I remember sitting in a principles of Applied Behaviour Analysis (ABA) class while pursuing my Master’s and hearing my professor speak about a 27 year old woman who was living very independently in a group home for adults with developmental disabilities. He described a very capable young woman, that despite all of her skills and abilities, was unable to speak with verbal language. She had other ways of communicating her wants and her needs, that for the most part, the staff in her home were able to fulfill when she needed. But one day she began to hurt herself. She injured herself to such a degree that there was a large sore on her throat and it was getting deeper and larger. It turns out that this behaviour was happening because she had unfortunately swallowed a pit from a fruit, and it had lodged itself there for such a period of time that tissue had begun to grow over it. That it had become very uncomfortable is an understatement to say the very least. Imagine being in this person’s shoes, unable to tell anyone that they are experiencing such discomfort, or imagine being the parent of this child/person and feeling powerless to help them. As graphic and as upsetting as this story sounds I share it today, and I always share it with my students in my Applied Behaviour Analysis (ABA) classes because it highlights the need to look at each person’s unique situation.
Any treatment that is based on ABA will always be based on that unique person’s individual circumstance.
People will engage in challenging behaviour for different reasons, and it is always to fulfil some sort of need that they may have. In very broad terms they might be doing it as a way to get something good whether it be a tangible thing or a feeling, or they might do it to get away from something that they don’t like or that makes them uncomfortable. As a Board Certified Behaviour Analyst (BCBA) I am ethically obligated to always look for why a particular person is engaging in a challenging behaviour. It is not always an easy thing to figure out but someone who is a BCBA has special training on how to figure out why a particular person is engaging in challenging behaviour. Once we have figured out why the behaviour is happening then we look for ways to help them fulfil that need in a way that keeps them safe and is functional. In ABA we call this a replacement behaviour. We might teach the young woman in the example above to ask for help so that the next time she is experiencing pain or discomfort she can ask for help and we can ensure that she receives the right medical attention. This would be taught in a way that makes sense for that person. Perhaps we would teach her a sign, or to exchange a picture symbol. Whatever we decide to teach it would be something that we determine based on her strengths and preferences but also after a guardian or parent has had some input. After all they know their child the best!
1. Consider individual differences
When attempting to help someone who is engaging in challenging behaviour we would want to first decide if this challenging behaviour is something that we even need to address in the first place. We would work with the person and his/her family to determine if it is something that is interfering with his/her quality of life but also if it is something that could lead to harm or is harming them. In the event that we decide it is important for this person’s quality of life that we do intervene, we would want to learn as much as we can about this person. We would want to find out their strengths and interests, what types of things are they really good at it and what motivates them. We would want to know about the things that they dislike and the types of things that they may still need to learn. All of this information will inform the final intervention that is developed.
2. Figure out why the challenging behaviour is happening
This is a critical part in any intervention that is based on ABA. It will inform what we do to help this person learn a new way to meet their needs. It is not always an easy thing to figure out and that is why a BCBA needs to be involved because there are tools that they have learned about that can help identify why it is happening.
3. Teach a new behaviour to get the need met
An intervention that is based on ABA will empower the person with a new way to get their needs met that is safe and functional. Whatever we decide to teach to replace the challenging behaviour will be determined based on observations of the person themselves, if possible through asking the person and through conversations with those who will be working with and interacting with the person on a regular basis. It needs to make good sense to everyone involved.
4. Consider that the “student is always right”
This is one of my favourite sayings in ABA. If the person we are trying to teach is not learning what we are trying to teach then we need to change how we are teaching. Perhaps we have selected the wrong thing to teach; perhaps it is too hard and we need to teach the pre-requisites first. For example, I would not start by teaching a student to use full sentences with please and thank you if they are only able to say one word utterances when we started.
These are just some of the considerations to ensure are in place when working on developing an intervention that is based on ABA. The Behaviour Analyst Certification Board (BACB) have very explicit ethical guidelines that must be considered in any intervention that is based on ABA. Check them out here.
From the moment I started working with children with autism and their families using a treatment that is based on ABA, I became very passionate about it. I saw myself how it could help improve the quality of life for children with autism and their families. It turns out there is a lot of science behind why we do the things we do and how we can teach new behaviours in the best way. If you would like to empower someone with a new way of getting his/her need met that reduces the likelihood of them hurting themselves I highly recommend that you seek out a BCBA in your area.
Editor’s Note: Opinions expressed by Autism Daily Newscast Contributors are their own.