Statement on Use of Applied Behavior Analysis (ABA) for Autism

The use of Applied Behavior Analysis (ABA)-based therapies has recently become a point of disagreement in the autism community.  

We write this statement to share our strong support for the use of therapies based on the principles of ABA to help those on the autism spectrum, and to provide examples of how the science and research behind ABA indicate that it is safe and effective in improving the functional abilities of people with autism across the spectrum and across the lifetime.  We address four main points regarding utility of ABA principles in autism intervention:

  •  ABA is not a single protocol or technique but rather is an approach or set of techniques tailored to individual’s strengths and challenges.  

Applied Behavior Analysis encompasses a wide array of approaches to intervention, including highly structured approaches (e.g., Discrete Trial Therapy) and naturalistic approaches (e.g., pivotal response training or natural environment teaching). The goal of applied behavior analysis is to promote the acquisition of skills needed to participate successfully in daily activities.  

  • ABA type approaches have changed over time.  The type of procedures used in the 1960s are different than what it is used today.

The very first studies around ABA-based interventions were groundbreaking.  Previous to those studies which took place almost 60 years ago, parents were told that their children would never live productive lives.  These first studies included mostly positive reinforcement with some punishment, using something called discrete trial therapy (DTT).  Those early behavioral modification techniques led to children going to school and being able to be more independent.  This kept people out of institutions enabled to remain in their communities.  But as our scientific understanding of autism changed, so did the techniques used as part of ABA.   Over the past 40 years, the term ABA has evolved to include a more holistic approach that incorporates developmental and other learning theories.  Today, evidence-based autism therapies that include principles of ABA entail a much broader array of goals, assessments, supports, and accommodations that incorporate a person-led approach and encourage learning through activities that are fun and engaging.   It also promotes the use positive, rather than negative reinforcement.

The procedures involved in ABA have become more sophisticated over time and with continual knowledge about autism and how behavioral supports can improve the lives of those on the spectrum, it continues to improve (Justin B. Leaf et al., 2021).  Many critics of ABA focus on punishment. Research has shown that positive behavior supports are most effective, and the ABA field has evolved – and continues to evolve – based on a growing body of research (Frampton & Shillingsburg, 2020; Maye et al., 2020; Sandbank et al., 2020; Schmidt, Luiselli, Rue, & Whalley, 2013). ABA-based approaches, especially naturalistic, developmental behavioral approaches, incorporate ideas and practices from many other schools of thought regarding the science of learning, including developmental theory, cognitive theory, and constructivist theories. 

  • Research has shown that ABA-based interventions help people with autism.   

Hundreds of studies, reviews and meta analyses collected over 40 years of research have shown that the principles of ABA, when used correctly, can lead to progress in communication, language ability, cognitive ability, academic skills, adaptive skills, and social interactive behavior in autistic individuals (Helt et al., 2008; Rodgers et al., 2020; Smith & Iadarola, 2015; Weitlauf et al., 2014)   While ABA techniques can be used across the lifetime, most of the science conducted so far has focused on use of these techniques prior to age 10 (Howlin, Magiati, & Charman, 2009; Reichow, Hume, Barton, & Boyd, 2018; Rodgers et al., 2020; Schreibman et al., 2015).    These changes lead to meaningful gains in quality of life, like developing social connections and friendships (Kasari, Rotheram-Fuller, Locke, & Gulsrud, 2012), maintaining employment (Wehman et al., 2017) and improved independence (Hume, Loftin, & Lantz, 2009).  

ABA can also dramatically reduce problem behaviors like aggression, destruction, and self-injury.  The Certification Board for ABA therapists recommend positive rather than negative reinforcement such as punishment be implemented in behavior plans.  

  •  The goal of ABA supports and therapies is not to change the essence of who someone is, or to stigmatize non-harmful behaviors, but to lessen disability and help individuals and families with ASD reach their goals.  

It is a mistake to throw out an entire canon of techniques and principles based on criticism of past practices. The goal of ABA is to maximize communication skills and minimize challenging behaviors that limit opportunity, not to eliminate neurodiversity.  In fact, autistic adults have acknowledged the benefits of certain interventions based on the principles of ABA (Schuck et al., 2021).  Additional issues surrounding the controversies around ABA are summarized and addressed in: J. B. Leaf et al., 2021.

