If you are the caregiver of a child with autism and you’re just learning about ABA therapy, you likely want to know: How does ABA therapy work, exactly?

Applied behavior analysis (ABA) is the gold standard of care for people with autism spectrum disorder. ABA therapy is an effective, evidence-backed, highly researched method that teaches those with autism essential skills to help them navigate the world with confidence and increase their quality of life.

When done correctly, ABA therapy focuses on each child as a unique individual, embracing them for who they are and unlocking their potential. Each therapy session is tailored to the child’s strengths and preferences and an individual plan of care. This guide will break down all facets of ABA therapy so you feel confident in selecting the best support for your child. 

The Science Behind ABA

ABA therapy is based on the principles of behaviorism, which holds that challenging behaviors can be modified through techniques such as reinforcement, prompting, and shaping.

These data-driven methods teach children vital skills in areas like communication, socialization, and adaptive functioning (the ability to manage everyday tasks and social demands). ABA therapy techniques also help reduce challenging behaviors in children with autism, such as tantrums, elopement (wandering or running away from a caregiver or safe areas), self-injury, aggression, and repetitive behaviors that interfere with daily functioning, learning, or safety.

Let’s take a closer look at a few of the main ABA techniques used in a typical ABA therapy session: reinforcement, prompting, shaping, and ABC Analysis.

ABC Analysis

The ABC model has three main elements: antecedent, behavior, and consequence.

• An antecedent is what comes before a behavior and may trigger the behavior to happen.
• A behavior describes any observable action or reaction.
• A consequence is what follows a behavior.

Understanding the different components of ABC analysis helps us understand why a behavior happens. It also offers insights into behavioral triggers and helps a Board Certified Behavior Analyst (BCBA) create a plan of care to address the behavior.

Reinforcement

Reinforcement is one of the most frequently used techniques for encouraging behavioral changes. There are two main types of reinforcement: positive reinforcement and negative reinforcement.

• Positive reinforcement rewards a desired behavior, which increases the likelihood that it will recur.
• Negative reinforcement removes an unpleasant consequence when the desired behavior occurs, which also increases the likelihood that the behavior will recur. Negative reinforcement is often confused with punishment, but this is not the case. 

Prompting

Prompting is a technique used to encourage positive behavior or the completion of an activity or task. Verbal, physical, model, gestural, and visual, positional, or material prompts are used to guide a child to a desired response or behavior.

• Verbal prompts include providing verbal instructions that include part of a word, a whole word, part of a sentence, or a whole sentence to assist a child with completing a task or response.
• Physical prompts include assisting a client with hand-over-hand or partial physical guidance when teaching new skills, such as a handwashing or toothbrushing routine.
• Model prompts include demonstrating or modeling a desired or expected response.
• Gestural prompts include pointing, nodding, or gesturing toward a correct response. 
• Visual, positional, or material prompts include providing pictures or a written schedule, placing the correct answer closer to the child, or arranging materials to assist with independent task completion, such as providing color-coded bins to assist with a sorting activity.

Shaping

Shaping involves using small steps to help a child learn a desired behavior or skill. For example, if you are using shaping to teach a child to say the word “water,” you might start by teaching them to say “wa” and then “wata” until the whole word is spoken. 

Task Analyzed Chaining Procedures

Task analysis involves breaking down more complex tasks into a series of smaller steps. For instance, a task like brushing your teeth may be broken down into many smaller steps: rinsing your mouth, wetting the toothbrush, applying toothpaste, brushing each section of your mouth, rinsing, spitting, and then cleaning the toothbrush. Task Analyzed Chaining Procedures break complex tasks into smaller, teachable steps that can be practiced and mastered one at a time and then chained together to create the final complex task.

What Happens in an ABA Session?

Understanding “How does ABA therapy work?” is easy once you know what happens during an ABA session.

ABA therapy can happen in your home, at an ABA therapy center, at a school, or online. The type of provider who works with a child is called a “behavior technician,” or, in other contexts, a therapist. ABA therapy sessions are highly tailored to a child’s individual strengths and preferences and are based on goals that are established after a thorough assessment of the child.

Because all children are different, each ABA session might look a little different. But here’s what a typical session might look like. 

