CT FEAT: Families Helping
Children Achieve Their Full Potential
Applied Behavior Analysis in Autism: Five Models
By: Roberta Brancato Daversa (May 2001)
Editor's Note: The author has a
family member with autism. She prepared this report in connection with
undergraduate course work at the University of Connecticut.
In 1970, behaviorist Ivar Lovaas (UCLA) began an experiment in which he
applied B.F. Skinnerís theory of behavior to the treatment of young children
with autism. Lovaas published his findings in 1987
(Behavioral Treatment and Normal Educational and Intellectual Functioning in
Young Autistic Children
and documented remarkable gains for many of the children in his study. This was
the first in a series of
based studies supporting applied behavior analysis (ABA)
as effective treatment for children with autism.
Good science typically forms a basis for further research and refinement of
methodology. This holds true for Lovaasí early behavior modification research.
Today, the application of the principles of behavioral science is the framework
for several different ABA models of autism intervention.
The efficacy of ABA in the treatment of autism has achieved growing
acceptance among families with autism, intervention professionals and educators.
Along with the decision to pursue ABA intervention there is often an
understandable confusion about the various models. This paper will provide a
brief look at the origins of ABA in autism treatment, a survey of the UCLA Young
Autism Project (Lovaas, 1970) and an overview of other ABA models. It will
hopefully provide insight on the current scope of ABA in autism and contribute
to the understanding of the distinctions among the five models discussed:
1) The UCLA Model: O. Ivar Lovaas, Ph.D.
2) Autism Partnership: Ron Leaf, Ph.D. & John McEachin Ph.D.
3) PECS and the Pyramid Model: Andrew Bondy, Ph.D. & Lori
Frost, MS, CCC/SLP
4) The Eden Model: David Holmes, Ph.D.
5) Verbal Behavior/ DTT-NET: Mark Sundberg Ph.D. & James
A Brief History of Behaviorism and ABA in Autism Treatment
The experimental analysis of operant behavior has led to a technology often
called behavior modification. It usually consists of changing the consequences
of behavior, removing consequences, which have caused trouble, or arranging new
consequences for behavior which has lacked strength (BF Skinner, date unknown).
In 1938 American behaviorist B.F. Skinner's Operant Conditioning theory
was published in his first book The Behavior of Organisms: An Experimental
Analysis. In it he examined the basic mechanism of behavior change
(learning). Simply stated, the consequences of the behavior influence the
likelihood that the behavior will occur again.
Skinner's laboratory research demonstrated that a behavior would increase
when it is followed by a reward such as a highly desired item. Behaviors will
decrease in frequency when they are followed by punishment (social disapproval,
loss of privileges).
At that time, psychology was a relatively new science. It was an offspring of
philosophy and science, born in 1879 when the German scientist Wilhelm Wundt
established a laboratory to explore human consciousness and mental processes.
This event signaled the beginning of a scientific approach to the mind and
human behavior, and a formal discipline to pursue it (Ashcraft, 1998:16).
In the early years of psychology, the science was dominated by interest in
mental states and research methods of introspection originally developed by
Wundt. By the turn of the century however, a small number of scientists became
concerned with more concrete areas of behavior such as response conditioning.
American psychologist John B. Watson was one of them and firmly rejected
mentalistic approaches in psychology. In 1913 he published a paper that is now
known as the "behaviorist manifesto". In it he advocated for a
psychology without the terms consciousness, mental states, mind, content,
introspectively verifiable, imagery, and the like (Watson, 1913 in Ashcraft,
1998:18.) Thus, by calling upon other psychologists to also reject
introspection and interpretation of mental states as scientifically valid, and
to develop psychology as the science of observable and quantifiable behaviors,
Watson began the era of behaviorism which was to dominate American psychology
through the mid-1950s.
Watson and the early behaviorists explained behavior as a response to
environmental states or events (stimuli). This basic stimulus Ė response
concept spawned various forms of behaviorism including the "radical
behaviorism" of Skinner. With his development of the
Conditioning Theory of Behavior, Skinner laid out
the basic principles of behavioral science: reinforcement, prompting, fading,
reinforcement schedules, extinction, shaping, discrimination, differentiation,
etc . . . the theoretical basis of ABA.
