Focused ABA involves direct service delivery to the client. It is not restricted by age, cognitive level, or co-occurring conditions. Focused ABA refers to treatment provided directly to the client for a limited number of behavioral targets.
Although the presence of problem behaviors may more frequently trigger a referral for Focused ABA treatment, the absence of appropriate behaviors should be prioritized, as this is often the precursor to serious behavior problems. Therefore, individuals who need to acquire skills (e.g., communication, tolerating change in environments and activities, self-help, social skills) are also appropriate for Focused ABA. In addition, all treatment plans which target reduction of dangerous or undesired behavior must concurrently introduce and strengthen more appropriate and functional behavior.
Examples of behavior-change targets in a focused ABA treatment plan for children who lack key functional skills include establishing compliance with medical and dental procedures, sleep hygiene, self-care skills, safe and independent leisure skills (e.g., appropriate participation in family and community activities).
Examples of treatment targets where the primary goal is to reduce behavior problems might include, but are not limited to, physical or verbal aggression towards self or others, dysfunctional speech, stereotypic motor 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:
- behaviors that may threaten the health or safety of themselves or others (e.g., aggression, self-injury or self-mutilation, property destruction);
- behavior disorders that may be a barrier to their ability to remain in the least restrictive setting, and/or limit their ability to participate in family and community life (e.g., aggression, self-injury, noncompliance);
- absence of developmentally appropriate adaptive, social, or functional skills (e.g., toileting, dressing, feeding, compliance with medical procedures) that are fundamental to maintain health, social inclusion, and increased independence.
When the focus of treatment involves the reduction of a problem behavior, the Behavior Analyst will determine which situations are most likely to precipitate problem behavior and begin to isolate its function or purpose. This may require conducting a functional analysis to empirically demonstrate the “purpose” (i.e., 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 may 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.
Social skills deficits, a core deficit of individuals diagnosed with ASD, are often addressed in focused treatment programs. Treatment may be delivered in either an individual or small-group format. When conducted in a small group, typically developing peers, or others with similar diagnoses, participate in the session. Clients practice behavioral targets while simultaneously mediating delivery of the treatment to the other members of the group. As is the case for all treatments, programming for generalization of skills outside the session is critical.