ABA / Behavior Therapy
Behavior is the most basic form of communication.
Babies cry to express need for caregiver attention. As we get older, we learn to communicate with speech and language. However, children with autism and other conditions require a much more intensive process to master appropriate communication and behaviors.
FOCUS offers pediatric behavior therapy in Fort Myers. Behavior therapy, also known as Applied Behavior Analysis or ABA, uses proven learning strategies and positive reinforcement to help kids master the social and emotional skills central to maximum independence, safety, and quality of life.
What is Behavior Therapy/ ABA?
Behavior Analysis is the scientific, evidence-based study of human behavior. Applied Behavioral Analysis (ABA) involves consistently applying behavior analysis principles of learning and motivation to help children develop and improve those “socially significant behaviors” to a meaningful degree.
To understand how behavior therapy works, we underscore again that behavior is communication. So we first ask, “What is the child communicating with this behavior?”
Challenging behaviors almost always serve a purpose. These generally include:
- Fulfillment of a sensory need;
- Escape of a demand or undesired situation;
- Effort to get attention;
- Obtaining an object/ desired tangible.
When we understand the underlying motivation for the child’s behavior, we avoid reinforcing problem behaviors or failing to reinforce desired behaviors. That’s why the first step of a behavior therapist is to conduct a thorough evaluation before developing an individualized ABA plan.
Behavior analysts and technicians are responsible for assessing the "ABCs" of each behavior. That is, we look at the Antecedent (what comes right before the behavior), the Behavior, and the Consequence (what comes right after). In doing so, we can identify the triggers, the motivation, and how the behavior is being reinforced (intentionally or not). From there, we create effective strategies to help the child alter, limit, or eliminate certain behaviors while still communicating their thoughts, needs, and wants.
What is the Process for Obtaining ABA Therapy?
To receive ABA therapy in Florida, most health insurers and therapy providers require a physician referral - typically from a specialist such as a pediatric neurologist, psychiatrist, or developmental pediatrician. Referrals are most often issued after a child is diagnosed with a specific condition, like autism, Down syndrome, or global delays. So the first step is talking to your child's pediatrician, who may then refer you to a specialist - or several specialists - who can evaluate your child's skills/deficits and identify possible interventions.
Sometimes, conditions besides autism, Down syndrome, or global delays that may justify referral/coverage of ABA therapy services, but there's no universal black-and-white list of diagnoses.
If a child is suspected or at high risk of having autism, the first step to diagnosis is usually an ADOS test. This is an in-depth evaluation of a child's development in areas of speech-language, social-emotional skills, cognitive function and more. FOCUS offers both free screenings and ADOS testing in Fort Myers for children suspected of having autism spectrum disorder or related conditions. A pediatric specialist will review the child's ADOS test results in determining whether an autism diagnosis - and ABA therapy - is appropriate. Other early interventions, such as speech therapy, occupational therapy, and physical therapy, may also be recommended.
Once your child has been evaluated, referred, and approved for coverage and services, you can reach out to ABA therapy providers in your insurance network and service area to ask about starting therapy. Demand is high, and most private clinics have waitlists.
If your child is under the age of 3, they may be eligible some therapy services through Early Steps, provided by the Florida Department of Health. This can be a great resource, giving young kids a jump-start on early intervention until a slot for private therapy services opens up.
Once your child begins ABA therapy, consistency and at-home carryover is key to success.
Early Intervention ABA Therapy Works
Numerous studies have shown that consistent ABA techniques incorporated as part of a comprehensive early intervention plan (starting between ages 2 and 5) can yield significant, long-term improvements in:
- Social Relationships;
- Self care;
- School success.
At FOCUS, we support the Verbal Behavior Approach. Here, positive reinforcement drives language learning by connecting words with the purpose of that word. Put in the simplest terms: Children are motivated to use language to get things they want.
However, it’s not bribery (a common misconception about behavior therapy). Rather, the approach involves moving away from simple labels (chair, dog, ball, etc.), and instead showing children how language can be used to make requests and share ideas. The goal is to help them recognize why words are useful so they are motivated to use them.
The verbal behavior approach begins by breaking down communication into its simplest form and function. Those are:
- Mand. A request. An example is the word “ball” used to ask for access to a ball.
- Tact. A comment used to draw attention to something or share an experience. An example would be a child saying, “car” to show you a passing vehicle.
- Intraverbal. A word given in response to a question. An example would be the word, “Cat” when shown a picture of a feline and asked, “What is it?”
- Echoic. Words repeated in an echo. An example would be an adult asks, “Candy?” and the child responds, “Candy,” without necessarily knowing the meaning.
The verbal behavior therapy approach starts with mands, prompting the child to use the word for a desired object. When the child complies, the therapist immediately grants access to the object.
In the beginning, a child might just signal the request or point at the object, instead of using an actual word. But that’s Ok at first - it teaches the child that communication in general produces positive results.
Eventually and with consistency, the child will start to sign or say the actual word. We then build on that to help the child develop more complex language and social skills.