In the 1960s, behaviorists began applying Skinner's theory to the development
of teaching methods. Some, like Ivar Lovaas at UCLA, designed programs
specifically for children with autism. Until then autism treatment was generally
based on a psychodynamic model . . . offering some hope for recovery through
experiential manipulations. By the mid-1960s, an increasing number of studies
reported that psychodymanic practitioners were unable to deliver on that promise
(Rimland cited in Lovaas, 1987). These failures prompted some professionals
to abandon Kanner's position that children with autism have potential for normal
intelligence and led to an emphasis on organic theories of autism that
offered little or no hope for major improvements through psychological and
educational interventions (Lovaas, 1987). Meanwhile, applied behavioral
approaches were firmly suggesting otherwise. Children with autism were making
treatment gains within behavior modification programs and these findings were
making their way into professional journals (Lovaas, 1987). These two
occurrences, the increased reports of the inefficacy of psychotherapy and the
documentation of favorable outcome with behavioral intervention, made the 1960s
pivotal for the study and treatment of autism.
It wasnít until the mid-1990s however that intensive behavioral treatment
for children with autism began receiving serious attention among families and
others outside the scientific community. In 1993 Catherine Maurice published an
autobiographical account of her familyís successful experience with the
intensive ABA of the Lovaas model. This book, Let Me Hear Your Voice,
along with the previously published ME BOOK (Lovaas, 1981)
gave families hope and direction that was supported by scientific research. The
Internet served as a conduit for the growing interest in ABA. The continually
growing number of web sites and mailing lists, like Ruth Allenís indispensable
ME LIST, provided access to additional information and support from families and
professionals. Several articles on Lovaas style home programs appeared in major
publications. ABA was working and improving the lives of the families who used
it and was propelled into the spotlight of autism treatment. By the end of the
decade, ABA had received
major endorsements (state and federal), including
a 1999 report from the U S Surgeon General.
Thirty years of research demonstrated the efficacy of applied behavioral
methods in reducing inappropriate behavior and in increasing communication,
learning, and appropriate social behavior.
(Satcher, D. 1999)
In the Beginning
The UCLA Young Autism Project
Teaching Developmentally Disabled Children: The ME BOOK (Ivar Lovaas,
I donít claim a cure because we havenít gotten to the organic variable
that is causing the autism. But the nervous system is pretty adaptable, and with
intensive therapy the child may be able to work around his organic deviation.
(O. Ivar Lovaas quoted in Johnson, 1994)
Ivar Lovaas began using behavior modification in autism treatment during the
In 1970, he began an innovative intensive behavioral intervention
program for young children with autism. The remarkable results of this study
Behavioral Treatment and Normal Educational and Intellectual Functioning in
Young Autistic Children
published in 1987. Almost half of the children who received the intensive
therapy (40+ hours per week) achieved normal functioning after 2 years,
completing first grade in a regular classroom without any special education
support (Lovaas, 1987). Most of the others made significant gains. The study
included three groups of children who were independently diagnosed (by a
physician or a licensed Ph.D. psychologist). All the children were under 4 years
of age when treatment began. The key results after 3 years of treatment are
summarized in the following table:
Average IQ Gain
40 Hours of one to one behavioral intervention per week (for at least
2 years), with carryover to the home environment;
Teaching occurred during most of their waking hours.
9 Children successfully completed typical first grade without support
-achieved "normal" functioning
-average IQ gain = 30 pts.
8 Children made substantial gains but required ongoing support
-completed first grade in special education or language delayed
2 Children were placed in classrooms for autistic or mentally
Control Group 1
10 Hours or less of behavioral intervention per week;
Other intervention treatments (special education)
8 Children made substantial gains but required ongoing support
-completed first grade in special education or language delayed
11 Children were placed in classrooms for autistic and mentally
Control Group 2
Outside group; not treated by Lovaas
1 Child successfully completed typical first grade without support
10 Children completed first grade in special education or language
10 Children were placed in classrooms for autistic and mentally
A follow up study at around age 12 (McEachin, Smith &
Lovaas, 1993) confirmed that the children in the experimental group maintained
their gains over the control groups. The 9 children who achieved apparent
normal functioning were given extensive evaluations by naÔve professionals
indicating that 8 of them were indistinguishable from average children on
tests of intelligence and adaptive behavior. Thus, behavioral treatment may
produce long-lasting and significant gains for many young children with autism
(McEachin ,et al., 1993).
By applying operant learning principles to autism intervention, Lovaas left
behind the disease treatment approach and replaced it with the teaching of
observable appropriate behaviors. The locus of intervention was changed from
treatment to teaching (Lovaas, 1981:xi).
There were several other developments that emerged as we moved away from
the traditional disease model of service delivery. We broke down the large
hypothetical constructs of "autism", "aphasia",
"retardation", etc. into more manageable components or behaviors .