The Autism Science Foundation supports the use of interventions based on the principles of ABA to help individuals of all ages across the spectrum lead their best lives possible.  Of course, we strongly are against any program or therapy that harms an individual.  However, we have concluded that ABA therapy, when properly rendered in an ethical manner, is beneficial to individuals who are impacted by autism.  

References

Frampton, S. E., & Shillingsburg, M. A. (2020). Promoting the development of verbal responses using instructive feedback. J Appl Behav Anal, 53(2), 1029-1041. doi:10.1002/jaba.659

Helt, M., Kelley, E., Kinsbourne, M., Pandey, J., Boorstein, H., Herbert, M., & Fein, D. (2008). Can children with autism recover? If so, how? Neuropsychol Rev, 18(4), 339-366. doi:10.1007/s11065-008-9075-9

Howlin, P., Magiati, I., & Charman, T. (2009). Systematic review of early intensive behavioral interventions for children with autism. Am J Intellect Dev Disabil, 114(1), 23-41. doi:10.1352/2009.114:23;nd41

Hume, K., Loftin, R., & Lantz, J. (2009). Increasing independence in autism spectrum disorders: a review of three focused interventions. J Autism Dev Disord, 39(9), 1329-1338. doi:10.1007/s10803-009-0751-2

Kasari, C., Rotheram-Fuller, E., Locke, J., & Gulsrud, A. (2012). Making the connection: randomized controlled trial of social skills at school for children with autism spectrum disorders. J Child Psychol Psychiatry, 53(4), 431-439. doi:10.1111/j.1469-7610.2011.02493.x

Leaf, J. B., Cihon, J. H., Ferguson, J. L., Milne, C. M., Leaf, R., & McEachin, J. (2021). Advances in Our Understanding of Behavioral Intervention: 1980 to 2020 for Individuals Diagnosed with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 51(12), 4395-4410. doi:10.1007/s10803-020-04481-9

Leaf, J. B., Cihon, J. H., Leaf, R., McEachin, J., Liu, N., Russell, N., . . . Khosrowshahi, D. (2021). Concerns About ABA-Based Intervention: An Evaluation and Recommendations. J Autism Dev Disord. doi:10.1007/s10803-021-05137-y

Maye, M., Gaston, D., Godina, I., Conrad, J. A., Rees, J., Rivera, R., & Lushin, V. (2020). Playful but Mindful: How to Best Use Positive Affect in Treating Toddlers With Autism. J Am Acad Child Adolesc Psychiatry, 59(3), 336-338. doi:10.1016/j.jaac.2019.09.003

Reichow, B., Hume, K., Barton, E. E., & Boyd, B. A. (2018). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev, 5, CD009260. doi:10.1002/14651858.CD009260.pub3

Rodgers, M., Marshall, D., Simmonds, M., Le Couteur, A., Biswas, M., Wright, K., . . . Hodgson, R. (2020). Interventions based on early intensive applied behaviour analysis for autistic children: a systematic review and cost-effectiveness analysis. Health Technol Assess, 24(35), 1-306. doi:10.3310/hta24350

Sandbank, M., Bottema-Beutel, K., Crowley, S., Cassidy, M., Dunham, K., Feldman, J. I., . . . Woynaroski, T. G. (2020). Project AIM: Autism intervention meta-analysis for studies of young children. Psychol Bull, 146(1), 1-29. doi:10.1037/bul0000215

Schmidt, J. D., Luiselli, J. K., Rue, H., & Whalley, K. (2013). Graduated exposure and positive reinforcement to overcome setting and activity avoidance in an adolescent with autism. Behav Modif, 37(1), 128-142. doi:10.1177/0145445512456547

Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., . . . Halladay, A. (2015). Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder. J Autism Dev Disord, 45(8), 2411-2428. doi:10.1007/s10803-015-2407-8

Schuck, R. K., Tagavi, D. M., Baiden, K. M. P., Dwyer, P., Williams, Z. J., Osuna, A., . . . Vernon, T. W. (2021). Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework. J Autism Dev Disord. doi:10.1007/s10803-021-05316-x

