What we do
The aim of the ABA Access4All parent campaign is to promote awareness, understanding and much wider access to professionally-managed ABA (Applied Behaviour Analysis) therapies for children and adults with autism and other developmental disabilities throughout the UK.
ABA has the strongest evidence base for improving outcomes with such disabilities and yet is still not widely enough understood or available in the UK. We will do this by raising awareness of ABA through all the media channels we can and on social networks, through lobbying and seeking to influence at government and local government level, and through judicial review, with successful settlement in Wolverhampton Read more. The UK-SBA's recent application for accreditation of its register by the Professional Standards Authority is also a crucial step for UK behaviour analysis.
A bit about ABA
The science of ABA has its roots in the work of pioneering psychologist Dr BF Skinner in the last century. Of course, like any science, ABA has moved on since those early days, but the principles remain the same: reward or "reinforce" the behaviours we want to see; ignore, or give a dull consequence to behaviour we do not want to see. And the words "reward" and "behaviour" are both misleading. Many think that reward is synonymous with a "treat" – rather, for a behaviour analyst, reinforcement is a consequence that is likely to lead to an increase in a behaviour occurring again, and is therefore meaningful for the individual child.
ABA is not "one thing" but is centred on and individualised to a child's particular needs and motivations. And the word "behaviour" colloquially has come to mean "bad behaviour". This is why some think, mistakenly, that ABA is just about "managing out" an autistic child's 'bad' or anti-social behaviours. But to a behaviour analyst, the word behaviour covers everything a person "does" – from all our actions, through to talking, reading and writing and even our thoughts and feelings. The principles of learning are universal and ABA can be used to teach any skill; it is used not just in the autism world, but also many other areas, e.g addictions, organisational behaviour and in mainstream schools. Please click here for our leaflet.
Move towards possible accreditation gathers pace
The UK Society for Behaviour Analysis (UK-SBA) is at an advanced stage in its submission to the Professional Standards Authority (PSA) seeking accreditation of its register of ABA professionals. Such accreditation, if achieved, would turbocharge both consumer protection and the standing/uptake of ABA in the UK. ABAA4ALL founder Jane McCready is a UK-SBA Advisory Board member and former consumer board member and continues to be part of the taskforce seeking accreditation.
Read our letter to the PSA here. It's also a useful tool to counter myths about ABA.
How it all began
Autism: Challenging Behaviour is the BBC documentary that kicked off the ABAA4ALL campaign. When it first aired in November 2013, and again in January 2017, it helped create a national debate and gave a huge boost to ABA awareness.
Although the documentary polarised views: ironically with some saying it was too anti-ABA and some too pro-ABA, it stimulated a debate. And the end shot, as the ABA child joyfully ate sausage and chips, while the child at the eclectic school seemed to be heading for tube-feeding, made it fairly clear to us that ABA was the better route to go. Indeed several mums we know started ABA pretty much as soon as the end credits rolled. Watch it below! (Click Vimeo to see it full-screen).
Once you've seen the programme, check out how Jack, the boy in the shot above, is getting on three years afterwards. Click here to see a short video.
ABA and the elderly
One of the less well-known areas of ABA is behavioural gerontology - the application of ABA to solving the problems of older adults. Behavioural gerontologists may work with older adults who are in distress, who are struggling with apathy and disengagement, and to prevent skill loss that is often associated with cognitive decline and dementia progression. Sadly, of the over 48,000 BCBAs across the globe, fewer than 0.2% report that they work with adults over 65. In the UK, we have a small but growing number of behaviour analysts who are interested in behavioural gerontology, and with an ageing population, there’s no time like the present for the benefits of ABA to be expanded into older adult services.
Dr Zoe Lucock BCBA-D and Emma Williams BCBA have recently launched the UK’s first BCBA-led behavioural gerontology service provision for older adults. They specialise in providing bespoke behavioural interventions to older adults with dementia and training their carers in how to best support them. They also provide on-demand BCBA CEUs for behaviour analysts who are interested in learning more about behavioural gerontology and supervision for those wanting to work with older adults. As has been the case with ABA service provision for children with autism, PACT services are currently funded primarily by private clients. However, Zoe and Emma are working with social care providers with the view to begin trials of their service with state funding. Their long-term goal is for behaviour-analytic provision to be available to all older adults across the UK who need it through the national health and social care systems.
NICE slightly softening towards ABA - autism best practice can accommodate ABA
When we started this campaign in 2013, the National Institute for Health and Care Excellence (NICE) had a blanket statement about not recommending ABA due to lack of enough of their preferred Randomised Controlled Trial (RCT) evidence. This has now softened and in fact NICE says in black and white (in response to our recent lobbying) that their recommended best practice for autism - both teaching skills and managing challenging behaviour - might include or “accommodate” the use of ABA. This is good news! It stops short of what we’d prefer - that they actually name as ABA the “psychosocial interventions for autism” that sound pretty much exactly like ABA, but are left vague - no help to consumers. However “accommodate” is better than a “no”.
The other good news is that, despite the inevitable lobbying by a small group of anti ABA level 1 autistic folk, NICE states categorically that “we did not find any evidence during surveillance that indicated ABA causes harm’:
https://www.nice.org.uk/guidance/cg170/resources/2021-surveillance-of-autism-nice-guidelines-cg128-cg142-and-cg170-9140525965/chapter/Overview-of-2021-surveillance-methods?tab=evidence - see paragraph headed "Views of Stakeholders”.
Here’s the actual wording. NICE said in its detailed responses to our ABAA4ALL submission in Appendix B* (below) that "We would like to highlight that the recommendations do not say ‘do not use ABA’. Recommendations 1.3.1 to consider a specific social-communication intervention and 1.4.9 which describes the attributes of effective psychosocial interventions for behaviour that challenges potentially accommodate the use of ABA-based interventions”: https://www.nice.org.uk/guidance/cg170/evidence/appendix-b-stakeholder-consultation-comments-table-cg170-pdf-9140525969
*NICE actually makes an error in Appendix B, as the National Institute for Health Research (NIHR) study into early ABA did indeed show gains in both adaptive behaviour and cognitive ability. They incorrectly said it showed no benefits for adaptive behaviour. They’ve accepted the error and say they will be changing their text. It’s quite a blunder, and - as we pointed out to NICE - it really doesn’t get much more important to autistic children and their families that a child learns adaptive behaviours early on - which phrase covers everything from toileting and putting their own clothes on, to communicating and taking turns in class.
Daily injections for Type 1 Diabetes can be a nightmare when you are autistic. But teen Johnny has learnt how to manage his own jabs through ABA. BeyondAutism, a charity providing ABA, has released this video to celebrate World Diabetes Day.
As an adult with severe autism, challenging behaviour and epilepsy, Harun has a bespoke ABA programme and spends much of his time learning on a farm, all due to his mum's dedication to getting him the right support in his EHCP.
Our very own Jane McCready talks about how ABAA4ALL was created and gives the lowdown on ABA in the UK in this interview by the Association for Science in Autism Treatment (ASAT), a US autism research organisation.