**8. Staff training**

There is nothing wrong with using one approach, if this 'one approach' is science [15]. Countless procedures have been developed from the science of behaviour analysis, many specifically for ASD, e.g., Discrete Trail Teaching (DTT); Pivotal Response Training (PRT); Natural Environment Training (NET); Verbal Behaviour Approach (VB); while other proce‐ dures have been developed for more general applications, e.g., Functional Analysis and Functional Assessment; Preference Assessments; shaping, forward chaining, backward chaining; differential reinforcement of low or zero rate and/or incompatible or alternative behaviours; Time-out from Positive Reinforcement (TOR); etc. . Some of these procedures have been combined into comprehensive packages for autism, such as Early Intensive Behavioural Interventions (EIBI) or Early Start Denver Model (ESDM), while others are used more gener‐ ally, e.g., Programmed Instruction, Generative Instruction; Peer Tutoring; Habit Reversal Training; etc. Given that the science of behaviour analysis underpins all of these programmes/ procedures and continuous data-based decision making is part and parcel of ABA, new procedures and progammes are developed continuously to meet the individual or group needs

ABA has been further ridiculed and accused of intending to change the person, while others pride themselves for accepting the person for who they are [69, 80]. In fact, the targets of ABAbased interventions are socially relevant behaviours, linked to cultural and personal norms and preferences [4]. The curricula are agreed with individuals with ASD and/or their caregiv‐ ers. They are generally based on wide-ranging target behaviours, including life skills, such as dressing, toileting, attending; social skills, such as playing or imitation; academic skills, including attending, reading, drawing, writing, and maths, and work/employment based

Basically, the aim of ABA is to enhance all skills necessary to lead a fulfilled life for individuals who would otherwise be limited in the quality of life they experience. These are the same aims that most parents have for all of their children, irrespective of a diagnosis. As such, ABA does not intend to 'change the person', but to enhance skills and help individuals to break down barriers to learning and achieve their full potential. After all, enhancing skills development

Once a new idea can no longer be ridiculed, the second point Schoppenhauer made comes to play: the new idea is opposed. In the case of ABA, this refers to statements such as there is no evidence to support ABA and therefore no recommendation can be made [64]. We have outlined the wealth of evidence in favour of ABA-based interventions earlier in this chapter. Given that behaviour analysts commonly are not included in review bodies, at least in Europe,

When the evidence can no longer be denied, the opposition turns to the behaviour analytic scientists themselves, stating that research conducted by behaviour analysts is biased and therefore not to be taken seriously. The idea, that it is objectionable that scientist conduct scientific research in their own subject area is rather intriguing. Given that it is against ethical guidelines of all social and health care as well as education professionals to work outside their own area of expertise [90], clearly, multidisciplinary practice and interdisciplinary research teams in ASD, should routinely include behaviour analysts, not least because others are not

this mountain of evidence generally is excluded from reviews [68].

qualified to make authoritative statements about behaviour analysis [16].

of service users.

256 Autism Spectrum Disorder - Recent Advances

increases choice.

skills, including interviewing or team work.

A Board Certified Behaviour Analyst (BCBA®) has received fully approved training in the science of behaviour analysis either at Masters or doctoral level, including at least 270 hours of course work and 1500 hours of supervised practice in ABA [3].

While NICE [64] did not make any recommendations regarding ABA or staff qualifications, they recommend a 'social-communication intervention' that includes play-based strategies with parents, carers and teachers to increase joint attention, engagement and reciprocal communication in the child or young person.


Table 1 offers a direct comparison of the basics of ABA-based interventions that were stipulated by the [8] and the NICE [64] recommendations.


**Table 1.** Comparision of ABA-based interventions and NICE [64] recommendation

#### **9. Conclusion**

In a recent review for the Canadian Medical Journal, [1] summed up the evidence for ABAbased intervention in ASD when they stated:

Current best practices for preschool-aged children with ASD include a focus on improving language, cognitive and adaptive skills using applied behaviour analysis (ABA) techniques. Applied behaviour analysis refers to the application of empiri‐ cally derived learning principles (i. e., the antecedent–behaviour–consequence contingency) to produce meaningful changes in behaviour. Such strategies are carefully engineered and implemented through a variety of approaches (e.g., discrete trial teaching to more naturalistic learning contexts) to teach skills and reduce problem behaviour. Applied behaviour analysis interventions can be provided in a variety of settings (e.g., home, specialized treatment centres, special‐ ized or public schools) by a range of front-line therapists, ideally supervised by a psychologist or board-certified behaviour analyst who specializes in ASD. (p. 515)

It is, therefore, not surprising that increasingly reports link ABA-based intervention with optimal outcomes. Individuals previously diagnosed with ASD are now living independent productive happy lives or no longer meeting diagnostic criteria. Mukaddes, Tutkunkardas, Sari, Aydin, and Kozanoglu (2014) suggested that '[i]t could be concluded that a group of children with an autism diagnosis could lose the diagnosis of autism upon early intervention' (p. 1). [65] for example, report a strong statistical significance of early intensive behaviour analytic interventions for children previously reported to have optimal outcomes [28], while [85] report on reductions of restricted and repetitive behaviours and [85] focus on improve‐ ments in academic skills following early intensive behavioural interventions.

Evidently, ABA translates into evidence-based interventions that allow individuals with ASD to overcome barriers by ensuring choice, human rights, equality and true active participation. ABA helps achieve potential by cherishing the person for who they really are and, by accepting difference, it values the difference we can make in people's lives.