. . we were teaching the children specific behaviors such as language, play,
and affection. These teaching programs were "interchangeable"
across diagnostic categories in the sense that what we had learned about
teaching language to retarded children could just as easily be applied to
teaching language to aphasic or autistic children (Lovaas, 1981: x).
Teaching goals were broken down into behavioral categories and presented
according to the following schedule (Lovaas, 1987):
Teaching appropriate play
Reducing self stimulatory and aggressive behaviors
Teaching expressive language
Teaching early abstract language
Establish interactive play with peers
Meaningful integration within a typical preschool group*
Teaching appropriate and varied expressions of emotions
(the Three Rs)
* Initial placement in special education classes was avoided because of the
detrimental effects of exposure to other autistic children.
Other key innovations of the UCLA project were:
Intensity of Intervention
Lovaas hypothesized that the intensity of instruction for these children, 40
hours a week of direct one to one with additional carryover by parents (to
extend teaching to almost all waking hours), would approach the influence of the
natural environment on a typically developing child. The average child spends
most of his time learning from his environment; he remains engaged with his
surroundings in a way that a child with autism cannot. . . The average, or
common environment that does so well for he average child does not fit the needs
nor provide the structure necessary to be a good teaching / learning environment
for these exceptional children (Lovaas, 1981: xi). One of the goals for the
experimental group was to design a program in which the child with autism was
always learning. We hypothesized that construction of a special, intense, and
comprehensive learning environment for very young autistic children would allow
some of them to catch up with their normal peers by first grade (Lovaas, 1987).
The Place of Intervention
The place of service was moved from the institution to the child's home and
community. The objective was to teach the children to function in the real
world. In a previous study, Lovaas had used intensive behavioral teaching
methods with children who were institutionalized. They were able to make
surprising and significant gains while in treatment (1 year) but regressed upon
discharge from the program. The importance of the environment in maintaining
learned behaviors had been completely underestimated with heartbreaking results.
Home based intervention also eliminated the potential for the child to pick
up inappropriate behaviors that he might observe from other children with
The Age of Intervention
All children in the UCLA Young Autism Project were under 4 years of age when
they began the program. Lovaas speculated that younger children would maintain
generalize skills more easily than older children because they would be
less likely to discriminate between environments . . . it was assumed it
would be easier to successfully mainstream . . . into preschool than to
attempt mainstreaming an older child into a higher grade
The Role of Parents and Other Significant People
Parents and other adults in the child's community were trained to be actively
involved in teaching the children. This way the parents could maintain and
support the gains made by the children. All significant persons in the child's
environments were actively included in the program. The parents and teachers
became the primary service providers with the professionals acting as
consultants, staff trainers and program coordinators.
Teaching Behaviors in Small Units: "Discrete Trials"
Tasks (behavior goals) were broken down into small steps. Each "discrete
trial" was taught separately using highly motivating reinforcers as
consequences for correct responses (behaviors).
Teaching Spontaneity and the Joy of Learning
One of the goals was to make it more fun to tune in and learn than to spin
or flap or wander around the room . . . the two fundamental goals, apart from
the content being taught, are to make the child want to learn and to make the
child feel that he can learn. That he is competent. (Lovaas quoted in Johnson,
Systematic Data Collection
Intensive data keeping was used to document the effects of the treatment on a
Development of a Training Manual
Another important contribution of the UCLA Early Autism Project was the
publication of a comprehensive, reader friendly 'how to" book for parents
and teachers that covers all the tools of behavioral teaching. It gives clear
examples of their application, both in one-on-one teaching sessions and in the
general life environment of the child. Teaching Developmentally Disabled
Children, also called The ME Book, was published in 1981 (PRO-ED, Inc) and
continues to give parents, teachers and other interested adults clear
instruction on how to establish appropriate and functional skills and responses
and eliminate problem behaviors. A series of video training tapes is also
The groundbreaking research by Lovaas and his colleagues raises several
intriguing possibilities. First, it suggests that intensive teaching that
requires young children with autism to engage actively with their physical
and social environments and provides them with consistent, differential
consequences can result in completely normal functioning for many . . .
