Scope of ABA
As discussed earlier in the module, behaviour analysts use general laws and principles of behaviour to address problems that are important to people. The implication of this is that behaviour analysis can and has been used in a wide variety of areas. This includes in education, in health, social care and business.
In this lesson, we?re going to look at some of those applications so we can better understand the scope of behaviour analysis.
The first case study of applied behaviour analysis addresses the problem of breast cancer. In 2020, more than 2.3 million people were diagnosed with breast cancer worldwide and approximately 685,000 died. Early detection and treatment are very important as those whose breast cancer is detected at an early stage have a 93 percent or higher survival rate.
The majority of breast cancers are first detected by someone?s fingers, either by accident or by deliberate examination.
In the early 1970s, a group of behaviour analysts at the University of Florida, undertook an experimental analysis of the task of manual breast examination. After several years of psychophysical and behavioral research, they created a method of breast examination that enabled individuals to approach or, in some cases, exceed the sensitivity of mammograph at the time.
Using the principles and techniques of behaviour analysis, they first developed a programme for breast self-examination. This became known as Mammacare.
During Mammacare training, a patient is taught to use his/her fingertips to discriminate small lesions from ordinary nodules in the breast. Initially, silicone breast models are used for this task. This training involves the use of discrimination teaching ? a technique you?ll learn about later in the course.
Once detection of small lumps has been mastered, the patients move on to learning additional palpation and search skills. The target of these procedures is to ensure that a woman?s fingers
contact a maximum volume of breast tissue during self-examination.
As you might expect from a behaviour analytic procedure, behavioural measurement procedures are used to assess a patient?s proficiency and they must be at least 95% proficient before training is complete.
Following the success of these early self-examination training techniques, the research team decided to focus on training physicians to be more sensitive and accurate in their breast cancer examinations. An initial investigation found that hospital staff were only successful in detecting lumps 44% of the time. After Mammacare training, after training, staff could detect at least 80% of the smallest, softest lumps and virtually all of the others.
They also examined new ways that could allow the techniques to be shared more widely by using automated, computer based Mammacare training. This was also found to be successful.
Today, the MammaCare Method is the recognized standard for performing and teaching clinical and personal breast examination. Clinicians are certified as having met the Mammacare standards which provides consumers with confidence in their competence.
MammaCare is an example of ABA. It has enabled patients to detect health problems earlier ? contributing to increased survival rates for those with breast cancer ? and it has increased the competency of clinicians by using a behavioural training package.
Another example of ABA is the Food Dudes programme developed by behaviour analysts at the Bangor Food Research Unit. Food Dudes aims to increase fruit and vegetable consumption in school children. As unhealthy eating in children is associated with a myriad of health problems in adulthood, you can see how a programme designed to increase healthy eating in children meets the ?Applied? criteria within behaviour analysis.
Many attempts have been made to increase healthy eating in children through health education campaigns ? telling children what is health and unhealthy. The Food Dudes programme took a different approach. Instead of tackling knowledge or attitudes, they decided to address the behaviour of interest directly.
The Food Dude programme uses what it terms the Three Rs: role models, repeated exposure and rewards.
Role Models: For 15?20 minutes daily, for 16 days, the children watch a series of DVD adventures featuring ?The Food Dudes?, a group of children who act as positive peer models. By eating fruit and vegetables, the ?Food Dudes? are shown to gain the superpowers they need to vanquish ?General Junk? and his ?Junk Punks? who are taking away the energy of the world by depriving it of healthy food.
Repeated Exposure: After watching the video, children are encouraged to taste fruit and vegetables. Many fruits and vegetables can be an ?acquired taste? for children. While they may not initially enjoy the taste, after repeated exposure they start to enjoy these foods.
Reward: If children taste fruits and vegetables after watching the video, they earn ?Food Dude Rewards? such as Food Dude branded stickers and pens.
There is also a home pack that provides parents with information and resources to extend the programme to a child?s home.
The programme has achieved success in the US, the UK, Ireland, Italy and other countries. Evaluations of the programme have found that schools that adopt the programme see significant increases in students? healthy eating. When researchers looked at the behaviour of students four months after the programme ended, they found that the students continued to eat more fruit and vegetables than before the intervention began.
Another school based example of ABA is the Headsprout Reading Basics programme. Headsprout is a phonics-based reading programme that is delivered over the internet. Headsprout teaches children essential reading skills and strategies in a fun online environment where they explore fun, fantastical environments such as Dinosaur World and Space World.
