I have lost count of the number of times that I have worked with a child who showed inconsistent abilities with a skill who quickly became consistent once behavioral treatment was started. At the age of 5, one girl I taught had a very limited vocabulary. She had made minimum progress on all of her speech goals because she wouldn’t consistently repeat any words. At the age of 4, one girl I worked with had made no progress at school in her ability to string beads. And at the age of 3, one boy I worked with used only 3 vocal approximations to request and typically did not repeat any other words.

Two weeks after starting behavioral treatment, the 3-year-old boy had quadrupled the number of objects he requested with vocal approximations. The mother had made a list of over 15 other words he had repeated during therapy. Three days after starting behavioral treatment, the 5-year-old girl was repeating words consistently, and her mother was able to hear her learn to say “mama.” 15 minutes after her mother used some behavioral techniques to shape stringing beads, the 4-year-old girl was able to complete a task she had not been able to master in months of previous teaching by others.

All of this is anecdotal information, and I don’t mean to offer it as proof of the effectiveness of behavioral treatment. Instead, I use it to ask the question, “Why the sudden change for some children once behavioral treatment starts?” From my observations of other forms of teaching, I think the answers are quite obvious.

1) Behavioral treatment guarantees a child’s success. Prompts and cues so that a child immediately responds correctly. A child doesn’t know which object is a boat? I’ll point to it or place his hand on it or move it closer to him on the table.

2) Behavioral treatment highly reinforces that success. Forgive the lack of behaviorally correct terminology here, but the best way to explain this is that when a child learns something, I want him to know he learned it! The child touches the boat for the first time on his own, I’m going to scoop him up in my arms, cheer and spin him around!

3) Behavioral treatment quickly but gradually builds on that success. When a child responds correctly with a certain prompt, I start lessening and changing the prompt so the child doesn’t become prompt dependent. When a child starts imitating gross motor movements (which are easy to prompt), I start teaching fine motor movements (harder to prompt) and then oral motor movements. And once a child is imitating my opening my mouth or my putting my teeth together, I can start adding sounds like “aaahh” or “eee.”

Through these steps, what seemed nearly impossible before – getting a child to repeat vocal sounds, seeing a child engage in pretend play, having a child engage in a conversation – becomes just another step in the ongoing chain of more complex behavior.

I’m interested in what others think are some elements of applied behavior analysis that make it so successful for so many children.

By Vince LaMarca, M.A., BCBA, Editor
Lovaas Institute - Indianapolis