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什么是ABA？

美国律师协会

应用行为分析 (ABA)是一种经科学验证的方法，用于理解行为及其与环境的关系。它注重教授新技能、改善沟通、促进社交适宜行为，同时减少可能干扰学习或日常生活的行为。重要的是，ABA 尊重自闭症人士独特的生活经历和视角，认识到他们的个性和挑战。

应用行为分析 (ABA) 被广泛认为是一种有效的自闭症患者疗法，它运用强化等学习和行为原则，帮助患者发展必要的生活技能。治疗师会根据每位患者的独特需求和目标，量身定制个性化方案，确保营造一个结构化且支持性的学习环境，在尊重个人真实性的同时，促进其成长。

ABA 如何使自闭症患者受益？

ABA 为自闭症患者带来诸多益处，帮助他们过上更加独立、充实的生活。主要益处包括：
1.提高沟通技巧：
应用行为分析 (ABA) 帮助个人学习如何有效地表达自身需求，无论是通过言语、手语还是辅助设备。这可以减少挫败感，并增强社交互动。
2.社交技能的发展：
通过结构化教学，ABA 促进积极的互动，例如分享、轮流和理解社交暗示，这些对于建立关系至关重要。
3.减少挑战性行为：
ABA 通过找出攻击、自残或发脾气等行为的根本原因并教授其他更合适的行为来解决它们。
4.增强日常生活技能：
ABA 帮助个人掌握基本的生活技能，例如穿衣、饮食、个人卫生和家务，培养更大的独立性。
5.个性化学习
每个 ABA 计划都是根据接受治疗的人的特定需求和目标进行定制的，确保在最重要的领域取得有意义的进展。
6. 技能的泛化
ABA 强调在家庭、学校和社区等各种环境中应用所学技能，确保个人能够在现实生活中取得成功。

ABA 如何发挥作用？

1. 评估和目标设定
全面的评估可以确定适合个人需求的优势、挑战和目标。

2.个性化行为计划
详细计划概述了教授积极行为和减少挑战性行为的策略。

3.技能发展
离散试验训练 (DTT)、建模和强化等技术用于教授沟通、社交和日常生活技能。

4. 强化
积极的行为会得到奖励，以鼓励重复和进步。

5. 数据驱动的调整
通过数据跟踪进展，确保干预措施有效且目标得以实现。

6. 推广与维护
技能应用于不同的环境，促进长期的成功和独立。

自闭症

谁提供 ABA 服务？

ABA服务由一支训练有素、精通行为分析的专业团队提供。主要成员包括：
  • 委员会认证行为分析师（BCBA）：
    • BCBA 是训练有素的专业人员，他们评估需求、制定个性化治疗计划并监督 ABA 计划。
    • 他们确保干预措施以证据为基础并针对个人进行量身定制。
  • 行为干预专家（BI）：
    • 他们也被称为注册行为技术员 (RBT)，在 BCBA 的指导下直接与个人合作实施治疗计划。
    • 他们专注于教授技能、鼓励积极行为和跟踪进度。
  • 监督行为顾问：
    • 监督治疗过程、为 BI 提供指导并根据需要调整计划的高级专业人员。
  • 护理人员和家人：
    • ABA 涉及与家庭的合作，以确保家庭、学校和社区等环境的一致性。
    • 父母经常接受培训，在日常生活中运用 ABA 策略。
该团队共同确保自闭症患者获得根据其独特需求量身定制的全面、一致和有效的支持。

有什么证据表明 ABA 有效？

Applied Behaviour Analysis (ABA) is a widely recognized therapeutic approach designed to support individuals with Autism Spectrum Disorder (ASD) by fostering positive behaviours and addressing challenging ones. Grounded in the principles of behavioural learning, ABA has been applied in various settings to enhance adaptive functioning and improve the overall quality of life for individuals on the autism spectrum. Importantly, ABA honors and respects the unique lived experiences and perspectives of autistic individuals, recognizing their individuality and challenges. Research evidence highlights its effectiveness in promoting growth across multiple dimensions for those on the spectrum.

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1. Behavioural Improvements

ABA has demonstrated significant success in facilitating adaptive behaviour changes in individuals with autism. A study published in the Journal of Autism and Developmental Disorders by Choi et al. (2022) examined the outcomes of ABA therapy for children aged 3 to 17 within an integrated healthcare system. The findings revealed that children, particularly those with lower initial functioning, exhibited significant improvements in adaptive behaviours after 24 months of therapy, even when the dosage of ABA was below the recommended level. This highlights ABA's capacity to foster meaningful behavioural changes over time.

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2. Skill Development

ABA interventions are tailored to meet individual needs, empowering children and adults with autism to develop essential life skills. By employing techniques such as positive reinforcement, task analysis, and data-informed strategies, ABA emphasizes the teaching of communication, social interaction, and daily living skills. These enhancements directly contribute to the ability of individuals with autism to engage more effectively with their surroundings and develop meaningful relationships with others.

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3. Flexibility and Customization

Another key strength of ABA lies in its inherent flexibility. The therapy can be adapted to focus on specific behaviours and adjusted in response to the individual’s progress. This adaptability ensures that the intervention is relevant and effective, meeting the evolving needs of each person.

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4. Support for Long-Term Engagement

Despite challenges such as therapy discontinuation and limited access to the recommended therapy dosages, the previously mentioned study indicated that children who engaged in ABA therapy over extended periods experienced greater benefits. Factors such as a background in special education contributed to longer participation in therapy, which, in turn, supported sustained behavioural and developmental improvements.

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Challenges and Implications

While the effectiveness of ABA is supported by evidence, challenges such as discontinuation rates and limited access to full therapy doses were highlighted in the study. Approximately 13% of children referred for ABA did not start therapy, and less than one-third received the full recommended dosage. Addressing barriers to consistent engagement and ensuring adequate access to therapy are essential to maximizing the benefits of ABA.

Consistency: The Cornerstone of ABA Success

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As a caregiver of a child with autism, it’s completely understandable to wish for them to reach the same milestones as their neurotypical peers. However, it’s crucial to acknowledge that autism is a lifelong experience that influences how individuals communicate, interact, and perceive the world. This understanding reinforces the necessity of consistent, ongoing therapy—particularly through Applied Behaviour Analysis (ABA)—to assist individuals with autism in developing and maintaining essential life skills. ABA relies on repetition and reinforcement, offering structured, step-by-step support to cultivate behaviours such as social interaction, emotional regulation, and daily functioning. Without a consistent approach, even hard-earned progress can fade, potentially leading to setbacks in areas like communication and social adaptation. By prioritizing regular, uninterrupted ABA sessions, caregivers can help ensure that their child continues to grow, sustain, and enhance these skills, laying the groundwork for long-term success and independence.

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Citations:

Choi, K. R., Bhakta, B., Knight, E. A., Becerra-Culqui, T. A., Gahre, T. L., Zima, B., & Coleman, K. J. (2022). Patient Outcomes After Applied Behavior Analysis for Autism Spectrum Disorder. Journal of developmental and behavioral pediatrics : JDBP, 43(1), 9–16. https://doi.org/10.1097/DBP.0000000000000995

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