What Is Applied Behavior Analysis (ABA) Therapy?

ABA therapy is used with people who have to learn basic skills or improve certain behaviors. It may be used with patients of any age and may be found in schools, clinics, homes and professional settings. It may be successful for people who have autism spectrum disorder, helping them develop skills to be more independent and successful in daily life. 

How Does ABA Therapy Work?

An ABA treatment plan is designed for each individual person, based on his or her age, needs, interests, existing skills and family situation. It’s developed after an ABA-qualified therapist meets, interviews and observes the person involved. Autism Speaks breaks down the steps of an ABA treatment plan as follows:

Consultation and assessment

A common first step is to determine a patient’s existing skills, goals and needs. A therapist assesses the person’s communications, behaviors and interactions with others. The assessment may include visits to a person’s school or home because observing that person in his or her natural environment may give a more accurate picture.

The assessment may also include interviews with parents or others to gather history, explore problem areas, specify desired and undesired behaviors, discuss development challenges (as with language usage or motor skills) and so on. All of this information goes into the creation of a treatment plan.  

Developing a plan

According to Autism Speaks, using these observations and interviews, the ABA therapist develops a treatment plan that improves upon existing skills and reduces negative behaviors. Depending on the desired goals or outcomes, the plan may address any of these areas:

• Language and communication skills, including such basic actions as how the person forms sounds and pronounces words
• Academic skills
• Motor skills, either fine or gross
• Social skills
• Self-care, such as cleanliness and grooming habits
• Recreation or play

The treatment plan expands on the above areas as needed, creating steps for each skill area. The steps may include techniques and interventions that are the hallmarks of ABA therapy.

Caregiver training

Although therapy lays the foundation, the treatment plan is typically shared with parents, caregivers and teachers to provide consistency in daily life. For instance, if a child were to get different responses to the same behavior from different people, his or her progress toward a goal behavior could be stalled or lost. On the other hand, receiving consistent responses from all the primary adults in a child’s life helps reinforce the desired behavior and increase progress toward the goal.

Frequent evaluation

An ABA therapist collects observations and data to track progress on the patient’s goals. He or she determines which strategies and techniques are working and which ones are not as successful and then adjust the treatment plan as necessary.

While ABA therapy may be delivered at home, most applied behavior analysts work in outpatient centers or hospitals or as individual and family service providers.

ABA Techniques

Autism Speaks, a non-profit organization dedicated to promoting autism treatment, notes that applied behavior analysts primarily rely on two techniques: positive reinforcement and antecedent-behavior-consequence (A-B-C) practice. However, there are other techniques that may create desired outcomes as well.

Positive reinforcement

Parents may be familiar with positive reinforcement; it’s a basic understanding that when we receive rewards for certain behaviors, we are more likely to repeat those behaviors. The reward may be as simple as praise, small treats like stickers, or privileges such as watching a video or having screen time. Over time, positive reinforcement builds meaningful, lasting change by associating good behavior and increasing skills with desirable outcomes. 

A-B-C practice

A-B-C practice, on the other hand, seeks to reduce bad behavior through making a practice of linking behavior with consequences. This type of intervention allows those struggling with autism and their caretakers to avoid the triggers associated with bad behavior or to more effectively intervene and reduce the consequent negative reactions. Generally speaking, these techniques are employed to address behaviors related to socializing or learning, such as communication, reading, academics, dexterity or occupational competence.

The initials stand for antecedent, behavior and consequence. The antecedent is whatever directly precedes and/or provokes a behavior. That may be a request or statement from another person, stimulation from the environment (such as noise, light, television or something happening outside), an object (such as a toy or device), or something within, such as a thought or feeling.

The behavior is the response to the antecedent. It may be a verbal response, an emotional outburst, a non-response or an action.

And the consequence is what happens after the behavior. In the case of a desired behavior, it may be some sort of positive reinforcement. If the behavior is not desired, it may be ignored or, occasionally, followed by negative reinforcement.

Negative reinforcement

It’s also important to understand the role that negative reinforcement may play in ABA. This doesn’t mean punishment, but rather a behavior that causes something negative to go away or end. It’s important to realize that children teach themselves negative-reinforcement behaviors as well. Two examples:

• A child doesn’t like carrots, so he throws a tantrum whenever there are carrots on his plate. This causes his parents to take the carrots away, creating a reinforcement for the child: When I throw a tantrum, the carrots are taken away.
• A child who wants to get down from the dinner table learns that when she eats three bites of her vegetables, she’s allowed to get down. In this case, the negative of having to sit at the table is removed when the child eats three bites.

Behavior contracts

Behavior contracts are what they seem: A contract between two people (an ABA therapist and a client, for instance, or a parent and a child) outlining a desired behavior and an agreement about what the reward may be for that behavior. The contract is put in writing, and both people sign it. An example: Every day that a child finishes homework without arguing, she receives a gold sticker. When she earns 20 gold stickers, she’s allowed to trade them for a bigger reward: a trip to the park, for instance. 

Video modeling

ABA clients—especially visual learners—may benefit from watching videos of how the desired behavior takes place. Watching a video of children raise their hands to ask questions rather than speaking out of turn may be more effective than simply telling a child what to do. An ABA analyst may watch a video with a child and then recreate that scene with the child, reinforcing the desired behavior.

Components of ABA Therapy

Consultation and assessment allow patients and their caregivers to meet with an applied behavior analyst to discuss the challenges they face and the results they hope to see. The analyst conducts a functional behavior assessment, which gauges the patient’s behavioral strengths and weaknesses. 