Second, that intensive behavioral intervention produces substantially better
outcomes than other treatments for young children with autism (Green,
But what about those children in the UCLA project that did not achieve normal
functioning? What variables could explain why some children developed to become
indistinguishable from their typical peers and some did not? This might suggest
a different etiology for these children or perhaps a different learning style
than was addressed in the original language based program. Lovaas and others
believe these children might be visual learners (Johnson, 1994). Efforts to
refine and expand on the concepts learned thus far continue. Some programs, such
as the Picture Exchange Communication System (PECS) or the Princeton Child
Developmente Institute (PCDI), utilize more visual approaches to teaching
communication. These techniques have been built up by many behaviorists
working with many children over many yearsí time. It is a constantly
developing system. (Lovaas quoted in Johnson, 1994)
The Autism Partnership Model
A Work In Progress: Behavior Management Strategies and a Curriculum for
Intensive Behavioral Treatment of Autism (Ron Leaf & John McEachin,
Discrete trial teaching is a specific methodology used to maximize
learning. It is a teaching process used to develop most skills, including
cognitive, communication, play, social and self-help skills. Additionally,
it is a strategy that can be used for all ages and populations. The
technique involves: 1) breaking a skill into smaller parts; 2) teaching one
sub-skill at a time until mastery; 3) providing concentrated teaching; 4)
providing prompting and prompt fading as necessary; and 5) using
Discrete trial teaching ensures that learning is an active process. We
cannot rely on autistic children to simply absorb information through
(Leaf & McEachin, 1999:131)
Rob Leaf and John McEachin studied under Lovaas and were directly involved
with the UCLA Young Autism Project for about twelve years beginning in the
mid-70s. Both received extensive training which lead to their doctorates under
the direction of Dr. Lovaas at the UCLA early intervention clinic. Subsequently,
their work included servicing people with autism of all ages in various
settings. Their model of treatment is based heavily on the UCLA model. It is
also influenced by their experiences with clients beyond the preschool level.
They have drawn from the work of other professionals and from their
collaborations with special education and language professionals,
paraprofessional teachers and parents.
Primary Teaching Methods
The primary teaching method is one-to-one discrete trials. Great emphasis is
placed on creating an intensive environment in which the child is continually
learning, in the same way that a typically developing child constantly learns
from his environment. Theirs is a treatment model with an average minimum
duration of 2 years. A minimum of 30 hours of direct instruction is recommended
(which includes structured play times and breaks). A high level of structure
beyond the therapy time is required as part of the program as is consistency of
behavioral approaches across all settings . . . the childís entire day
becomes part of the therapy process and the parents become an integral part of
the team (Leaf & McEachin, 1999:11). In this way, the child spends most
of his time reacting to and interacting with his environment (as typical
children do) rather than engaging in preoccupation with self and with
Intervention begins with a month or so of establishing a positive
relationship between the child and the therapists. During this time reinforcers
are identified and established and much of the time is spent in play.
Reinforcement is provided freely on a non-contingent basis so that the
therapists and the teaching setting become reinforcing to the child. Gradually
discrete trials are introduced and this direct DTT time increases steadily, with
a highly structured use of contingent reinforcers, until it is the primary
method of therapy. In the later stages of treatment the time spent in DTT
decreases as more time is spent with incidental teaching and group training.
Stages of Therapy
The stages of therapy are based on the following general guidelines:
Beginning Stage - "Learning to learn"
- Remaining on task
- How to process feedback
- Understanding cause and effect
- Communication skills
- Play skills
- Social skills
- Subtle social skills
- Higher level play skills
- Advanced cognitive and communication skills
- Integration of skills to everyday environments (school)
A strong program emphasis is placed on treatment of disruptive behaviors that
takes more patience and skill than teaching something as complex as language
(Leaf & McEachin, 1999). Disruptive behaviors are often the primary
barriers to the learning process and integration with typical environments.
Other detrimental behaviors that require intensive treatment are inattention,
lack of participation, isolating and being off task.
Place of Intervention
Intervention occurs throughout the entire day and across all settings. The
base location of the program can be center or home but home based appears to
have specific advantages for young children, such as arranging therapy around
nap times to enhance its effectiveness.
Age of Intervention
Age of intervention is not limited to preschool years. While most research
on intensive behavioral treatment has been done exclusively with very young
children, our experience has demonstrated that older children can benefit
substantially from a similar treatment format (Leaf & McEachin,
Autism Partnership has given special attention to the unique needs of older
children with autism. Adjustments to the general model are made in consideration
of previous efforts and the need for age appropriate skills. Older children
often have a higher degree of disruptive behaviors that interfere with learning
and that must be addressed in their program.
