Therapies for autism

What is ABA

• based on Operant conditioning

• consequences will reinforce or punish behaviour

• Usually use positive reinforcement e.g. high five / puzzle piece when desired behaviour is displayed, motivates them to repeat

• Therapist identify what promotes desired behaviour

• Records of successes/failures taken to adapt therapy to child

Supporting for what ABA is

Gale et al 2010

• 3 children with autism underwent ABA to improve behaviours like refusing to eat

• First identify target behaviours then positive reinforcers for each child.

• When food accepted by child, positive reinforcer given

• Found at end of treatment acceptance of food increases, sustained change 5 months later

Refuting for what ABA is

Gale et al 2010

Cannot be sure this change in behaviour will be generalised to all eating behaviours

Lowers Validity

How does ABA work in practice

• Up to 40hours weekly, one to one, intense

• 1-2 hours of parent training

• Behaviour broken down into its simplest forms, then systematically prompted/ guided repeatedly till mastered

ABA in practice supporting research

Lovaas 1987

compared 19 children who had 40 hours of ABA per week to 40 that did not have ABA

9/19 children who had ABA were in school with minimal support compared with just 1/40 in control

ABA in practice refuting

ABA limits child to specific behaviours that are taught, no own choice

If not comply with specific desired behaviour = negative punishment

social control

How does PRT work

Same OC principles as ABA

instead uses more spontaneous activities like asking client to name object they want to reinforce speaking

Revolves around what client wants to do, and rewarding with reinforcements they want to keep up motivation

Supporting how PRT works

Mohammedzaheri et al 2014

randomised clinical trial comparison between structured ABA and naturalistic PRT in autistic children

2 groups of children matched on age, sex and vocabulary

found PRT was significantly more effective in improving targeted and untargeted areas after 3 months

How PRT works refuting

Ventola et al 2015

Found that PRT can change brain functioning when looking at biological movement (which is evidence of PRT), but found these differences of changes in different types of children

Individual differences - results unpredictable

PRT in practice

Help child with autism become more independent

• mixing new tasks with tasks already mastered

• child chooses activities

• Child does not have to master task to gain reward, high effort also rewarded

• 25 hours intensive training

PRT in practice supporting

Ventola et al 2015

FMRI scans to study brain responses in human movement perception task in 10 pre school children with ASD

brain activity before and after 16 weeks of PRT

neural systems found to be malleable, like neural systems that relate to social perception were more similarto normal developing children

PRT in practice refuting

Can require hours of therapy which could be disruptive for family

Therefore families may choose to not have their child take part in therapy

May lack real life application