ABA AND AUTISM

There is no single therapeutic treatment for autism. Given the complexity and heterogeneity of the clinical picture and symptoms of individuals with autism spectrum disorder, an integrated therapeutic project is necessary. During the developmental age, the therapeutic interventions implemented are aimed at:

• Reduce or correct maladaptive behaviors;
• Direct development so that skills can emerge that promote subject/environment adaptation;
• Promote good emotional adjustment (impulse control, frustration tolerance, regulation of emotional states, adequate self-image).

(SINPIA, 2005) The treatment plan indicates that intermediate goals are established that are appropriate to the child’s developmental profile, his or her needs, and those of the family. The pervasiveness of the disorder may require that we set multiple goals at the same time or that the individual may benefit from multiple differentiated interventions. To date, within the Guidelines 21 of the Istituto Superiore di Sanità (LG21, the treatment of Autism Spectrum Disorders in children and adolescents) interventions based on Behavior Analysis and behavioral interventions in general are recommended as effective. Evidence-based interventions are defined as those interventions that are based on scientific evidence demonstrating their effectiveness. An intervention is defined as effective when the results and improvements obtained can be traced back to the treatment and not to the natural growth path of the child. Evidence-based interventions refer to studies that have been published in scientific journals and whose results demonstrate that the particular intervention practice is responsible for the objective improvement in the child’s living conditions. Ad oggi si parla di“Early Intensive Behavioural Intervention” (EIBI), il termine EIBI include tutti i modelli d’intervento comprensivi derivati dall’ABA, come il Denver Model, e non è limitato al modello UCLA/Lovaas. The term “evidence-based education” refers to the use of the latest scientific evidence to guide decisions about teaching, including ABA (Applied Behavior Analysis).  Studies show that the application of Behavior Analysis leads to significant improvements in intellectual skills, communication and language, adaptive behaviors in children on the autism spectrum, it is essential to involve all figures that are part of the context of life of the subject so that we can talk about an intervention not only effective but also generalized. Applied Behavior Analysis is the applied science derived from the basic science known as Behavior Analysis (Skinner, 1953), provides a mode of scientific observation of human behaviors, what determines them and the consequences they produce on the environment and the subject. It provides the implementation of processes of learning/teaching new skills, the decrease of dysfunctional behaviors in order to improve the quality of life of the individual. Applied Behavioral Analysis and autism have been a pairing for about 30 years even though ABA was not really born with autism but as a methodology for the recovery of intellectual and developmental disabilities in general.

ABA is characterized by seven dimensions (Baer, Wolf, & Risley, 1968):

• Applied, that is, it takes into account socially significant behaviors for the person and pays attention to the context in which they occur.
• Behavioral because it is based on the measurement of behaviors, on defining and evaluating behaviors according to quantifiable and objective dimensions. 
• Analytical because it is based on the relationship between stimulus and response, on the relationship between behavior and environmental variables.
• Technological in that each procedure is described in detail and analytically.
• Effective is the ability that this science has to modify significant behavior, its application necessarily involves a modification of behavior.
• Conceptual because of the theoretical principles to which it refers.
• Generalizable in other contexts and with other people by promoting the highest level of adaptation possible.

ABA does not forget the individuality of each person as it starts by taking a “picture” of the person by defining the characteristics, preferences, skills present, emerging and absent, what is necessary to teach respecting the dignity and values of the person and protecting its social image, ensuring a process of inclusion as being with others doing things with others. Psychoeducational and individualized interventions concern the areas of development of verbal and communication skills, cognitive skills, social and personal autonomy through intervention programs that involve parents, teachers, operators and any person who is in relationship with the subject. According to the World Health Organization, health is not the absence of disease, but bio-psycho-social well-being, the full realization of one’s potential, of one’s capability (Sen, 1994).