In our community, decades of research and clinical practice has made one thing clear: Applied Behavior Analysis (ABA) is a highly effective intervention for children diagnosed with autism spectrum disorder (ASD). In fact, the comprehensive nature of the Early Intensive Behavior Intervention (EIBI) model of ABA, which includes upwards of 25 hours per week of services for two or more years, is consistently associated with best child outcomes.
While we know the dosage (i.e., hours per week) of intervention plays an important role in children’s long-term outcomes, is simply measuring the total number of hours received per week enough??
NO!! You might be surprised to learn that intensity-per-week alone, while very important, is far from being the only relevant factor in determining a child’s outcome.
Today, we will address another essential component of effective treatment for ASD – how those hours are spent!
Not All Treatment Hours Are the Same
In 1987, Ivaar Lovaas of UCLA published his seminal study, the first to investigate the model now known as Early Intensive Behavior Intervention (EIBI). Here, Lovaas demonstrated that young children receiving 40-hours-per-week of early, intensive ABA exhibited significantly more progress, testing gains, and educational growth after two years of treatment compared to those children who received either low-dosage ABA treatment at 10-hours-per-week, or the usual “standard of care” community-based services typical of that time.
Following this groundbreaking study and subsequent replications, many in the developmental disability field hypothesized that the clinically significant progress of the children receiving ABA in these studies was simply the result of the intensive number of hours (rather than the ABA model of treatment), as ABA was delivered at higher levels than any previous treatments had been delivered in the past.
To address this theory, Howard et al. (2005) sought to compare different interventions delivered at similarly high intensities. Specifically, the authors compared 1) intensive ABA (25-40 hours per week), with 2) intensive “eclectic” special education services designed for children with ASD in the school setting (25-30 hours per week), and 3) general special education preschool classes. The authors again found that children receiving ABA exhibited significantly greater gains than the other two groups on measures of cognitive functioning, communication, and adaptive behavior. Furthermore, learning rates across different skill domains (such as language, social skills, etc.) accelerated rapidly for the ABA group, while the children’s learning and development in the other two groups remained flat, and in some cases even declined.
In other words, when provided with similarly intensive number of treatment hours, the children who specifically received ABA demonstrated significantly more progress than children receiving eclectic services, even when those services were specialized to educate children diagnosed with ASD.
What could possibly account for such differences in outcomes? What makes one hour of treatment that much more effective than another hour of treatment? And in turn, how can we make one hour of ABA even more effective than another hour of ABA? While there may be many factors at play, there is one element of effective treatment that proves absolutely essential: It’s all about the learning opportunities!
What Are Learning Opportunities?
You may have heard the term “learning opportunity” at some point during your intervention journey – as in a given program “will afford your child many ‘learning opportunities’ per day” – but what precisely does this mean?
Different fields may use this term in different ways (and similarly, different terms may be used in place of “learning opportunity”), but in order for a teaching moment to be a TRUE learning opportunity, certain components must be in place. As a parent, understanding the critical components of a learning opportunity will help you evaluate the richness and power of the intervention you child is receiving and take action if needed.
So, let’s dive in!
While we are all aware that traditional education focuses on the student’s evidence of learning often referred to as “permanent products” – e.g., completed artwork, a written story, a test score, etc. – the “learning opportunity” shifts the focus to measuring the behavior of both the learner AND the instructor. As summarized by Greer & McDonough (1999), a learning opportunity (or “learn unit”), is a distinct, measurable interlocking interaction between an instructor and a learner that leads to significant changes in the learner’s behavior.
Each distinct learning opportunity includes:
- Teaching Stimulus – (Antecedent) A question, verbal cue, picture, written material, circle time song, or essentially anything happening in the environment that cues a learner to engage in a particular response. Over time, with repeated appropriately delivered feedback (see below), this teaching stimulus takes on “discriminative” properties so that the learner immediately knows to give the correct answer when presented with this instruction or activity again in the future (called a “discriminative stimulus” or “SD”)
- Opportunity to Respond – (Behavior) Just like it sounds! This is the child’s opportunity to show what they have learned and now know – their response (or non-response) to the teaching stimulus.
- Feedback – (Consequence) Immediately following the child’s response, the instructor provides feedback about how they did! If correct, feedback in the form of “reinforcement” is given, causing the learned response to become more likely / frequent in the future in the presence of the teaching stimuli. If the child’s response is incorrect, the instructor provides that assistance and feedback so that the incorrect response does not occur in the future.
While this may sound quite technical, it is really quite a simple interlocking dance between the instructor’s and learner’s behavior! The instructor presents a learning opportunity, and the child responds which then influences the instructor’s behavior with either additional cues and assistance / error feedback, or lots of reinforcement and “hurrays!” provided. When the child is able to confidently and accurately respond to that learning opportunity, the instructor moves on and introduces a new learning opportunity for the child. And on and on the dance goes, ensuring optimal learning and quick progress for the child.
Look Familiar?
