Disabilities Impact Adaptive Behavior

Navigating life as an adult involves utilizing a range of knowledge and abilities, from reading comprehension and time management to basic math skills. Practice in many of these areas occur throughout childhood by means of schooling and parental guidance, although sufficient preparation for adulthood goes beyond academic achievement. According to psychologists and child development professionals, becoming a capable, independent adult requires developing a selection of skills collectively known as adaptive behavior. However, children with chronic conditions or injuries that interfere with development or intellectual capacity can find this challenging.

Adaptive behavior refers to those behaviors needed to meet societal expectations for adulthood, as well as the conceptual and practical skills essential to everyday life. For instance, self-sustaining adults show competence in practical skills like self-care, housekeeping, and those skills necessary for retaining employment, caring for their health, and using public and shopping services. Conceptual skills encompass abilities connected to functional academics and self-direction intrinsic to daily life, including reading, basic math skills, problem-solving, and activity planning.

However, impairments to cognition, motor function, and speech can make it difficult for children to acquire skills in one or multiple adaptive behavior subsets. These challenges in many cases devolve into adaptive developmental delays. During early childhood, parents and guardians can pinpoint signs of this by tracking their children’s developmental milestones, which outline specific adaptive skills at each age range indicative of normal development. The milestones primarily comprise skills associated with self-care and motor coordination, such as the ability to dress oneself and use eating utensils.

Developmental delays might lead to a child remaining unable to brush their own hair or teeth by age 6 or still requiring assistance with handwashing at this age. Having trouble in forming age-appropriate adaptive behaviors can also manifest as restricted intellectual abilities that become more apparent as a child grows. For example, some children begin to develop verbal communication skills later than their peers.

Delays in adaptive behavior commonly occur in children with conditions and developmental disabilities such as neuromuscular diseases (NMDs). Youth with NMDs exhibit insufficient practical adaptive skills. Furthermore, the American Association on Intellectual and Developmental Disabilities lists limitations in adaptive behavior as a defining characteristic of intellectual disabilities. Signs of these disabilities range from learning and memorization difficulties to below-average ability in reading and comprehension.

Despite the emphasis placed on academics in childhood, traditional classrooms do not inherently incorporate all of the adaptive skills necessary for adulthood. Children typically learn about self-care, public-facilities use, and many other practical skills from their parents or guardians, although not all families can effectively impart this information. Moreover, developmental and intellectual delays often hinder learning and slow understanding of basic concepts, transforming otherwise simple tasks into complex endeavors involving multiple steps, subskills, and cognitive processes. This can leave children ill-equipped for the transition into adulthood, as well as living independently.

Child specialists and behavioral experts emphasize the importance of dedicated lessons and training in adaptive behavior for children with developmental delays and tailoring instruction to each individual’s needs. This allows children to receive coaching in the adaptive behavior subsets that they find most perplexing and provides them with the opportunity to practice specific skills. Studies indicate that among the most successful approaches for this is applied behavior analysis (ABA), which involves manipulating a person’s environment to facilitate positive behavioral changes.

An Overview of ABA Therapy

Applied Behavior Analysis (ABA) is a scientific approach to the understanding of the effect of the environment on behavior, learning, and skill development. A major application of ABA is to improve functioning across a variety of skill areas such as communication, socialization, and self-help skills in children with Autism Spectrum Disorder.

Behavioral psychologist Dr. Ivar Lovaas was among the first practitioners to use ABA in the treatment of autism. In 1987, he conducted several ABA studies at UCLA. The goal of autism-focused ABA therapy is reducing maladaptive behaviors and teaching new skills.

ABA therapy is characterized by evidence-based interventions, ongoing assessments of progress, and observed behavioral changes. Clinicians can implement ABA techniques in all environments and all ages. Children can benefit from ABA at home and school, while adults can use ABA to improve their performance at home and work.

Therapists must practice under the direction of Board-Certified Behavior Analysts (BCBAs) to provide ABA services. BCBAs earn their graduate-level qualifications from the Behavior Analyst Certification Board (BACB).

BCBA’s and therapists use various teaching methods during ABA interventions. One of the oldest and most basic ABA teaching methods is called Discrete Trial Training (DTT). Since children with autism often experience learning difficulties, DTT breaks down teachable skills into small, simple components that children can process more easily. For example, asking a child to pick a red card from a group of colored cards on a table may be confusing to the child, but asking them to “touch red” may help children understand their teacher’s words. DTT also features positive reinforcement by using incentives. When children respond correctly, the teacher provides a reward such as food, a token, or praise. When children give an incorrect response, they do not receive a reward.

Alternative teaching methods include Early Intensive Behavioral Intervention (EIBI), Pivotal Response Treatment (PRT), and Natural Environment Training (NET). Specialists use EIBI for children aged 5 or younger in one-on-one sessions supervised by trained professionals. PRT focuses on skill acquisition in “pivotal areas” that leads to widespread behavioral changes across many other, untargeted behaviors and favors the use of natural reinforcers. NET, tackles complex skills in natural settings. Teachers carefully use a child’s interests to teach them skills. Children who receive NET therapy may apply their learned skills to other environments.

ABA interventions are categorized into two classes: comprehensive and focused. Comprehensive interventions target key developmental skills, while focused interventions resolve specific issues.

As long-term treatments, comprehensive interventions address the major deficits associated with autism over a year or more. The treatments improve social skills, communication, and functional competencies in children with autism.

Focused interventions, on the other hand, aim to adjust specific behaviors. For example, therapists can use focused interventions to reduce tantrums or teach children how to request things. Unlike comprehensive interventions, focused methods are time-limited.

Studies show that ABA therapy provides effective interventions for children with autism. A 2018 meta-analysis demonstrated that ABA programs are most useful in improving children’s communication and intellectual abilities. ABA also moderately alters socialization and adaptive behaviors. Research indicates that ABA proves most effective as a long-term treatment plan, especially when implemented at a young age.