Exploring the relationship between ABA and SLP

Throughout my experiences in grad school to become a speech-language pathologist, I heard a lot of people say that ABA, which stands for Applied Behavior Analysis, was bad. I generally just nodded and did not contribute anything to the conversation because I did not know what to say. For all I know, maybe behavior analysts say the same things about our field! They might say we “just play games” and do not take enough quality data. As a part of my blog, I wanted to delve deeper into whether there can be a happy marriage between the two.

ABA is a systematic approach to intervention which brings to mind the concepts of Ivan Pavlov and B.F. Skinner. Pavlov is of course most famous for his experiments with dogs where he found out he could condition the dogs to salivate when they heard a bell ring because they had begun to associate the bell with food. B.F. Skinner came up with operant conditioning which basically states that individuals learn behaviors based on the reward or punishment they receive. The plan of ABA is to slowly fade (get rid of) prompts and rewards as the individual becomes more independent. The ultimate goal is that the individual will carry out the action/behavior without even being prompted.

As an aside, keep in mind that a punishment in these terms does not mean a spanking or whatever, but rather some type of action which makes the behavior less likely to occur again. Punishment in psychology does not always match up with the traditional definitions of the word and could in fact mean the opposite. What if a child refuses to do a classroom assignment, throws a tantrum, and gets sent to timeout. What happened? It is possible that the child achieved his goal through the behavior (the tantrum) because he did not have to finish the assignment. Is that a punishment? On the contrary, it is reinforcement.

Two main components of ABA are prompting an individual to do a certain behavior/action and then rewarding them when they do it. Prompting could be telling the individual to do it, gesturing towards what or where they have to do something, modeling (acting out) the behavior, providing hand-over-hand assistance, etc. I have listed them in the order that generally represents the most to least independence required by the student. Rewards can vary based on how independently and “correctly” the individual carried out the action or behavior. He might get a minute on the iPad if he followed the directions after simply being told to do so but only get 30 seconds if he displayed some undesired behavior.

So what do SLPs have against ABA? They say it is too robotic and does not generalize. Generalization refers to a skill that was learned in therapy being able to be used outside of the “therapy room” and in real situations. In the real world, they say, you never get a Hershey Kiss for following directions.

I am more optimistic that speech and ABA can have a symbiotic relationship. One of the reasons for this is that we as SLPs are not given enough training in behavioral management skills. And since undesirable behaviors might be inextricably linked to individuals’ difficulties with language and communication, it behooves us to learn a thing or two about it. In fact, the “undesired behavior” itself is a means of communication. And at the very worse, even if an SLP does not want to explicitly incorporate ABA therapy into sessions, they can examine the data kept by behavior analysts to figure out why behaviors seem to be occurring (antecedents) as well as what prompts and rewards seem to help the individual cooperate with others. Moreover, if we figure what a behavior is communicating, we can come up with alternative and adaptive ways for the student to communicate the same thing.

Not only can an SLP examine behavior analysts’ data and learn by talking to them, SLPs already actively use some principles of ABA in their sessions without even realizing it. What if we suddenly stop playing with a child and wait for them to request the action before continuing the play? That is rewarding the behavior of requesting.

The PLAY Project developed by Dr. Rick Solomon is an early intervention technique which incorporates naturalistic play into helping children communicate and develop deeper bonds with others while training the parents to keep carrying out this intervention. On the surface, one might say this is the antithesis of ABA but it is actually, in my opinion, an effective hybrid.

I went to a seminar by Sheryl Rosin, Ph.D., CCC-SLP, at the 2016 ASHA Convention titled ‘The PLAY Project: An Evidence-Based Early Intervention Program for Children With Autism Spectrum Disorders’. Mostly, her presentation involved showing and discussing videos of her consulting with parents during play-based activities. During one video, a child expressed interest in a ball. The mother took the ball and ran away from him. At first, he just chased her happily, but as time went on, the mother was consulted to do more and more to facilitate interactions (Rosin, 2016). She stopped and waited for her son to request for play to continue. She made comments and encouraged responses. What was she doing? She was rewarding requests, the reward was more play.

We can learn a lot from ABA. But also, if we dismiss a field, we are missing a chance to develop a multidisciplinary team that allows them to learn from us too. Behavior is inextricably linked to communication. Not only that, remember that we can help behavior analysts by contributing information based on our expertise. We can tell behavior analysts when a child is not completing a certain behavior because of their apraxia, dysphagia, receptive language disorder, or whatever it may be. We can come up with alterations and adaptations that help the child.

References Rosin, S. (2016). The PLAY Project: An evidence-based early intervention program for children with autism spectrum disorders. Presented at the 2016 ASHA Convention, Philadelphia, PA.

You might be interested in reading these articles:

http://www.difflearn.com/product/speech-language-pathology-and-ABA/
http://teachmetotalk.com/2015/04/23/lessons-from-aba/
http://blog.asha.org/2012/02/07/the-abcs-of-aba-in-the-slp-world/
https://www.reddit.com/r/slp/comments/2wy1vy/what_do_slps_think_about_aba_therapy_and_aba/
https://spectrumnews.org/features/deep-dive/controversy-autisms-common-therapy/
https://www.autismweb.com/forum/viewtopic.php?t=1410
http://speechandaba.blogspot.com/
http://www.autism-pdd.net/testdump/test16288.htm
http://www.sentex.net/~nexus23/naa_aba.html
https://www.theatlantic.com/health/archive/2016/08/aba-autism-controversy/495272/
https://sociallyanxiousadvocate.wordpress.com/2015/05/22/why-i-left-aba/
http://autismmythbusters.com/parents/therapy/the-truth-about-aba/
https://www.psychologytoday.com/blog/breaking-barriers/201411/answers-beliefs-about-aba-0
http://www.wikihow.com/Tell-if-an-Autism-ABA-Therapy-Is-Harmful
http://blog.theautismsite.com/aba-therapy-controversy/