64 Established Treatments

Applied Behavior Analysis (ABA)

ABA is a research-based philosophy of working with individuals (not just individuals with autism), and is based on the work of BF Skinner. ABA is an umbrella term that applies to a range of strategies. Some people equate ABA to specific methods (discrete trial training, intensive behavioral intervention, ABA therapy) rather than the broad-based meaning of the term. ABA relies on standard behavioral principles to address reduction of behavior as well as alternatives to the environment and teaching of appropriate skills to support reduction of behaviors. It also focuses on data-driven decision-making with consideration of both antecedents and consequences in evaluation behavior and in planning and implementation of intervention plans.

Generally, behavior is believed to equate to communication. Individuals are believed to repeat behaviors that work for them (or serve a purposeful function) and stop doing those behaviors that don’t work. If an individual is given access to watch TV whenever they scream, they will likely continue to scream to request TV. In contrast, if the individual is not able to access TV when they scream, but only when they say “TV please,” they will likely learn to say “TV, please” to access TV vs scream.

Discrete Trial Training

In Discrete Trial Training (DTT), an individual is taught one specific (or discreate) skill through a sequence of repeated trials. The individual may be taught to follow an instruction “stack blocks” or “match same”. This skill would be practiced with corrective feedback until data collected indicates that the skill was learned. DTT was established by Ivar Lovaas in the 1970s and requires that the individual receives 25-40 hours per week of intervention. The strategy has been well established as an evidence-based practice despite some controversy regarding the generalizability of the skills learned to everyday life and application.

Incidental Teaching

In Incidental Teaching, the individual leads the learning. Caregivers set up the environment in ways to encourage communication, interaction, and skill building based upon the individual’s motivation and interests. Motivation to access the visible objects and interests set the stage or opportunity for teaching, practice, and learning. For example, if an individual likes trains, the trains may be placed on a high shelf to encourage the need to make a request for access. Once the individual requests with an approximation, word, phrase , or gesture, the caregiver provides access and then further works on expanding the appropriateness and level of request in further trials. Dr. Gail McGee developed the intervention at Emory University in the 1970s with further study occurring since that time.

Pivotal Response Training

Pivotal Response Training (PRT) evolved from DTT and was an effort of experts having trained in the Lovaas method and desiring to incorporate a more naturalistic approach to DTT methods in an effort to increase generalizability. With this method, two key (or pivotal) types of responses are taught : motivation and responsivity to multiple cues. These key behaviors  are known to have widespread impact and results on a range of other behaviors. PRT has been used to improve language skills, social skills, play skills, and behavioral difficulties. This method was developed by Robert Koegel and Laura Schreibman in the 1980s.

Social Stories®

Social Stories®, developed in 1991 by Carol Gray, describe what to do in situations that may present complexity or challenge for the individual. The strategy is designed to assist in processing and understanding the situation by providing concrete explanations, rules, expectations and assurances in a visual and repetitive format. The stories may contain words, pictures, or both and can be used for many areas of challenge, such as how to respond when others break the rules or getting a shot at the doctor.

In this way, the story can be read before, during, and/or after the situation to assist with comprehension and calming. Social Stories® are useful because individuals with ASD often process visual information more effectively than verbal information particularly when more anxious and the information remains and can be consistently repeated regardless of the context and caregivers involved.