Treatment Team, Training and Supervision
The typical treatment team consists of 2-5 tutors who are trained in discrete
trial teaching, parents who are trained to systematically integrate teaching
goals into everyday family life, a program supervisor to provide case
management, team supervision and parent training 2-3 hours per week, and often a
clinical supervisor to provide general supervision of the childís program.
Discrete trial teaching is a very sophisticated teaching method and involves
complex application of reinforcement and prompting techniques. Effective
behavior reduction treatment also requires a high level of training. A highly
qualified and experienced professional should provide program supervision. The
level of supervision required depends upon several variables, including the
experience and skill level of the team, the number of treatment hours and the
complexity of the programs.
Leaf and McEachin present a comprehensive, reader friendly training program
in A Work In Progress. In it they effectively and clearly
explain behavior intervention concepts and techniques and provide essential
information for parents and others who wish to use intensive behavioral therapy
for their children. Important attention is given to two very critical components
of effective ABA therapy, reinforcement and problem behaviors, along with
detailed instruction on delivering discrete trials. The Autism Partnership
Curriculum for Discrete Trial Teaching with Autistic Children, an extensive and
thorough collection of systematically introduced teaching programs is also
included. Examples of data collection, charts and other significant information
are also provided to assist those who wish to set up a program based on the
Autism Partnership model.
Additionally, Autism Partnership offers on-site training workshops for
families, teachers and therapists. Program supervision and case management
services are offered to families in Connecticut and other areas and include
development, refinement and evaluation of ABA programs. School consultation
services are also available.
PECS and The Pyramid Approach to Education
PECS: The Picture Exchange Communication Training Manual
and Lori Frost, 1994)
One of the principal advantages of PECS is the integration of theoretical
and practical perspectives from the fields of applied behavior analysis and
speech/language pathology (Bondy & Frost, 1999)
Behaviorist Andrew Bondy designs ABA educational plans for children with
autism that emphasize communicative opportunities across all environments.
Teaching in enhanced natural surroundings (e.g. a classroom set up to maximize
the chances for social communication) is preferred to intensive one to one
discrete trial teaching.
The basic teaching strategies are derived from ABA: powerful reinforcers,
prompting, fading, shaping, etc. and include the use of the innovative Picture
Exchange Communication System (PECS) that the pair developed within the Delaware
Autistic Program, which Bondy directed for many years.
PECS was originally developed as an augmentative communication system for
preschool autism spectrum children and others with severe communication
disorders. Since then it has been adapted for use with other populations that
lack functional speech.
Rather than wait for long term results of speech training or development of
the imitation and motor skills required for sign language, both of which can be
quite time intensive with this population, Bondy and Frost designed PECS as a
system of socially interactive communication that can be implemented very early
on. They emphasize the importance of having children learn to approach their
communicative partner from the beginning of training rather than solely waiting
for specific clues from the partner (Bondy & Frost, 1999).
The Pyramid Education Model
The Pyramid Approach to Education emphasizes 4 fundamental structural
elements that together form the base of the program:
- functional communication
- functional activities
- powerful reinforcers ( "no reinforcer = no lesson")
- strong behavioral intervention plan
Additionally, the instructional methods form the walls of this
pyramid. They include:
- planned lesson formats
- various prompt strategies
- error correction strategies
- planned generalization
These basic structural elements and specific instructional methods are
crucial for the implementation of an effective educational program. Bondy also
recommends highly individualized, data based programs and curricula development.
His approach leans heavily on the establishment of functional communication,
even for the nonverbal child. He strongly advises against teaching without such
a system in place.
A very high priority is placed on the ongoing identification and
establishment of powerful reinforcers. As Bondy points out during his training
sessions, "no reinforcer means no lesson."
PECS: The Primary Vehicle of Instruction
In the late 1980s, Bondy and speech-language pathologist Lori Frost
co-developed the Picture Exchange Communication System. PECS differs
significantly from previous picture systems that rely on pointing. PECS teaches
the child to initiate communication and to become what Frost and Bondy call a persistent
communicator (Frost and Bondy, 1994). It is designed to be an initial mode
of communication within a social context. PECS teaches the "essence of
communication" Ė approaching a communicative partner and interacting in
an effective manner.
Unlike programs that teach labeling before requesting, PECS training begins
with teaching simple requests for concrete items. Requesting is taught first
because it is likely to be learned rapidly. From a Skinnerian perspective,
requesting (manding) behavior is naturally maintained by its consequences
(getting the desired item) whereas labeling is naturally maintained by social
First the child is taught to exchange a picture for a desired object
(powerful reinforcer). This is initially done in trial format with the child and
the teacher/parent at the same table, with the picture of the item in clear
view. Physical (not verbal) prompting by a third person demonstrates for the
child what is expected of him in order to get the desired item.