Smith, T., & Iadarola, S. (2015). Evidence Base Update for Autism Spectrum Disorder. J Clin Child Adolesc Psychol, 44(6), 897-922. doi:10.1080/15374416.2015.1077448

Wehman, P., Schall, C. M., McDonough, J., Graham, C., Brooke, V., Riehle, J. E., . . . Avellone, L. (2017). Effects of an employer-based intervention on employment outcomes for youth with significant support needs due to autism. Autism, 21(3), 276-290. doi:10.1177/1362361316635826

Weitlauf, A. S., McPheeters, M. L., Peters, B., Sathe, N., Travis, R., Aiello, R., . . . Warren, Z. (2014). In Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update. Rockville (MD).

The Autism Science Foundation (ASF), a nonprofit organization dedicated to supporting and funding innovative autism research, today announced its fifth round of COVID-19 Research Grant recipients. The latest grantees are Dr. Allison Shana Nahmias and Dr. Matthew Lerner of Stony Brook University and Dr. Shuting Zheng, University of California San Francisco. 

This new funding will help grantees examine ways to improve mental health services for people with Autism Spectrum Disorder (ASD). One study will examine the efficacy of an online intervention to help autistic adolescents deal with pandemic stress, while another study will examine ways to improve mental health services for autistic adults.

ASF initially launched its COVID-19 grants in early 2020 to support scientists who were struggling to continue their research studies when institutions were shut down. The mechanism then evolved to fund research examining the unique effects of COVID-19 on people with autism, and to study ways to make permanent improvements to diagnoses and treatment based on service gaps the pandemic brought to light.

“The lingering mental health effects of the COVID-19 pandemic continue to impact so many people with autism. Our goal with this latest round of funding is to provide support for people in the short-term, and to examine ways to make lasting improvements to mental health services that will aid people with autism long after the pandemic is over,” said Dr. Alycia Halladay, Chief Science Officer of ASF.

The following projects have received funding:

Allison Shana Nahmias, Ph.D.

Stony Brook University

Title: Evaluating an Online Intervention to Help Autistic Adolescents Deal with Pandemic Stress 

Most mental health interventions require multiple clinician visits, can be costly, and are not feasible for many families from diverse socioeconomic communities.  This project will study the effects of a single-session intervention, successfully utilized with neurotypical adolescents during the COVID-19 pandemic, to see if it is also successful in supporting autistic adolescents. Stressful events have increased during the pandemic, resulting in additional mental health challenges throughout the ASD community.  

Shuting Zheng, Ph.D.

University of California San Francisco

Improving Mental Health Service Delivery for Individuals with Autism

Only about half of autistic adults who reported experiencing symptoms of depression during the pandemic received treatment for their depression due to problems accessing services. This project will expand a longitudinal study of autistic adults reporting their own experiences with mental health care. The goal is to better understand the different factors that support or deter mental health support, learn how autistic adults receive and prefer to receive support, and then improve the services they receive.

NEW YORK — October 12, 2021 — The Autism Science Foundation (ASF), a nonprofit organization dedicated to supporting and funding innovative autism research, today announced the first funding recipients in its ‘Next Gen Sibs’ research project. The goal of this project is to establish a future collaborative network that will help in identification, evaluation and possible diagnosis and intervention for the Next Generation: the children of typically developing siblings of individuals with autism spectrum disorder (ASD). The study will begin at two sites where adult siblings have participated in previous research tracking autism families into adulthood: Emory University (under the direction of Dr. Michael Morrier) and University of California, Los Angeles (under the direction of Dr. Catherine Lord).

This project is based on data from the Baby Siblings Research Consortium (BSRC), which has shown the rate of autism in typically developing non-autistic siblings of those with a diagnosis to be 15x that of those with no family history. Together with the results of a recent ASF-funded study – which showed an increased rate of autism in the children of siblings of autistic individuals – it is clear that future research examining heritability of ASD should expand into the next generation. This next generation needs early recognition, diagnosis and services that can help them live the most fulfilling lives possible, and in order to do that we need a better understanding of their needs. 

