Therapy can be a great tool for working through challenges in life. Whether physical, mental or behavioral challenges, there is a wide range of reasons for seeking therapy. Thus, there is a wide range of therapies offered to tackle these different challenges. Choosing the right type of therapy for a particular challenge is important for success. One type of therapy may be better suited to a particular challenge than another type of therapy is. So, what type of therapy is best when it comes to behavioral challenges with children with autism spectrum disorder?
As we here at LakiKid strive to be a strong resource for the community, we’ve put together a short list of behavior therapies which are proven to work well for children with autism spectrum disorder.
Before we go any further, let me say there will be other types of therapy which may be beneficial to a child with autism, depending on the particular challenge. This post, however, will focus on behavioral challenges and three specific behavior therapies with proven success in such situations.
Behavior therapies focus on providing a patient with the tools he/she needs to react differently in particular situations. When children with autism become overwhelmed with stimuli or a certain situation they are in, it is common for them to display some troubling behavior, which can be harmful to the child or others around the child. Behavioral therapies seek to provide the child with the tools needed to better communicate before a situation escalates to that level.
The three behavioral therapies we’re going to discuss are Applied Behavior Analysis (ABA), Verbal Behavior Therapy (VBT) and Cognitive Behavioral Therapy (CBT).
Applied Behavior Analysis (ABA)
ABA therapy has the potential to affect challenging behavior quickly. Especially when it is conducted in an intensive one-to-one scenario, between the therapist and the child. ABA therapy aims to decrease challenging behavior while improving the life of the child and the child’s family. However, Dr. Meme Hieneman notes that these one-to-one scenarios have potential drawbacks as well. In an article titled “Simple Ways to Use ABA Intervention in Family Routines,” found in Autism Parenting Magazine, Hieneman lists such potential drawbacks as:
- Developed skills may seem mechanical or habitual, not always relevant to the circumstance.
- Some children may resist repetition-based learning tasks.
- Learned skills may not translate across time, people or specific circumstances.
- When improperly planned, these skills may interfere with daily family routines, making things more difficult rather than easing the life of the child and family members.
For these reasons, it is important for families to work with the ABA therapist to implement the lessons and tools into their everyday lives, using the therapy and learned skills to improve quality of life rather than hinder it. It’s important to discuss family goals, so the ABA therapist can work with regular caregivers to help develop skills that can be easily introduced and used in natural settings.
Heineman describes this as the “process of routine-based intervention, offering 5 stages to this process: identifying goals, assessing patterns, designing strategies, using the plan and monitoring outcomes.
Identifying goals: First, it must be considered how the child’s quality of life can be improved, along with the routines the family would like to see improve.
Assessing Patterns: After routines which produce challenging behavior are identified, the ABA therapist will assess patterns which may be contributing to such behavior within the given routine.
Designing Strategies: Once patterns have been identified, the next step is design strategies to not only address these patterns, but to fit into the family’s life as well. There are three categories of strategies used in an ABA plan.
- “Proactive strategies involve preventing problem behavior and prompting positive behavior by rearranging environments or establishing expectations.”
- “Teaching strategies focus on building skills a child can use to replace his/her challenging behavior and participate more successfully in the routine.”
- “Management strategies focus on consequences, specifically providing reinforcement for positive behavior and withholding it for problem behavior.”
Using the Plan: When it comes to putting the plan into place, ABA therapists should serve to instruct the parents in how to best work strategies into daily life as opposed to intervening themselves.
Monitoring Progress: As you move forward with the ABA strategies, it is important to monitor whether your child’s behavior is improving in different routines, taking note of what appears to work well and what does not work as well.
ABA is perhaps the most generalized behavior therapy discussed here, and thus, better suited to more situations. VBT and CBT use the underlying principles of ABA to develop address other, more specific challenging behaviors.
Verbal Behavior Therapy (VBT)
The goal of VBT, when it comes to a child on the autism spectrum, is to improve the child’s ability to communicate. It is often difficult for children with autism to communicate desires or feelings. According to an article titled “Verbal Behavior Therapy” on autismspeaks.org “Verbal Behavior Therapy motivates a child, adolescent or adult to to learn language by connecting words with their purposes. The student learns that words can help obtain desired objects or other results.” Being able to communicate more effectively may help to decrease challenging behavior.According to the article titled "Verbal Behavior Therapy for Children with Autism" on Autism Parenting Magazine, VBT teaches children to make simple requests through language, picture exchange, or pointing to the desired object. Rather than focusing on words as mere labels for things, VBT seeks to teach why we use words. There are four types of language which VBT focuses on:
VBT focuses on repetition to help teach a child with autism to use words to fulfill his/her desire. In doing so, VBT therapists use a method called errorless learning. Using this method, “the therapist provides immediate and frequent prompts to help improve the student’s communication. These prompts become less intrusive as quickly as possible, until the student no longer needs prompting” (autismspeaks.org). The goal is for the child to eventually be able to use a word, or string of words, to obtain a desired outcome of his/her own accord.
VBT is better suited to children with autism who are on the lower-functioning end of communication. On the other hand, CBT is better suited to children on the higher-functioning end.
Cognitive Behavior Therapy (CBT)
When it comes to children with autism spectrum disorder, CBT often pairs behavior practices with cognitive practices. This is because people with autism tend to be more concrete thinkers, rather than abstract ones.
The Beck Institute for Cognitive Behavior Therapy offers “An Introduction to CBT for people with an Autism Spectrum Disorder,” outlining some of the ways in which CBT is used to help children and adults alike. According to the article, “a component of treatment often focuses on the ‘rules of the game’ in social situations, which may be intuitive to others but are generally very hard for a person with ASD to penetrate.” This is due to the tendency to be concrete thinkers. It can often be very difficult to understand the abstract use of words coupled with body language and facial expressions in order to accurately read a social situation, something many neurotypical take for granted.
What Therapy Works Well?
ABA therapy is the most generalized of the therapies discussed above. It is likely to have an impact on a wider variety of situations than VBT or CBT. That being said, there are many scenarios where VBT and/or CBT are viable and important therapy options for a child with autism spectrum disorder.
In all three cases, it is paramount that immediate family members and regular caregivers work closely with the therapist. The behavior therapists should be working with you to implement the learned skills into everyday life, improving the quality of life for everyone involved.
And remember, every kid brings good luck!