Picture exchanges are practiced in both mass trial format and in numerous
natural environment opportunities throughout the day.
When the child masters the exchange independently, more distance is added
between the child and the teacher. Eventually the teacher will have his back to
the child so the child must get the adult's attention for the exchange to occur.
Eye contact becomes a requisite for the exchange. Pictures are supported with
verbal words as the adult labels the item as part of the exchange. Training
progresses in this way until the child can build complete picture sentences
independently and initiate "conversation" (sentence strip exchange)
with the teacher.
A PECS book is created for the child with a functional picture
"vocabulary". The child should have access to his book across all
One of the major advantages that PECS offers is its universality. The child
can communicate with most people that he meets.
After the child is proficient at requesting, teaching focuses on other
communicative purposes such as commenting, labeling and answering questions. It
is intended to be a two-way system of communication leading to dialogue between
the communicative partners.
With a little imagination, PECS can easily be adapted to other methods of
Using a Visual Approach to Communication
PECS was created primarily to teach the process of communication through a
visual modality and within a social context. Its intent was to open the door of
effective social communication for children by teaching them how to gain
attention appropriately and initiate interaction with others. An emphasis on
vocal communication is present but secondary. Frost and Bondy observe that many
of the children who learn PECS begin speaking soon after. To what extent PECS
influences verbal language is unclear. However, many children appear to benefit
from the visual bridge to social communication that PECS provides them. The
ability to express needs and desires is extremely important for all humans. With
functional communication (PECS) the child has the tools to appropriately request
in place of engaging in tantrums or other undesirable behaviors. He now has a
More Applications of the Use of a Visual Modality
The Pyramid Model also uses pictures in reinforcement systems (visual reward
systems), such as token systems and "puzzle" reward cards in which the
student earns pieces of a picture of a desired object.
Pictures are used across many different types of interactions throughout the
day. They are used as visual supports for verbal instructions, as in showing a
picture of a spoon with the request "Letís get the spoon." Children
are also taught to use sequences of pictures as effective schedules for routines
Staff Training and Program Implementation
Educational staff and family members can be easily trained to implement PECS,
making it highly accessible. The system does not require lengthy training of
repertoires maintained by artificially arranged consequences. Rather, it begins
with the recognition of what the child seeks in the real world. PECS promotes
communication in a social exchange during which the child initiates the
interaction (Bondy & Frost, 1994)
The PECS Training Manual provides step-by-step instructions on implementing
the PECS system. Videotapes and other training and program supplies are
available through Pyramid Consulting (www.pecs.com).
Program consultation services are also available.
The Eden Model
Autism through the Lifespan: The Eden Model (David Holmes, 1997)
Edenís programming is based on applied behavior analysis. Teachers work
in small groups or one-on-one. They modify behavior and teach skills through a
wide variety of reinforcement and aversive techniques and keep careful data on
each session. Eden does integrate elements of other treatment approaches, such
as sensory integration therapy, but these remain secondary to applied behavior
The Eden Institute began as a private school for children with autism in
1975. Before beginning Eden, David Holmes had been working at Princeton Child
Development Institute, an ABA school for children with autism. The influence of
the work of Lovaas and aspects of his work at PCDI were carried over to the
philosophy and systems employed at Eden.
Family of Services
Edenís mission is to provide a comprehensive continuum of services to
people with autism. Eden currently provides the following collection of services
to children, adults and families with autism. Each is designed to enable
children and adults to live independent lives within their communities to the
full extent of their abilities:
Year round educational services for children and adolescents.
Community based residential services for adults with autism.
Supported employment opportunities for adults.
Outreach and Support Services
Consultations, diagnostic and evaluative services, parent training,
professional training, program support and curriculum resources.
Wawa House Services
Early intervention services for infants and toddlers.
Supplemental clinic therapy for older students.
Educational and outreach services for children and adults.
Educational and outreach services for children and adults.
Discrete trial training is used but less intensely than with the UCLA and
Autism Partnership examples. Eden uses discrete trials training to "jump
start" skill acquisition. Children at the Eden Institute receive an average
of 20 hours a week in direct DTT instruction. This is supplemented with
"more global" ABA techniques such as incidental and group training.
(When consulting to school districts, Eden generally recommends about 2 hours of
discrete trials each day, according to Eden consultant Michele Brooks.)