“ASF is incredibly proud to be funding this Next Gen Sibs project, which will play an important role in further understanding the genetic role of autism and how we can more quickly diagnose and treat young children who have a history of autism in their families,” said ASF Chief Science Officer Dr. Alycia Halladay. “Siblings who participated in research studies over 20 years ago are now adults and have expressed interest in better understanding why there is a higher rate of diagnoses in their own children, who are the nieces and nephews of autistic adults. The Next Gen Sibs project aims to find the answers these families seek.”

“The Next Gen Sibs project is an example of how ASF strives to address the most urgent questions in the autism community,” said ASF Co-Founder and President Alison Singer. “This new project is a direct result of many conversations we’ve had over the years with autism families and researchers who want to know more about the genetic factors associated with autism, and specifically how they might impact the children of typically developing non-autistic siblings. We are so grateful to our generous donors, who make this important new research project possible.”

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About the Autism Science Foundation

The Autism Science Foundation (ASF) is a 501(c) (3) public charity. Its mission is to support autism research by providing funding to scientists and organizations conducting autism research. ASF also provides information about autism to the general public and serves to increase awareness of autism spectrum disorders and the needs of individuals and families affected by autism. To learn more about the Autism Science Foundation, or to make a donation, visit www.autismsciencefoundation.org.   

Media Contact

Kathy Ehrich Dowd

Forefront Communications for Autism Science Foundation

617-970-5842

kdowd@forefrontcomms.com

Annual charity event to benefit the Autism Science Foundation celebrates its seventh year by ringing the NYSE Closing Bell®

Wall Street Rides FAR (For Autism Research), the annual charity cycling and walking event benefiting the Autism Science Foundation (ASF), today announced that it will ring the New York Stock Exchange (NYSE) Closing Bell® on August 30, 2021. The event, which was co-founded seven years ago by Bryan and Melissa Harkins, has raised over $2 million to date for ASF, each year attracting some of the most prominent firms on Wall Street and beyond to participate. 

“We are thrilled to once again return to the floor of the iconic NYSE to promote the Ride and champion the critical mission of the Autism Science Foundation,” said Bryan Harkins, who is President of BIDS Trading and EVP, Cboe Global Markets. “What makes this event so unique and powerful is the incredible sense of community that is displayed by firms across the industry, many of which are fierce rivals during the day, coming together to support this incredible cause. In standing together with our sponsors on the podium, that sense of community is heightened, and we are indebted to them for their unwavering support.” 

“ASF is incredibly grateful to the NYSE for giving Wall Street Rides FAR the opportunity to ring the bell, and to the Wall Street community, which has been so supportive of our organization,” said Alison Singer, President and Co-Founder of ASF. “The funding from Wall Street Rides FAR has made a significant impact in the lives of people with autism spectrum disorder and their families, and we look forward to another successful ride in October.”

This year’s Wall Street Rides FAR (WSRF) will be held on October 2, 2021, once again at Saxon Woods Park in White Plains. The ride offers courses for participants of all abilities – family rides of 4 and 12 miles, longer rides of 20, 30 or 62 miles, and a 5K trail walk. Since the inaugural event in 2015, the Ride has grown rapidly in terms of participants, sponsors and industry reach, last year raising $435,000. WSRF will also feature two satellite rides for the first time, this year in Baltimore, Maryland and Toronto, Canada. 

WSRF attracts many of the industry’s most prominent trading and financial services firms as participants, with companies including T Rowe Price, Cboe, FTX, GTS, Paxos, XTX, Tower Research Capital and Trumid sponsoring (see the full list of sponsors here). Firms interested in joining the roster of sponsors can find more information here and individual riders interested in signing up may do so at https://wallstreetridesfar.org/register/.

All proceeds from WSRF go to the Autism Science Foundation, a nonprofit corporation that supports autism research by providing funding and other assistance to scientists and organizations conducting, facilitating, publicizing and disseminating autism research. The organization also provides information about autism to the general public and serves to increase awareness of autism spectrum disorders – which today impacts 1 in 54 children – and the needs of individuals and families affected by them. 

The Closing Bell will ring at 4:00 pm EDT and can be viewed live on the NYSE’s website. Photos and video of the bell ringing will be available via Facebook and Twitter @NYSE.

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Contact

Alex Hamer

Forefront Communications for Wall Street Rides FAR

ahamer@forefrontcomms.com