In 2020, 1 out of every 36 children were diagnosed with Autism Spectrum Disorder. The good news is that today, intervening with Applied Behavior Analysis (ABA) early can make a bigger change than has ever been possible before. ABA has been the most effective intervention for Autism and Developmental Disabilities for decades, but today’s ABA is not the ABA of yesterday. ABA is undergoing a revolution. New ideas from a new generation of practitioners, combined with cumulative lessons learned by a passionate field over decades, have culminated in dramatic shifts in ABA. This Second Wave of ABA can be seen in everything from how we relate to our clients and their families, the techniques we use, and the level of success we expect of ourselves.
As with any revolution, I want to be careful to point out that the below may not be universally applicable across the field. Many practitioners and companies still practice the way they have for decades, often with great results.
To understand the Second Wave of ABA, you need to know where it was.
Origin of Applied Behavior Analysis
Since its inception, Applied Behavior Analysis (ABA) has been a group passionate about taking the discoveries of behavioral science and using them to improve people’s lives. Behavioral Science in the 20th century, led by such figures as B.F. Skinner, produced volumes of scientific research about the nuanced ways in which humans and animals learn from their environment. Scientists like Skinner systematically uncovered how language is learned, how reinforcement shapes behavior, the role of emotions in behavior, and the variables that affect learning. Skinner himself was passionate about helping people and saving the world with his science. Throughout his research he explored applications for different discoveries towards this end. As its name suggests, Applied Behavior Analysis was the movement that applied this goldmine of scientific research to directly improving the lives of individuals.
One of the earliest fruits of this effort was the discovery that the principles of learning can have a dramatic impact on helping people who are otherwise struggling to learn. As early as 1962, a professor at UCLA by the name of O. Ivar Lovaas explored using the principles of learning to help teach children with Autism. Prior to this, very little consideration was given to their ability to learn and grow if given the right help. ABA quickly became the most effective treatment for Autism, simply because it took the time to evaluate how individuals with Autism learn and what would help them the most.
ABA used its principles, such as positive reinforcement, prompts, and modeling to accelerate learning in those who traditional teaching methods left struggling. ABA excelled at teaching useful behaviors and eliminating disruptive ones in children with developmental disorders. Discrete Trial Training and Natural Environment Training were two commonly used strategies that emerged.
As with any field of therapy, especially those in the 1960’s, ABA had a steep learning curve. ABA started with a very optimistic, modern approach to individual potential: anyone can learn anything with the right support and environment. This approach allowed ABA to accomplish things that to this day seem miraculous to many outside the field. However, early ABA also inherited some of the assumptions of society and the field of Psychology. While not so aggressively as most other treatments in Psychology, ABA still often imposed its treatment on patients. ABA was among the strongest advocates against the need for institutional treatment facilities (think One Flew Over the Cuckoos Nest). We still had a lot to learn, however.
Older versions of ABA also tended to use more restraints and punishment. These also were never used more so than in other fields of Psychology. We had strict ethical codes stating only to use restraint and punishment when the patient’s safety was in the balance (to save them from hurting themselves or others).
Finally, traditional ABA held to a stringent individuality of treatment. Correctly, they believed that each treatment plan should be absolutely individualized to the patient, so as to ensure that it was exactly meeting their needs. However, this also meant that there was no room for standardizing treatments or collecting data to drive improvements in best practice across the field (as seen in other fields of healthcare).
Fortunately, with time, the ABA therapy treatment plan has been modified. It has found ways to center treatment more around the desires of the patient, rather than the assumptions of society. It has also found safe strategies to reduce and even eliminate the need to restrain patients, while still keeping them safe. ABA Therapy has accomplished much, but it is on the precipice of accomplishing much more in its Second Wave.