Visual aides are sometimes used in programming. Augmentative communication
system preference is for voice rather than visual systems. Neither PECS nor
American Sign Language is supported within the Eden model.
Teaching ranges from one-on-one to small group sessions with opportunities
for integration when appropriate.
Teaching goals are divided into 5 different programs at Eden Institute.
Children progress through each program based on their age and skill level. The 5
The Early Childhood Program
independent living skills
- basic self care
- learning readiness
- language development
small group instruction
work preparation skills
daily life skills
community based work-study programs
Disruptive, inattentive and socially stigmatizing behaviors are other foci of
attention within this model. The Eden Institute employs a "full range"
behavioral approach that includes the use of aversive techniques to modify
behavior when necessary. This topic is addressed at length in Holmes' book Autism
through the Lifespan.
Outreach and Support Services
Edenís Outreach and Support Service is available to provide a variety of
ABA based services to school districts and families in Connecticut and other
areas. Services include training workshops, diagnosis and evaluation services,
consulting services and ABA program support services. Outreach DTT training
workshops expose participants, usually paraprofessional and professional
teachers and therapists, to basic procedures and understanding of the technique.
Consulting services are in the form of "best practices for autism
service delivery". Eden offers consultation to public and private schools,
state and private agencies and to individual families.
Eden offers published curricula for ABA programs including an educational
curriculum, a residential curriculum and an employment curriculum, which can be
purchased independently of other services. Eden also offers lectures and various
training workshops throughout the year. Autism Through the Lifespan
provides a detailed overview of the model at Eden Institute. Unlike the
other books mentioned in this article, it offers little in the way of
comprehensive training for individuals interested in setting up a program based
on the Eden model.
Applied Verbal Behavior/ (DTT-NET)
Teaching Language to Children With Autism Or Other Developmental
Disabilities, (Mark Sundberg and James Partington, 1998)
At present it is not exactly clear why some children fail to acquire
language. However, it is clear that if language does not develop in a timely
manner it is reasonable to expect that various forms of negative or
inappropriate behaviors will . . . come to function as the childís main
form of communication (Sundberg & Partington, 1998)
Sundberg and Partington base their approach directly on B.F. Skinnerís
analysis of verbal behavior that was published in 1957. Skinner believed that
language is a result of operant conditioning, similar to other learned behavior.
Children learn to speak through selection by consequences (operant
conditioning). But verbal behavior, according to Skinner, requires a separate
analysis. With verbal behavior, the child does not operate directly on his
environment. The behavior of others in a verbal community is an additional event
that must be considered (Skinner, 1957 cited on B.F. Skinner Foundation Web
Verbal behavior (VB) differs from other ABA models in it that it is focused
primarily on Skinnerís analysis of language as a learned skill. Skinner
proposed that language is behavior that is primarily caused by environmental
variables such as reinforcement, motivation, extinction and punishment. This
view of language differs substantially from others that assume language is
primarily caused by cognitive or biological variables (Sundberg &
With the VB model, language (i.e. verbal behavior) is analyzed into formal
and functional properties. Formal properties include grammar, syntax,
articulation, pitch, etc. Functional properties of language are the stimulus for
the behavior, the motivation for it and the consequences that control the
response. Using these concepts, language dysfunction can be targeted very
specifically and programs are designed to teach verbal behavior in its
functional context. VB is an intensive treatment model that attempts to develop
language as rapidly as possible using highly structured direct teaching and
intensive natural environment teaching.
In the current edition of their verbal behavior training manual, Teaching
Language to Children . . . Sundberg and Partington stress the need for both
intensive, one to one discrete trial teaching (DTT) combined with natural
environment training (NET), which focuses on the child's immediate interests as
a guide for language instruction. The advantages and disadvantages of each
method are discussed at length in their manual (pages 255-271). Sundberg and
Partington conclude that the balance between DTT and NET may change
frequently during the language acquisition process, but training should always
include both approaches (Sundberg and Partington, 1998: 270).
In general, DTT is recommended as the primary instructional method for:
- academic activities
- specific skill development
- structured learning of academic skills in later elementary classrooms
NET is considered more effective for teaching:
- early requesting
- instructional control
- observational learning
A combination of both is most effective when teaching:
- making requests
- receptive language
- motor imitation
- verbal imitation
- early conversational skills
Comprehensive Language Assessment as a Basis of Individualized Curriculum
Sundberg and Parting ton have developed a comprehensive language assessment
to identify the deficits that are present in the child and to guide the
development of an appropriate language intervention program for the child. The
Assessment of Basic Language and Learning Skills (ABLLS) is also a valuable
tool for determining IEP (Individualized Educational Placement) objectives. It
is designed to be used by parents and teachers. With it, key developmental
skills are evaluated under several general headings.
