Parent Resources

Autism spectrum disorder (ASD) is a developmental condition characterized by challenges in social interaction, communication, behavior, and limited interests and activities. The Centers for Disease Control and Prevention (CDC) reported in 2021 that 1 in 44 children in the United States is diagnosed with ASD, with a higher prevalence in boys than girls. Symptoms can range from failure to develop appropriate social relationships to a lack of spoken language, repetitive language use, hyperactivity, and self-injurious behavior.

Evidence-based treatment for ASD focuses on developing social and communication skills while minimizing behaviors that interfere with functioning and learning. The Diagnostic and Statistical Manual of Mental Disorders is the most widely accepted reference used for the classification and diagnosis of ASD, which is characterized by persistent deficits in social communication and social interaction, in addition to restricted, repetitive patterns of behavior, interests, or activities.

ASD symptoms and severity vary widely among individuals, with early signs observable as young as six months old. Screening tools, such as the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R), can assess an individual’s risk for ASD. Prevalence has increased more than 150% since 2000, with boys more likely to develop ASD than girls. The cause of ASD is unknown, but evidence suggests many genetic and environmental factors may be involved.

Intensive behavioral intervention (IBI) using applied behavior analysis (ABA) is the only empirically validated treatment for ASD. ABA is conducted at a high intensity, typically between 30 and 40 hours per week, for multiple years, with evidence suggesting that greater treatment intensity leads to superior outcomes.

Applied Behavior Analysis (ABA) is considered the most effective form of treatment for individuals diagnosed with Autism Spectrum Disorder (ASD). The method has been proven effective in numerous research studies in increasing patient skill development and reducing challenging behaviors. The principles of ABA are based on the principles of Behavior Analysis, which state that all behavior is shaped by its interaction with the environment. In simpler terms, the consequences that follow a behavior have a great influence on the behavior. If a behavior is followed by a pleasant consequence, the behavior is likely to increase over time. Thus, ABA uses positive consequences, also known as "positive reinforcement," to teach and strengthen new, desired skills and behaviors, leading to positive behavior change and growth.

Quality ABA programs use both structured and naturalistic teaching strategies to provide optimal learning activities for each patient. For most individuals, both types of teaching are necessary to create a successful learning environment that results in learning new skills that can be applied in everyday life. Moreover, ABA programs approach teaching new skills by breaking them down into small steps that are easier to learn. These steps are then linked together to form more complex skills that the individual can then perform successfully. Learning activities and targets are individually selected, designed, and progressed according to the needs of each person, making each ABA program uniquely tailored to every learner.

It is important to note that ABA is a science-based approach to behavior change. Behavior analysis is the scientific study of behavior, and ABA is the application of the principles of learning and motivation derived from behavior analysis. Decades of research have validated treatments based on ABA. The Report of the Maine Administrators of Services for Individuals with Disabilities (MADSEC) Autism Task Force (2000) provides an independent expert opinion on the effectiveness of ABA. The report states that over the past 40 years, several thousand published research studies have documented the effectiveness of ABA across various populations, interventionists, settings, and behaviors. These include individuals with mental illness, developmental disabilities, and learning disorders in schools, homes, institutions, group homes, hospitals, and business centers. ABA has been proven effective in teaching language, social, academic, leisure and functional life skills, aggression, self-injury, oppositional, and stereotyped behaviors.

Discrete Trial Training (DTT) is a specific ABA teaching strategy that allows the learner to acquire complex skills and behaviors by first mastering the subcomponents of the targeted skill. For example, if one wishes to teach an individual to request a desired interaction as in “I want to play,” one might first teach subcomponents of this skill, such as the individual sounds comprising each word of the request or labeling enjoyable leisure activities as “play.” By utilizing teaching techniques based on the principles of behavior analysis, the learner can gradually complete all subcomponent skills independently. Once the individual components are acquired, they are linked together to enable mastery of the targeted complex and functional skill. DTT is highly effective in teaching basic communication, play, motor, and daily living skills.

Pivotal Response Treatment (PRT) is an intervention approach developed by Robert Koegel, Lynn Koegel, Laura Schreibman, and other researchers, based on the principles of Applied Behavior Analysis (ABA). PRT is a naturalistic and developmental intervention that focuses on teaching children within their natural environment, often during playtime, to improve their responsiveness to learning and social opportunities through naturally occurring contingencies. Rather than addressing individual behaviors separately, PRT targets key areas of a child's development, such as motivation, response to multiple cues, self-initiation, and self-management of behavior. PRT has been shown to lead to widespread improvements in social, communication, and behavioral areas that are not directly targeted by addressing these pivotal areas. The implementation of PRT involves both direct intervention and parent education, as parents are regarded as primary agents of intervention for their child's development and learning.

The natural environment pertains to the child's usual surroundings, such as school, home, playground, day care, and other places they frequent. It is in these places where the child's communication and learning abilities should be utilized to their fullest potential. The ultimate objective is for the child to be able to interact with others in their environment independently. Consistent and continual training should be conducted in the natural environment. Sometimes, the environment may not offer many opportunities for the child to use their skills. In such cases, we create learning opportunities by "setting up" the environment. Although these situations may be contrived, they are not considered "unnatural." Training in such circumstances simply provides a context where the child can apply the skills they have learned.