Second-Wave Applied Behavior Analysis Therapy
Applied Behavior Analysis has seen various reformations which we will combine into what we call “Second Wave ABA.” Generally, the approaches are more client-centered, data driven, and trauma-informed. Here is how they stand out:
Trauma-Informed Approach: In addition to the do-no-harm approach that has always been a core belief of ABA, trauma-assumed care takes it a step further and makes the assumption that the client is especially susceptible to harm. The understanding and consideration of trauma experiences are incorporated into the entire treatment process. Regardless of what we know about the client’s background, we assume that they have experienced trauma and that we need to be especially careful not to hurt them further. For clients that are often non-verbal, they are unable to tell us of past trauma so it is better to assume it. Dr. Camille Kolu has been a leading advocate for Trauma-informed care in ABA.
Assent-Driven Approach: In Second Wave ABA, clients lead the treatment. They emphasize the individuals voluntarily participating in their treatment. Even for non-verbal clients, practitioners find ways to understand and incorporate the client’s wants and needs in guiding treatment. Gone are the days of making assumptions about what the client needs to learn. While professional experience and data still play a big role in choosing goals for the client, what the client wants plays an even bigger role. Dr. Greg Hanley has played a leading role in advancing this value in ABA.
Prioritizing the role of the Family and Culture: The Second Wave ABA centers on the involvement of the family to bring a more successful outcome. Different families have different goals, based on their history and culture. The therapist should not assume the goals that the family wants, but rather attempt to understand them and help them achieve them. Behavior analysts involve the family members in choosing goals, measuring them, and implementing interventions. This ensures that the family understands each step of the process and is heard. Nicole Gordon, BCBA has been highly successful in teaching BCBA’s to recognize and embrace culture in ABA treatment.
Standardized Best-Practices: While ABA still holds individualized plans to be the gold standard of a good treatment plan, we are beginning to recognize that this shouldn’t be at the cost of being able to analyze and compare our results as a field. Credentialing groups like the Behavioral Health Center of Excellence are fighting to bring consistent standards to the field of ABA. More recently, companies like Acquire Learning are finding ways to integrate and standardize the field: allowing BCBA’s to share their programs and data in a way that makes it possible to find larger patterns. This will help to improve practices across the field, and helps guide BCBA’s in choosing the best programs for their client. This allows clients to learn faster than ever before- benefiting from all the others that have come before them.
Standard Quality Maintenance: Closely related to the above- the days of ABA quality being relative are coming to an end. The Second Wave of ABA includes standardized metrics, frequent audits, and set strategies. Gone are the days of each BCBA writing their programs in isolation with little to no oversight. Second Wave ABA practices hold their BCBA’s to a high standard, and they measure performance to ensure its met. This means that the treatment that a client can expect to get from ABA is consistently high quality. The goal is to provide excellence and sustain a standard in the practices of all ABA. This movement in ABA is best epitomized by the work of Nicole Da Lima Leitao at BehaviorSpan. The clinical program she has developed is unique in its organization and the results it achieves for clients.
Final Thoughts
As mentioned before, this wave is not breaking evenly. Some companies reflect and drive these new approaches, while others remain traditional in many respects. BehaviorSpan, for example, is a great example of a Second Wave ABA center.
Second Wave ABA is a more assent-based, trauma-informed, and data-driven approach. Many of these components have only become popular in the last few years, but they are already driving new levels of success helping clients. First-wave ABA discovered new possibilities helping individuals with Autism over the last 40 years. Second Wave ABA promises to make the field far more successful, compassionate, and effective than had previously imagined.
BehaviorSpan, a leading Second Wave ABA company, has been able to graduate children into mainstream school more quickly than I have ever seen before. In addition to the above, we offer Denver an early intervention ABA therapy model that uses the child’s early years to pave the way for their positive and promising future.
BehaviorSpan offers center-based ABA therapy in Denver, Colorado. It allows us to deliver one-to-one care for every child to cater to. Our certified behavior analysts spend intensive hours a week to cater to a child with ASD or developmental delays. We leverage the most recent and modern ABA approach.
If you want to know more about us, reach us today.
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