Rapport Building

Before the formal part of a session begins, there will be some time to settle a child into the therapy environment and make sure they are comfortable. It’s also an opportunity for the child to warm up to their ABA behavior technician and build rapport.

Here’s what to expect at the start of the first few sessions:

• The ABA behavior technician may ask the child simple questions and engage in conversation.
• The ABA behavior technician may also observe the child’s behaviors and mood to determine where to start.
• The ABA behavior technician might join in activities the child is already engaging in and finds reinforcing.
• The ABA behavior technician might pair themselves with reinforcement (e.g., activities or items the child enjoys).
• The ABA behavior technician might try working on a few goals if the child seems ready.
• The ABA behavior technician may need some time to explain to the child what will happen over the next two hours. 

Typical ABA Session

ABA therapy sessions typically last between 2-3 hours and rotate through the main skills that a child will be learning, including communication, social skills, and adaptive skills.

ABA therapy should emphasizes a more play-based approach. When done well, there is a strong emphasis on learning in an environment that mirrors a child’s everyday life, so that the skills learned can be easily transferred to environments where they are needed. To that end, many of the activities practiced in ABA therapy look like activities the child might do at home, at school, and in the community.

Some of the activities a child might engage in during ABA therapy include:

• Play-based activities that promote joint attention and social communication, like sensory play, art, board games, role play activities, and puzzles
• Fine and gross motor skills practice
• Adaptive skill building, which can include hand washing, snack preparation, or shoe tying
• Communication skills building
• Socializing skills, either with the ABA behavior technician or other children

What a Child Experiences

ABA sessions are focused on the child’s specific strengths, preferences and goals. The sessions are “shared control,” where a behavior technician guides the session but provides frequent opportunities for the child's choices and input. This means activities are based not only on the child's strengths and preferences to learn, but also on their interests.

The activities are meant to engage the child in interests they enjoy and typically engage in throughout their day. In other words, the activities should be fun for the child while simultaneously teaching essential skills.

What Makes ACES Different

ACES stands out from other ABA therapy providers for several key reasons:

• ACES has over 30 years of industry experience.
• ACES’ team of 400 board-certified behavior analysts receives training that far exceeds the requirements of other ABA therapy companies.
• While 40 hours a week is often the norm for ABA therapy, ACES provides the same results in fewer hours than other companies.
• ACES’s blueprint for delivering high-quality services includes 7+ assessment tools (whereas most ABA therapy providers use only a few). Those used by ACES include Vineland-3, (Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP), Assessment of Functional Living Skills (AFLS), (Social Responsiveness Scale, Second Edition (SRS-2), Developmental Assessment of Young Children Second Edition (DAYC), Quality of Life (QOL), and Parenting Stress Index/Stress Index for Parents of Adolescents (PSI/SIPA).

Get Started with ACES Today

Common ABA Strategies

Deepening your understanding of how ABA therapy works also means getting acquainted with some of the terminology and strategies used. This can feel complicated, which is why it’s best to break it down in the simplest terms.

Here’s what to know about the most common ABA strategies.

Discrete Trial Training (DTT)

Discrete Trial Training (DTT) involves utilizing the ABC model (antecedent, behavior, and consequence) to help a child learn a specific behavior. This involves giving the child an instruction and a prompt for the behavior, observing the behavior, and then rewarding the behavior.

DTT is sometimes embedded in play activities rather than used only as a rote exercise. For instance, DTT might be used to teach children colors, shapes, numbers, or letters during a play activity. It can also be used to teach a child how to perform tasks like brushing their teeth or washing their hands.

Natural Environment Teaching (NET)

Natural Environment Teaching (NET) is the concept of using a child’s natural environment and real-life settings and scenarios during behavioral therapy. It also involves following a child’s lead and engaging in activities they enjoy and show interest in. 

Pivotal Response Treatment (PRT)

Pivotal Response Treatment (PRT) involves teaching a child the skills needed to communicate successfully, including engaging in conversations, responding to questions, and participating in back-and-forth dialogue. PRT also involves natural rewards and reinforcements. This might look like a child asking for a toy or to participate in an activity they like, and then being rewarded with the toy or activity they asked for. 