Following the initial observation, the analyst will produce a plan to encourage good behavior and discourage bad behavior, with specific treatment goals and strategies, usually with the aid of caregivers. Once the plan is mutually established, the analyst will train the caregiver(s) on how to properly adhere to it, discussing specific tactics for reinforcing good behavior and reducing bad behavior. 

The last phase of ABA therapy is continuous, insofar as evaluations by the analyst should be ongoing to ensure that the plan for treatment is both effective and adhered to or that it is modified when necessary.

Who Qualifies for ABA Therapy?

Applied behavior analysts work with everyone from children to adults who want to improve their behavior as it concerns socialization and learning. In particular, analysts may help patients improve their communication, reading, academics, dexterity or occupational competence. They may also help patients address more specific issues with substance abuse, brain injury, autism spectrum disorder or other medical conditions. 

The best way to tell if an analyst can help a patient is through the first component of ABA therapy: consultation and assessment.

Autism Spectrum Disorder (ASD) and ABA Therapy

According to Autism Speaks, autism spectrum disorder is characterized by challenges with social skills, repetitive behavior, speech and nonverbal communication. ASD is estimated to affect one in 59 children in the United States today. Although the causes are not certain, it is thought to be influenced by a combination of genetic and environmental factors.

Because autism is a spectrum, it manifests differently in different people. Some people struggling with ASD may live entirely independent lives while others may require significant daily support. Autism may be accompanied by gastrointestinal conditions, seizures, sleep disorders and mental health challenges such as anxiety, depression and attention-related issues. 

Symptoms typically appear around age two or three, but it may be diagnosed as early as 18 months. Early intervention, in the form of therapy and medication, can improve later outcomes.

Symptoms of autism

There are symptoms that can generally be attributed to autism spectrum disorder. Broadly speaking, these are challenges with social skills, repetitive behavior, speech and nonverbal communication. More specifically, these can be difficulties with spoken language, gestures and eye contact; challenges recognizing emotions, intentions and personal space; and repetitive body movements, ritualistic behavior and extreme interest in narrowly defined subjects. 

While some of these symptoms become most noticeable in childhood, signs can be found in infants younger than 24 months, including limited facial expressions, lack of eye contact, and little babbling or speaking.

How does ABA therapy help with autism?

According to Autism Speaks, ABA therapy can assist those struggling with autism by building social skills, improving communication and reducing problematic behavior, primarily through two techniques: positive reinforcement and antecedent-behavior-consequence practice.

Positive reinforcement encourages desirable behaviors and skills through reward, which, over time, builds meaningful and lasting change. A-B-C practice reduces problematic behavior through analysis of what leads to and results from such behavior, allowing those struggling with autism and their caretakers to avoid triggers or intervene to reduce negative effects.

What Is the Evidence That ABA Works?

ABA therapy focuses on each behavior individually, outlining steps to create preferred behaviors and ways to reinforce them when they occur. With time and consistency, positive behaviors begin to replace problem behaviors.  

Applied behavioral analysis has been the subject of decades of research. In 2014, the American Academy of Child and Adolescent Psychiatry said, “ABA techniques have been repeatedly shown to have efficacy for specific problem behaviors, and ABA has been found to be effective as applied to academic tasks, adaptive living skills, communication, social skills, and vocational skills.” Autism Speaks says that ABA is an “evidence-based best-practice treatment,” which means it has “passed scientific tests of its usefulness, quality, and effectiveness.”

The Centers for Disease Control and Protection (CDC), the National Institute of Mental Health (NIMH) and the National Institute of Child Health and Human Development are organizations that note the effectiveness and merit of the ABA process. And the U.S. Surgeon General’s 2001 Report on Mental Health said, “Among the many methods available for treatment and education of people with Autism, Applied Behavior Analysis (ABA) has become widely accepted as an effective treatment. Thirty years of research demonstrated the efficacy of applied behavioral methods in reducing inappropriate behavior and in increasing communication, learning, and appropriate social behavior.”

Salaries and Projected Job Growth of ABA Therapists

While the U.S. Bureau of Labor Statistics does not have figures on applied behavior analysts in particular, it does track substance abuse, behavioral disorder and mental health counselors in general. From 2019 to 2029, the BLS expects counseling jobs to grow 25%—great news for anyone looking to become a behavioral analyst.

Counselors may be employed in a variety of settings, detailed in a table below, and earn a median annual salary of $46,240, though compensation may be significantly higher depending on location. 

Work environment for substance abuse, behavioral disorder and mental health counselors:

• Outpatient mental health and substance abuse centers: 19%
• Individual and family services: 16%
• State, local and private hospitals: 10%
• Residential mental health and substance abuse facilities: 10%
• Government: 8%

Top-Paying States for Substance Abuse, Behavioral Disorder and Mental Health Counselors

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State	Hourly mean wage	Annual mean wage
Utah	$32.41	$67,410
Nevada	$30.73	$63,910
Oregon	$29.31	$60,960
Alaska	$29.25	$60,830
New Jersey	$28.90	$60,120

*Information gathered from BLS: Substance Abuse, Behavioral Disorder and Mental Health Counselors

While the information list above may be helpful in understanding what Applied Behavioral Therapy (ABA) is; it is important to note that this article is for information purposes only and that it is always best to seek the advice from experts. 

Last Updated: January 2021