooning around and making bad choices with other idiot teenage boys. I'm hoping that by the time he is happy to engage again with society he will be dealing with other guys whose frontal lobe has developed (him too).
•    Anonymous said... You have to adjust your responses to the outbursts and also reinforce what good choices look like for your child as well as what bad choices look like. The teen years are rough for everyone, but Aspergers and kids in the Autism Spectrum have it even harder. Pick your battles. You do not always have to win an argument. Actively listening and explaining what is going on is the best win for both you and your family.
*   Anonymous said...My upstairs neighbors (mom) are very uncooperative when it comes to respecting my household! The teenage son stalks me, destroys my plants and flowers.. breaks my patio decor and had almost destroyed my 5ft windmill. He makes a lot of noise constantly and walks in place to make the floor squeak in many areas of their apartment... And, how does he know when I am using my bathroom... It's embarrassing that he lets me know he knows I'm in my bathroom because he will make noise or flush the toilet or run the water in the sink or bathtub... He will run out and sometimes stomp very loud upon exiting.

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