Basic Learner Skills
Cooperation and reinforcer effectiveness
Intraverbals (Early conversation)
Syntax and grammar
Social interaction skills
Self Help Skills
Gross motor skills
Fine motor skills
(Sundberg and Partington, 1998)
The ABLLS separates specific skills into various phases of development.
Parents or teachers can assess the present level of the child at each stage.
Goals and curriculum are developed to emphasize these unaccomplished steps. They
are then taught systematically using basic behavioral techniques in both DTT and
Sundberg and Partington propose that the majority of negative behavior
issues, tantrums, social withdrawal, self-stimulation, etc. are directly related
to dysfunctional language. They suggest that eliminating an undesired
behavior that is linked to a defective verbal repertoire without considering the
language link is an example of the mistake of treating the symptom and not the
cause. Language training is an essential part of behavior reduction programs
(Sundberg & Partington, 1998).
Discrete trials in verbal behavior are structured differently than in typical
Sessions are less scripted and there is less differentiation between teaching
programs than in other DTT models. The overall program is highly structured but
the treatment sessions are not. Typically, data is not taken during teaching
sessions, so the teacher can spend more time engaging the child. Sessions should
be creative and flexible while targeting curriculum programs. A high level of
positive reinforcement is maintained throughout (errorless) teaching. High
priority is placed on making learning fun.
Other differences include the pace of instruction, concept integration (i.e.
not adhering to sets of trials), and the use of receptive language training as a
direct bridge to expressive language.
While speech is the primary goal, those children who do not learn to speak
must have an alternative communication system. Sundberg & Partington provide
a lengthy discussion of augmentative communication systems and conclude that
American Sign Language is the preferred method with PECS a close second
Treatment Team and Training
VB training is a very precise and sophisticated model of intervention. A high
level of training and ongoing support and supervision through qualified case
managers is required for people working with children in VB programs. The team
should be trained in ABA and VB techniques. They should also be trained in
augmentative communication systems when appropriate.
Parents are active members of the treatment team, facilitating development
and use of skills in home and community settings. Parents need to know what the
child is currently learning. Additionally, parents should be trained in the
teaching skills they wish to know.
The set of manuals by Sundberg and Partington, Teaching Language to
Children with Autism Or Other Developmental Disabilities and The
Assessment of Basic Language and Learning Skills present materials and
training to conduct a comprehensive language assessment of the child, used to
direct an individualized curriculum for the child. A language curriculum and
teaching techniques are provided along with data systems and tracking forms.
Guidelines to assist with program selection (home or school-based) are also
included, as are options for augmentative communication systems.
Comments on Similarities and Differences among the Models Reviewed
ABA approaches are consistent in their use of operant conditioning principles
and techniques (reinforcement, shaping, prompting, chaining, behavior
In all cases, target skills are broken down into smaller units of information
and practiced repeatedly. All place a high priority on data collection and
qualified interpretation of the data to drive the program. Keeping the child
"on task" is emphasized.
Differences between the models appear most obvious in the predominant
teaching techniques used - intensive one-on-one discrete trial teaching (UCLA,
Autism Partnership), more natural environment training (PECS) or a combination
of both environments as instructional vehicles (VB, Eden). Significant
differences also exist between the overall intensity of the methods used, the
level of team training and support required or recommended by each model, the
hierarchy of program stages, behavior reduction programs and philosophies, and
the role of the family.
Perhaps ABA models can be separated into two broad categories: ABA treatment
models, and ABA educational models, with differences in approach that each view
inherently incorporates. Those examples that focus on intensive, short term (2-3
years) intervention can be placed in the former category, with the objective of
bringing the child into a more typical pattern of development. Others are more
keenly focused on long-term methods of adaptation around the disability to
educate the child and foster supported independence.
Contemplating the different approaches to ABA brings intriguing questions to
mind. Is the key in keeping the child engaged in his surroundings, "on
task" for the majority of the time? Is the intensity of the focus and
attention required related to outcome? Do the various approaches affect brain
development? If so, what are the components required for optimal long-term
gains? It will be interesting to see what ongoing and future scientific research
tell us about the underlying relationship between behavioral and
neurodevelopmental issues and effective treatment for children and others on the
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