Headsprout uses the principles of behaviour analysis and has been found to be an effective programme for neurotypical children, autistic children, those with ADHD and those with other conditions that affect their learning.
The Headsprout programme is self-paced and progress depends on meeting some criteria related to demonstrating a target reading related behaviour. The programme builds in multiple exposures to the same kind of tasks, and encourages children to approach reading problems from different angles. It automatically records student behaviours such as time spent on episodes, percentage of correct responses. The aim is for each child to work independently on the episodes, which last on average 20 min each.
The goal of the Headsprout Programme is not only to teach children to read but also to teach a love of reading.
Aside from demonstrating the characteristics of ABA, you may have noticed that the three examples of ABA we?ve talked about so far show another characteristic in common. While all were developed by behaviour analysts, they are designed to be used by other groups ? parents, teachers, doctors, nurses and patients.
Next we?ll look at some of areas of ABA that require a behaviour analyst to work directly with a client and/or their carers and that typically require extensive training in behaviour analysis.
The first area we?ll look at is Functional Assessment (FA). Functional Assessment is sometimes called Functional Behaviour Assessment or Functional Analysis.
Functional Assessments are usually used to address behaviours that challenge.
A behaviour that challenges is typically a behaviour that somebody displays that is a challenge for others to manage or that puts the person engaging the behaviour at risk.
When a behaviour analyst conducts a functional assessment, they look at all of the factors that might affect the occurrence of the behaviour that challenges. This would include a client?s medical history, their learning history, what the behaviour appears to occur in response to, what it looks like and what happens after the behaviour.
In short, they identify the reasons why a behaviour is happening and then work to change that person?s environment to reduce the challenging behaviour. This involves reducing their motivation to engage in the behaviour and teaching them alternative means of achieving the same or better outcomes.
Research finds that, when conducted with rigor, conducting a functional assessment and developing a behaviour support plan based on a functional assessment is highly effective in reducing behaviours that challenge when compared to other types of intervention for behaviors that challenge.
Behavior technicians often make important contributions when assisting behaviour analysts conducting of a functional assessment. The quality of outcomes for clients can be life-changing.
The second area we?ll look at is comprehensive ABA for autistic people.
Most of the other types of ABA we?ve looked at related to single issues or problems. A comprehensive ABA programme for an autistic individual will seek to promote the acquisition of new skills in a variety of areas related to cognition, communicative, social, emotional, and adaptive functioning. The overall goal of such a comprehensive ABA programme is to promote quality of life for that individual.
The types of skills targeted enable goals such as self-care, communicating wants and needs, community participation, coping and tolerance, play and leisure, academic and pre-academic skills, self-advocacy and negotiation, safety skills, social and relationship skills, and self-management.
In a comprehensive ABA programme, there may be dozens of individualised interventions and strategies that are adopted and synchronised so that they work together to enable the client to live the kind of life they would like to live. Each of these individual interventions will have been based on an assessment of the client that seeks to understand the factors that account for their current level of functioning and what environmental changes are required to promote new skill development.
Studies that evaluated the impact of comprehensive ABA programming have found that it leads to outcomes such as improvements in IQ, improvements in standardised test scores, improvements in adaptive behaviour, improved language scores, reduced support requirements in schools and decreased challenging behaviour.
As a result of these findings, insurance funding for comprehensive ABA programmes where a client has autism is now mandated in 50 US states.
Behaviour Technicians are typically responsible for the delivery of these interventions on a comprehensive ABA programme. This course aims to provide you with the skills needed to begin working in that role, but continuous training and supervision from an experienced behaviour analyst is required for the delivery of a comprehensive ABA programme.
In this lesson, we?ve highlighted a range of different examples of ABA in practice. A full description of the areas in which ABA has been applied goes beyond the scope of this course. If you?re interested in learning about applications such as training astronauts or mixed martial artists, check out the suggested reading at the end of the lesson. We?ve also included links to articles on clinical applications such as acceptance and commitment therapy and dialectical behaviour therapy. For those interested in applications of behaviour analysis with animals, we?ve included a link to information of Hero Rats ? rats trained using the principles of behaviour to detect landmines.
The take home point of this lesson is that, because the principles of behaviour analysis are universal, it can be applied to any area where humans behave.