Focused ABA Treatment

Focused ABA refers to treatment provided directly to the client for a limited number of behavioral targets. It is not restricted by age, cognitive level, or co-occurring conditions.

Focused ABA treatment may involve increasing socially appropriate behavior (for example, increasing social initiations) or reducing problem behavior (for example, aggression) as the primary target. Even when reduction of problem behavior is the primary goal, it is critical to also target increases in appropriate alternative behavior, because the absence of appropriate behavior is often the precursor to serious behavior disorders. Therefore, individuals who need to acquire skills (for example, communication, tolerating change in environments and activities, self-help, social skills) are also appropriate for Focused ABA.

Focused ABA plans are appropriate for individuals who (a) need treatment only for a limited number of key functional skills or (b) have such acute problem behavior that its treatment should be the priority.

Examples of key functional skills include, but are not limited to, establishing instruction-following, social communication skills, compliance with medical and dental procedures, sleep hygiene, self-care skills, safety skills, and independent leisure skills (for example, appropriate participation in family and community activities). Examples of severe problem behaviors requiring  focused intervention include, but are not limited to, self-injury, aggression, threats, pica, elopement, feeding disorders, stereotypic motor or vocal behavior, property destruction, noncompliance  and disruptive  behavior,  or  dysfunctional  social behavior.

When prioritizing the order in which to address multiple treatment targets, the following should be considered: 
When the focus of treatment involves increasing socially appropriate behavior, treatment may be delivered in either an individual or small-group format. When conducted in a small group, typically developing peers or individuals with similar diagnoses may participate in the session. Members of the behavior-analytic team may guide clients through the rehearsal and practice of behavioral targets with each other. As is the case for all treatments, programming for generalization of skills  outside the session is critical.

When the focus of treatment involves the reduction of severe problem behavior, the Behavior     Analyst will determine which situations are most likely to precipitate problem behavior and, based     on this information,  begin to identify its potential  purpose (or “function”).  This may require  conducting a functional analysis procedure to empirically demonstrate the function of the problem behavior. The results enable the Behavior Analyst to develop the most effective treatment protocol. When the function of the problem behavior is identified, the Behavior Analyst will design a    treatment plan that alters the environment to reduce the motivation for problem behavior and/or establish a new and more appropriate behavior that serves the same function and therefore  “replaces”  the problem  behavior.

In some cases, individuals with ASD display co-occurring severe  destructive  behavior  disorders  that require focused treatment in more intensive settings, such as specialized intensive-outpatient, day- treatment, residential, or inpatient programs.   In these cases, these behavior disorders are given    separate  and  distinct  diagnoses  (for  example,  Stereotypic  Movement  Disorder  with  severe  self- injurious behavior). The ABA services delivered in these settings typically require higher staff-to-client ratios (for example, 2 to 3 staff for each client) and close on-site direction from the Behavior Analyst. In addition, such treatment programs often have specialized treatment environments (for example, treatment rooms designed for observation and to keep the client and the staff as safe as possible).

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