Visual Strategies

Visual supports involve pictures, flashcards, or other visual objects or cues. These can be helpful for people with autism who have difficulty organizing and completing tasks or communicating. Visual Strategies also include visual schedules, visual tasks, and visual work systems to help those with autism become more independent in various environments.

Functional Communication Training (FCT)

Functional Communication Training (FCT) addresses behavioral problems that a child may exhibit, including inappropriate or aggressive behavior. FCT seeks to identify the “function” of these behaviors, which often involves an unmet communication need.

FCT then seeks to provide more positive replacement behaviors for the child. For example, if a child cries when they want more water, they may be guided to communicate their need for water by saying, “Can I have more water, please?” 

Behavior Intervention Plans

Behavior Intervention Plans (BIPs) are written, collaborative plans between parents, behavior technicians, teachers, and other professionals involved in a child’s care. BIPs are used to identify problems, offer solutions, and set goals so that all parties involved are on the same page. 

ACES' Toolbox Approach

At ACES, ABA behavior technicians don’t just use one of these methods in isolation as designed by their BCBA supervisor. Instead, they employ a strategic combination of methods, tailoring each session to the strengths, preferences, and skill set of the child they are working with. Over the course of ABA therapy, several of these methods may be used, and the methods used may change from one session to another, depending on the child’s care plan. 

Generalization: Making Skills Stick

It’s one thing to be able to perform a skill or exhibit a behavior during an ABA therapy session, but what happens when ABA therapy is over?

Generalization is the ability to apply skills and behaviors learned in ABA therapy across different settings, with different people, and in various social situations. It’s about making ABA skills “stick” and applying them to everyday life. Generalization is also one of the most crucial aspects of ABA therapy, and one that some ABA therapy providers miss. 

ACES' Approach

ACES places great emphasis on generalization. After all, therapy is only effective when it’s effective outside of a clinical setting. ACES’s approach to generalization focuses on caregiver training, data collection, and the use of specific caregiver tools.

Caregiver Training and Involvement

While ABA behavior technicians are vital, caregivers also play a crucial role in the success of ABA therapy and in its ability to have enduring impacts. To this end, ACES provides training to caregivers, so they can help implement the skills that the child is learning. Parent and caregiver training with an ACES supervisor translates to 4.5x better outcomes for children.

Role of Data

At ACES, all aspects of a child’s therapy are tracked, and the data is provided via a parent portal. This information repository provides caregivers with ongoing access to information about the skills their child is learning, the challenges they may encounter, and the progress they are making. 

Tools Offered to Caregivers

ACES also provides various tools to communicate with a child’s caregivers and keep caregivers up-to-date on a child’s progress, including:

• Visual graphs displaying how goals are progressing
• Monthly parent training meetings with ABA supervisors to discuss progress
• A “Client Accomplishment Tracker” (CAT) tool to track their child’s goals and progress across months

Where to Go From Here

Now that you have answers to the question of “How does ABA therapy work?” and have a clearer understanding of what’s involved in ABA therapy and of ABA therapy techniques and strategies, you are ready to begin the next steps.

ACES is here to support you every step of the way—from finding a provider, paying for care, to navigating the ins and outs of therapy—and most importantly, reaping the benefits of ABA therapy and seeing the many ways a child can grow and thrive.

Get Started with ACES Today

References

National Autism Center. National Standards Project, Phase 2. 2015. 

National Professional Development Center on ASD. Discrete Trial Training (DTT), EBP Brief Packet. 2016.

Tiger, J. H., Hanley, G. P., & Bruzek, J. (2008). Functional communication training: a review and practical guide. Behavior analysis in practice, 1(1), 16–23. 

V., Howlin, P., & Charman, T. (2020). Beyond intervention into daily life: A systematic review of generalization following social communication interventions for young children with autism. Autism Research: Official Journal of the International Society for Autism Research, 13(4), 506–522.

Yale Medicine. Pivotal Response Treatment.

Zimmerman, K. N., Torelli, J. N., & Chow, J. C. (2022). Planning Positive Reinforcement Cycles in Behavior Intervention Plans. Behavior analysis in practice, 15(3), 924–937.