If you read our previous entry on What is ABA in which we covered the ABCs of ABA (Antecedent – Behavior – Consequence), it should! Each effective learning opportunity is taking the power of the ABCs and using it to maximize learning for the child. We see this “three-term contingency / A-B-C” model across a variety of behavior analytic teaching procedures, from discrete-trial training (DTT) to natural environment training (NET). What all have in common, and make them effective, is the rapid presentation of multiple learning opportunities.
The Power of Learning Opportunities
When it comes to getting learning happening for our children, well-constructed, well-delivered learning opportunities are an extremely powerful tool in an instructor’s tool-kit. But what makes them so potent?
Let’s take a peek at some of the qualities that work together to create the learning magic:
- They’re Clear – To highlight the difference, picture a typical classroom morning during which children and parents arrive at different times and the teacher busily greets students, helps everyone get settled, and prepares the day’s materials. There is noise and distraction aplenty! Once the teacher calls the children to the rug, the challenge continues for our kids with ASD as the teacher delivers instructions in song, describes multiple step plans for the day, while simultaneously taking out learning materials for circle time. Without a doubt, without support, this classroom morning can be tough on our kids…the relative commotion unfortunately causes them to miss the cues, miss the social opportunities, and fall further behind their peers. In contrast, one-on-one learning with clearly defined learning opportunities cuts through all the noise and makes learning much easier for our kids and results in skill development moving quickly!
- They Keep Learning FUN! – With a clear focus on immediate feedback following the child’s response, learning opportunities provide ample opportunities to keep learning positive and FUN. In this format, learners never flounder, fail, or languish in confusion. Rather, instruction is customized to each child’s current goals and level, immediate fun feedback is given for correct answers and responding, and immediate help is given when needed, getting the learner right back on track.
- They’re EFFECTIVE – More than anything, the power of the learning opportunity lies in its efficiency. Research shows time and time again that when instruction is presented in the structured form of the learning opportunity (as defined above) as opposed to a more “amorphous” form of instruction often seen in group learning or other models of early intervention, learners demonstrate significantly higher levels of correct responses as well as greater numbers of instructional goals and objectives met (Greer, McCorkle, & Williams, 1989). In other words, our kids demonstrate rapid and significant LEARNING. Now that’s what we call a win-win!
Maximizing the Power of the Learning Opportunity
So now that we know what a learning opportunity includes, what can we as interventionists and families do to harness their power?
Keep Up the Pace – This one may sound a little counter-intuitive, but there is quite a bit of science (and clinical experience) backing it up! Sometimes when we’re teaching children, we feel the urge to go slowly, give a lot of breaks, and include a lot of “downtime” in between attempts, with the intention of reducing frustration. Clinical experience and research have shown, however, that teaching slowly, can actually increase frustration and hinder progress as the learner has more time to become distracted, off-topic, etc. and therefore not access the fun reinforcement that comes with rapid learning. Numerous studies have found that faster presentation rates of intact learning opportunities result in better learner performance (Greer & McDononough, 1999), aka LEARNING!
Present A LOT of Learning Opportunities – And this takes us full circle! What makes one hour of treatment more effective than another hour of treatment? The presentation of lots and lots of well-structured, rapid, and fun learning opportunities. Just as with the quick pacing of their presentation, there is a considerable body of research showing that the sheer number of learning opportunities presented is directly tied to positive clinical outcomes, with the greater the number of learning opportunities being positively correlated to the number of skills acquired, goals met, and so on.
Looking back at the Howard et. al article discussed above, it has been hypothesized that perhaps the high rate of clear, rapid, structured learning opportunities (“…50-100 learning opportunities per hour presented via discrete trial, incidental teaching, and other behavior analytic procedures” [Howard, et al., 2005]) may have attributed to the improved gains of those children receiving ABA services compared to those receiving school-based services.
All research aside, doesn’t this just make sense? The more opportunities to practice a new skill, the quicker you’re going to learn that skill. And the quicker you learn that skill, the more opportunities you’ll have to start learning other new skills. And so on and so on, the learning opportunity dance continues!
Wrapping Up YOUR Learning Opportunity
Now that you’ve learned what true learning opportunities are, how effective they are in increasing learning and skill building, and how to make them even more effective through speed and frequency, we hope you feel better equipped to make informed decisions regarding your child’s treatment program.
If you have any additional or follow up questions about how you can capture the power of learning opportunities for your child, please reach out to your local FirstSteps clinic today!
Sources
Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3–9.
Howard, J.S., Sparkman, C.R., Cohen, H.G., Green, G., & Stanislaw, H. (2005). A comparison of intensive behavior analytic and eclectic treatments for young children with autism. Research in Developmental Disabilities, 26, 359-383.
Greer, R.D., & McDonough, S.H. (1999). Is the learn unit a fundamental measure of pedagogy? Behavior Analyst, 22, 5-16.
Greer, R.D., McCorkle, Williams. (1989). A sustained analysis of the behaviors of schooling. Behavioral Residential Treatment, 4, 113-141.
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